Abdullah Khushi Muhammad, 45, sits on a charpoy under a tree, stoically fighting silicosis, a life-threatening disease caused by continuous exposure to silica dust during his eight years of work at stone-crushing factories. For as long as he lives he will have to cope with shortness of breath, a chronic cough, recurring fever and severe chest pain.

“My younger brother and two cousins died of this disease not long after they quit the job and returned,” Abdullah tells Dawn. “I am getting weaker by the day.”

Abdullah’s village Nut Kallar, some 30km east of Gujranwala, has lost nine of its sons to silicosis. All worked in the stone-crushing industry, from six months to several years. Besides Abdullah, two others have the same disease. Near his home, Yasmin Bibi struggles to make ends meet. Her husband, Allah Ditta, died almost a month before she gave birth to their only son, now 12.

“He died six months after he returned home from working at one of these factories. We had to sell everything to pay for his treatment,” Yasmin recalls. “He suddenly lost a lot of weight and coughed endlessly. The doctors said he had contracted tuberculosis. His brothers also had similar symptoms. They too died.”

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Allah Ditta, who was the first in the village to die of silicosis, may not have known the cause of his illness was the dust at his workplace but most others knew of the hazard. Still they didn’t quit their jobs.

“For the illiterate and unskilled it’s a very well-paid job,” says Mohammad Riaz, who has been diagnosed with silicosis. “A man working at a stone-crushing factory earns up to Rs20,000 a month.”

A road snaking through the vast basmati fields takes you to Glotian Mor on Gujranwala-Sialkot Road, an hour’s drive from Nut Kallar. Ashraf Ansari shifted his small stone-crushing plant here just outside the Small Industrial Estate from Alam Road in Gujranwala. The relocation came after many men from Nut Kallar and its surrounding villages working in his factory contracted the disease and the news leaked to the media a few years back.

Ashraf denies any of the dead worked for him. “I relocated the factory because the old one was suffering losses. We don’t use silica dust nor crush stone into [silica] powder,” he claims. “A Punjab government official visited the factory today and found nothing wrong.” Nevertheless, he admits his factory was not registered with any government department or agency.

Inside the factory, four boys, the eldest in his early 20s, are working. Their job is to first break down quartz stones into smaller pieces with a hammer and then feed them into a small crusher that will reduce them to the size of chickpeas. These small stones are mixed with silica dust and boric acid with hands or shovels before being packed into polythene bags for supply to foundries for the inner lining of furnaces. The facility has no mechanism to control the dust rising from the crushing or during mixing and packing.

“Ashraf [the owner] has given us cloth to cover our faces,” says Mohammad Waseem, 22. “I know the dust we mix with crushed stones can cause breathing problems but we get paid well — Rs12 for each bag. We live on the factory premises, work for a couple of months and return home with Rs35,000-40,000.” Back home, their example inspires others.

Waseem’s co-workers are unaware of the adverse effect of the dust they inhale. “It is this lack of awareness and poverty that makes men take up jobs in such unsafe working conditions,” insists Usama Khawar, a lawyer from Nut Kallar who has filed an application with the Supreme Court requesting suo motu notice of the deaths of workers from silicosis. “No province has framed rules regulating occupations involving stone-crushing and the hazardous emission of silica dust. Even if they had, most stone-crushing factories are not registered with or regulated by the government.”

Lack of dust control systems at stone-crushing factories mean silica dust will also affect people in nearby areas. In fact, most crushing units are located in or near residential areas.“

Silica is found in rocks. When inhaled, silica dust can cause silicosis and cancer and increase the risk of other lung diseases. People working in industries such as cement, mining, plastic, foundry work, glass and stone-crushing are prone to inhaling it unless protective measures are taken,” says Dr Khalid Waheed, who has treated several silicosis patients at Lahore’s Jinnah Hospital. Three of them died last year. “Workers aren’t provided safety gear to prevent dust inhalation. Silicosis-related deaths could be prevented if factory owners took proper safety measures and their workers underwent medical check-ups every six months.”

By the time most silicosis patients are brought to the doctors, they are already at an advanced stage of the disease. Early diagnosis can save lives. As most industries where workers are exposed to silica dust operate in the informal sector, it’s hard to guess their number and how many workers they employ. The number of factories could be in the hundreds, that of workers in the thousands.

According to Usama, 18 men have died in the three villages of the Wahndo area, including Nut Kallar, of Gujranwala. “Another 100 are reported to have died in D.G. Khan in recent years. But the actual number of workers exposed to the risk of contracting silicosis or of the deaths caused by it cannot be concluded without data on factories, ” he says.

Published in Dawn, July 18th, 2014