World-first research offers hope for earlier occupational lung disease diagnosis
The Particles in Exhaled Air (PExA) machine is being used to investigate whether silicosis can be identified before irreversible lung damage occurs
World-first research underway at The Prince Charles Hospital (TPCH) could change the way occupational lung diseases, including silicosis, are detected and understood.
Supported by The Prince Charles Hospital Foundation (TPCHF) through its Tradie Health Institute initiative, researchers are using Australia’s first dedicated PExA (Particles in Exhaled Air) machine to investigate whether silicosis can be identified before irreversible lung damage occurs – creating the potential for earlier intervention and improved outcomes for thousands of Australian workers.
Silicosis is mostly associated with occupations such as construction, mining, tunnelling and stonemasonry. It is an incurable chronic lung disease caused by breathing in fine silica dust and remains one of the most serious occupational lung diseases which can be fatal.
The inhaled dust causes inflammation and scarring in the lungs, which can lead to symptoms such as shortness of breath, persistent cough, fatigue, chest pain, and an increased risk of lung infections.
Despite stronger workplace protections and growing awareness, silicosis is frequently diagnosed only after significant and irreversible scarring has developed within the lungs.
The Particles in Exhaled Air (PExA) machine is enabling world-first research, comparing breath samples, bronchoalveolar lavage (BAL) and blood-based biomarkers.
The PExA technology is already enabling world-first research comparing breath samples, bronchoalveolar lavage (BAL) and blood-based biomarkers, with researchers analysing samples from both silicosis patients and healthy volunteers to identify early disease signatures and develop future non-invasive screening tools.
Unlike current invasive diagnostic methods, the PExA machine captures microscopic particles naturally exhaled from the very deepest part of the lung through a simple breathing test. Researchers believe the proteins expressed in these particles could reveal the earliest biological changes associated with silicosis, long before the disease can be detected through existing testing.
The PExA technology was first introduced to Australia in 2024 through research supported by the TPCHF. Until now, researchers have relied on a machine on loan from Sweden. Industry investment will enable the purchase of Australia’s first dedicated PExA machine, ensuring ongoing access to the technology and allowing the research program to expand.
TPCH Senior Thoracic Physician and Queensland Lung Transplant Service (QLTS) Head of Research Dr Dan Chambers said the technology represented a major shift in what was possible for workers at risk.
“Our research has the potential to reshape how these conditions are identified, monitored, treated, and ultimately prevented,” Professor Chambers said.
“What excites me is not just better diagnosis, but the possibility of earlier intervention.
“If we can identify disease at a much earlier stage, we have a real opportunity to change outcomes for workers and their families.”
QLTS Researcher Kiara Knuckey said a future where lung screening was portable and on-site, enabling high-risk workers to be monitored before symptoms appear, had garnered much support from industry.
This includes a grant from Brisbane construction company, CPB Contractors, which has contributed $300,000 over three years to this next phase of research.
“Support from industry has allowed us to explore the full potential of the PExA technology and accelerate research that could ultimately benefit workers across Australia,” Ms Knuckey said.
“This could completely change what early detection looks like in practice.
“The idea that we may one day identify disease before symptoms appear is incredibly powerful.”
For more information, visit the TPCHF website.