Australian researchers are investigating whether microscopic particles in exhaled breath can detect silicosis before irreversible lung damage develops, using the nation's first dedicated PExA machine.
World-first research underway in Brisbane could pave the way for earlier, non-invasive diagnosis of silicosis, with investigators hoping a simple breath test will identify disease before permanent lung damage occurs.
Researchers at The Prince Charles Hospital are using Australia’s first dedicated Particles in Exhaled Air (PExA) machine to investigate whether proteins contained within microscopic particles exhaled from the deepest regions of the lung can reveal the earliest biological changes associated with occupational lung disease.
The project, supported by The Prince Charles Hospital Foundation through its Tradie Health Institute initiative, aims to address one of the biggest challenges in silicosis care – diagnosing disease before irreversible fibrosis has developed.
Silicosis is an incurable occupational lung disease caused by inhalation of respirable crystalline silica dust, most commonly affecting workers in construction, mining, tunnelling and stonemasonry.
Although workplace controls have strengthened in recent years, many cases continue to be diagnosed only after substantial lung damage has occurred.
Professor Dan Chambers, senior thoracic physician and head of research at the Queensland Lung Transplant Service, said the technology could offer a fundamentally different approach to early disease detection.
“We’re trialling a new technology that can detect tiny particles from the deepest part of the lungs using a breath sample,” Professor Chambers said.
“This could allow us to identify disease much earlier – before serious damage occurs.”
Unlike bronchoscopy or bronchoalveolar lavage, the PExA platform collects microscopic particles naturally released from the peripheral airways during breathing, providing a non-invasive window into biological processes occurring in the distal lung.
Researchers are comparing proteins identified in exhaled particles with bronchoalveolar lavage and blood biomarkers from patients with silicosis and healthy volunteers, with the goal of identifying molecular signatures that could eventually support earlier screening.
If successful, the approach could enable disease monitoring before radiological abnormalities or clinical symptoms become apparent.
“Positioning Queensland at the forefront of global efforts to detect occupational lung disease earlier, more safely and more precisely than ever before, our research has the potential to reshape how these conditions are identified, monitored, treated, and ultimately prevented,” said Professor Chambers.
“What excites us 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.”
The PExA technology was first introduced to Australia in 2024 through research supported by The Prince Charles Hospital Foundation using equipment on loan from Sweden.
Dedicated funding has now enabled the purchase of Australia’s first permanent PExA machine, allowing the research program to expand.
Queensland Lung Transplant Service researcher Kiara Knuckey said industry investment had accelerated the work.
“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.”
Researchers ultimately envisage portable screening systems that could be deployed at workplaces to monitor high-risk workers without invasive testing.
The research has attracted support from construction company CPB Contractors, which has committed $300,000 over three years to the program. The company said the investment reflected its focus on improving health outcomes for workers exposed to occupational dust hazards.
CPB Contractors Queensland and PNG general manager Vince Sanfilippo said the partnership reflected the company’s long-term commitment to protecting workers and supporting a healthier future for the construction industry.
“The work being undertaken is genuinely moving the dial towards earlier detection, better treatment outcomes and greater protection for workers,” he said.
“It demonstrates how industry can play a meaningful role in advancing innovative health solutions and investing in the long-term wellbeing of workers in our industry.
“Construction is one of the most exciting and rewarding industries to be part of. We’re creating the infrastructure that connects communities, transforms places and shapes the future of our cities and regions, and protecting the health and wellbeing of our workforce remains our highest priority.
“The continued trialling and development of technologies such as the PExA machine have the potential to transform how we protect our workers from silicosis through non-invasive and accessible early detection methods. This is a gamechanger for our workforce today and into the future.”
Research and impact manager at The Prince Charles Hospital Foundation, Dr Rebekah Engel, said philanthropic funding was essential for advancing early-stage research with the potential for significant clinical impact.
“Early-stage research is often the most difficult to fund, yet it has the greatest potential to create meaningful change,” said Dr Engel.
While the breath-based approach remains investigational, researchers believe the technology could eventually reshape how occupational lung diseases are detected, monitored and potentially prevented.
For respiratory clinicians, the work represents another step towards biomarker-driven diagnosis of occupational lung disease at a time when Australia continues to respond to the resurgence of silicosis linked to engineered stone and other high-risk industries.
Earlier, non-invasive detection could provide opportunities for intervention before irreversible fibrosis develops, although further validation will be required before the technology can be adopted in routine clinical practice.
