A devastating health crisis is unfolding across California as hundreds of countertop fabrication workers develop silicosis, an incurable lung disease caused by exposure to toxic silica dust from engineered stone. Medical experts and workplace safety officials are now calling for an urgent ban on the material, following Australia’s successful prohibition implemented in 2024.
The Human Cost of Artificial Stone
Lopez, a 43-year-old father of four, sits confined to his East Bay residence, dependent on an oxygen machine to breathe. After spending more than twenty years cutting and polishing engineered stone countertops, he received a silicosis diagnosis that has devastated his life. The once-vigorous worker now awaits a double lung transplant, unable to walk even short distances without stopping to catch his breath.
His story represents a growing tragedy affecting primarily Latino immigrant workers across California. Two of Lopez’s colleagues have already died from the disease, while three others remain on transplant waiting lists. The emotional toll extends far beyond the workers themselves, as families watch their breadwinners become unable to provide or participate in daily life.
“It’s agonizing waiting for the hospital to call me so I can finally get the transplant I’m waiting for and be able to go back to work,” Lopez said, speaking through an interpreter. KQED is withholding his full name due to his undocumented status and concerns about losing access to vital medical treatment.
An Epidemic in the Making
Since 2019, California’s Division of Occupational Safety and Health has confirmed more than 430 silicosis cases among stoneworkers. The grim statistics include 25 deaths and 48 lung transplants. Alarmingly, approximately 40 percent of these cases were identified just this year, suggesting the crisis is accelerating rather than slowing.
Public health projections paint an even bleaker picture. Cal/OSHA estimates that between 1,000 and 1,500 California stoneworkers could develop silicosis within the next decade, potentially resulting in roughly 285 deaths. These projections are particularly concerning given that the state’s countertop fabrication workforce consists of only about 5,000 workers, predominantly Latino immigrants.
The geographic concentration of cases adds another layer of urgency. Half of all confirmed silicosis patients are located in Los Angeles County, which has become the epicenter of the state’s outbreak. Many affected workers are shockingly young, some still in their twenties, contradicting the traditional understanding of silicosis as an occupational disease requiring decades of exposure.
The Science Behind the Danger
Engineered stone products marketed in the United States typically contain more than 90 percent pulverized crystalline silica, far exceeding the silica content in natural materials like marble and granite. When workers use power tools to cut, polish and grind these slabs, microscopic silica particles become airborne. If inhaled, these particles lodge deep in lung tissue, causing progressive scarring that increasingly impairs breathing capacity.
The toxic effects extend beyond silicosis. Respirable crystalline silica exposure can trigger lung cancer, chronic obstructive pulmonary disease, and various other serious health conditions. What makes engineered stone particularly hazardous is that the silica particles are so small and numerous that even sophisticated safety measures struggle to provide adequate protection.
Dr. Ryan Hoy, a respiratory physician and researcher at Monash University in Melbourne, Australia, compared working safely with engineered stone to handling asbestos or uranium. Both can theoretically be done safely, he explained, but only with extremely sophisticated control measures that are unrealistic for the small fabrication shops that dominate the industry.
Current Regulations Fall Short
California has implemented some of the nation’s strictest workplace safety regulations regarding silica exposure. In December 2023, Cal/OSHA introduced emergency measures targeting the engineered stone industry, which became permanent in early 2025. These regulations mandate continuous water suppression during cutting, prohibit dry fabrication processes, require powered air-purifying respirators, and establish regulated work areas with restricted access.
Additionally, Governor Gavin Newsom signed Senate Bill 20 last month, further strengthening protections. However, enforcement data reveals these regulations are largely being ignored. Among 107 worksites inspected by Cal/OSHA through mid-October, a staggering 94 percent had violations of silica regulations.
Maegan Ortiz, director of the Instituto de Educacion Popular del Sur de California, expressed frustration with the gap between regulatory intent and workplace reality. Her organization has surveyed stoneworkers in Los Angeles County and witnessed dangerous conditions firsthand, even in larger shops claiming to follow regulations.
“We need to ban this. I think the concern is great, but it is kind of like thoughts and prayers in the face of other crises that don’t go far enough,” Ortiz said. “Workers see the dust, they carry it on them.”
Australia’s Path Forward
Australia confronted a similar silicosis crisis before taking decisive action. After attempting various safety measures including drycutting prohibitions, full-face respirators, enhanced ventilation systems, and rigorous monitoring, Australian authorities concluded that protection measures were insufficient for the small-shop structure of the countertop industry.
In July 2024, Australia banned the use, supply and manufacture of engineered stone benchtops entirely. The prohibition forced major manufacturers to pivot to silica-free alternatives for the Australian market, though these same companies continue selling their high-silica products in the United States.
The transition, while initially controversial, proceeded more smoothly than critics predicted. Dr. Hayley Barnes, now medical director of UCSF’s Interstitial Lung Disease Program, witnessed the Australian experience firsthand. She recalled predictions that the building industry would collapse and jobs would disappear.
“The companies just made a low-silica or no-silica product, which is currently available in Australia and many other countries,” Barnes explained. The construction sector adapted without major disruption, and consumers continued purchasing countertops for renovations and new buildings.
Manufacturers’ Response and Responsibility
Major engineered stone manufacturers have faced hundreds of lawsuits from injured workers in the United States and abroad. Companies including Minnesota-based Cambria, Israel-based Caesarstone, and Spain-headquartered Cosentino maintain that their products are safe when proper safety protocols are followed.
Caesarstone alone faces claims from more than 500 individuals, with most of the 320 U.S. cases still awaiting trial. The company has recorded a $46 million provision for probable losses, though only about half is covered by insurance. Last year, a jury awarded a 34-year-old stoneworker $52 million after finding Caesarstone and other companies liable, a verdict the company has appealed.
Interestingly, these same manufacturers have developed crystalline silica-free countertop surfaces in response to Australia’s restrictions. Caesarstone recently unveiled what it markets as safer alternatives for American fabrication workers. The company’s financial reports indicate sales growth in Australia following the silica ban implementation, while U.S. sales declined.
Cosentino announced a new mineral-surface product containing zero crystalline silica will be available globally next year. However, neither Caesarstone, Cosentino, nor industry associations have explained why they continue selling high-silica products in America while offering safer alternatives to Australian consumers.
The Call for California Action
A September memorandum obtained by KQED reveals that medical experts and workplace safety specialists have drafted recommendations for emergency action. The document, prepared by a committee convened by Cal/OSHA, suggests the Governor’s Office could issue an emergency declaration pausing the processing of artificial stone until a permanent ban is pursued through formal rulemaking.
However, the draft memorandum was never sent to the state board responsible for adopting new workplace safety regulations. The Department of Industrial Relations clarified that the document represents an incomplete working draft by the Silica Technical Committee, not official Cal/OSHA recommendations.
Governor Newsom’s press office did not respond to requests for comment regarding his position on banning engineered stone in fabrication shops. The agenda for the Occupational Safety and Health Standards Board’s next meeting notably excludes any decision-making on artificial stone, despite several board members publicly expressing dismay about rising silicosis cases for months.
Dr. Sheiphali Gandhi, an assistant professor of medicine at UCSF who treats dozens of silicosis patients, advocates strongly for phasing out artificial stone countertops. She argues that regulations alone have proven inadequate given the continuing surge in cases.
“We’ve tried all these regulations, but we still are seeing that the cases are going up,” Gandhi said. “We need to move towards the more effective strategies of elimination or substitution, where we really go for safer alternatives.”
An Uncertain Future for Workers
For Lopez and his family, the damage is irreversible. His state disability benefits have expired, leaving the family dependent on financial support from their 20-year-old daughter, who works as a medical assistant. Lopez has joined hundreds of workers across multiple countries in suing top engineered stone manufacturers, claiming silica-related injuries.
His wife, fighting back tears, reflected on the profound impact on their family, which includes a 3-year-old son. She wished her husband had received accurate information from manufacturers, vendors and employers before working with artificial stone, allowing him to make an informed choice about accepting the risk.
Medical professionals warn that diagnosed cases represent only the tip of the iceberg. Pulmonologists predict silicosis cases will continue rising even if exposure stopped immediately, because the disease often remains asymptomatic until it has significantly advanced. By the time workers experience breathing difficulties, lung damage is typically extensive and irreversible.
Gandhi faces a mounting caseload, with approximately 40 additional referrals of critically ill workers awaiting evaluation. The overwhelming influx troubles her deeply.
“It’s just like every month, my mailbox is full of more referrals of silicosis cases,” she said. “The number of cases is exploding. It’s insane.”
Consumer Impact and Industry Transition
The engineered stone market represents a multibillion-dollar industry in the United States, with global demand projected to grow significantly. California sales are expected to increase even more dramatically due to rebuilding efforts following the January wildfires that destroyed more than 16,000 homes and buildings in Los Angeles.
Consumers favor engineered stone for its stain resistance, competitive pricing compared to natural stone, and diverse color and design options. However, most homeowners remain unaware of the health consequences faced by workers who fabricate their countertops.
The Australian experience demonstrates that industry transition to safer alternatives is economically viable. While manufacturers’ costs increased when switching to silica-free products, consumer demand remained robust. The building sector continued without the catastrophic disruption that opponents of the ban had predicted.
Medical experts emphasize that protecting workers need not come at the expense of consumer choice or construction projects. The safer alternatives already exist and are being sold in other markets. The question facing California policymakers is whether they will mandate the transition before hundreds more young workers develop this preventable, incurable disease.
As state officials deliberate, Lopez continues his agonizing wait for a lung transplant that might allow him to breathe normally again. His cautionary tale underscores the urgent need for decisive action to prevent the next generation of countertop workers from suffering the same fate.
