Silicosis is an often-fatal lung disease caused by the exposure to respirable silica dust. Silicosis often leads to more severe lung diseases such as; lung cancer, Bronchitis, and Tuberculosis. In 2003, Turkish investigators performed and published a case study in the "Journal of Occupational Health" on five sandblasting factories. They found workers inside poorly ventilated factories being exposed to respirable silica dust 20 times that of the recommended safety levels. This case study followed a sample of sandblasters from these factories, with a mean age of 23, and an employment duration of three years. When the study concluded, over one third of the sandblasters had lab-confirmed silicosis and two workers had died during the study. Exposing the dangers of sandblasting has forced government agencies to step in and attempt to contain and control the amount of dust exposure. One method of containing the silica dust is the addition of water. Average respirable particulate levels drastically declined after water spray controls were installed in a stone crusher mill in India. This measure brought to light the effectiveness of reducing silica exposure through relatively inexpensive modifications. It may take time to get these factories to comply with the Permissible Exposure Limit for silica but at least some measures are being implicated, or suggested, to have a positive health impact for the sandblasting workers. Another popular chemical involved in an alternate sandblasting technique is Potassium Permanganate or KMnO4. It is an odorless, dark purple, sand-like oxidizing agent. It is used to lighten the color of denim in specific areas. In the process of sand blasting, a worker sprays the potassium permanganate on a specific area on the denim garment with a hose or a brush. It is then washed off, leaving the chemical treated area a lighter color than the surrounding untreated area. When the potassium permanganate dries, bleach is sprayed on top of the previously treated area to neutralize potassium permanganate and is then washed a second time. There are multiple exposure routes for potassium permanganate to cause serious adverse reactions to the worker, these are: dermal contact, contact with the eye, inhalation and ingestion. When potassium permanganate comes in contact with the skin, it can cause irritation, deep burns, rashes and even dying of the skin. If potassium permanganate is exposed to the eye, severe irritation as well as permanent eye damage is possible. Inhalation of potassium permanganate can irritate the respiratory tract and can even lead to chronic lung diseases such as asthma, silicosis, and pulmonary edema.