Céline Gounder
César Manuel González, 37, used to work with stone that was engineered to endure: dense, polished slabs designed to outlast the kitchens by which they had been put in.
Engineered quartz counter tops have surged in reputation within the residence renovation market, with business analysts estimating the worldwide engineered stone market at around $30 billion. It’s persevering with to broaden as quartz surfaces substitute pure stone in kitchens within the United States and worldwide.
When González was working, the mud that rose from his noticed didn’t look extraordinary. It settled on his garments, in his hair, throughout the store ground. In a small countertop fabrication store, he reduce marble and granite earlier than shifting to engineered stone after the 2008-09 recession, when demand for cheaper quartz counter tops surged.
But the crystalline silica launched whereas the engineered stone was reduce and polished additionally settled into his lungs, scarring them past restore. What started as breathlessness hardened into silicosis, an irreversible illness that stiffens the lungs till even unusual motion turns into effort.
A lung transplant was his path ahead. The process can prolong survival, but it surely redraws the boundaries of a life: anti-rejection medicine day-after-day, fixed monitoring, vulnerability to an infection, the information that respiratory relies on the delicate acceptance of one other particular person’s donated organ.
González, who was identified with silicosis in 2023, just isn’t alone in coping with a illness that when was related to miners on the finish of lengthy careers. It’s now prevalent among the many a lot youthful, usually Hispanic males who work on this business, physicians and public well being officers say.
In the United States, circumstances are showing in countertop fabrication retailers from California to Texas, Florida, and the Northeast. Because silicosis just isn’t a nationally reportable illness and surveillance varies by state, no complete nationwide rely exists. But clinicians who deal with occupational lung illness say the variety of staff — usually males of their 30s and 40s — identified after reducing engineered stone has risen sharply over the previous decade.
As of early March, California had recognized 519 confirmed circumstances of engineered-stone-associated silicosis and 29 deaths since 2019. The median age at prognosis is 46; at dying, 49.
Doctors don’t debate whether or not working with engineered stone can scar lungs.
Manufacturers argue, although, that correct air flow, moist reducing, and respirators could make fabrication secure. Workers, physicians, and plaintiffs’ attorneys counter {that a} materials composed nearly completely of crystalline silica could also be unimaginable to deal with safely at scale.
“This is comparable to the tobacco industry saying cigarettes are safe,” mentioned epidemiologist David Michaels, an assistant labor secretary beneath President Barack Obama who led the Occupational Safety and Health Administration.
More than 370 lawsuits have been filed by staff who say engineered stone producers did not warn workers in regards to the dangers or offered a product that can’t be fabricated safely. At the identical time, members of Congress are considering legislation that may largely protect producers from legal responsibility in these circumstances, turning a office well being disaster right into a nationwide debate over regulation, accountability, and the bounds of civil litigation.
Gustavo Reyes, 36, is a part of that debate. Like González, he spent the early years of his profession reducing marble and granite earlier than shifting to engineered stone, a quartz-based materials that may include as much as 95% silica and generates way more hazardous mud when reduce.
In the store, he mentioned, reducing was accomplished with water to regulate the mud. But ending work — sanding and shaping — generated heavy mud. He mentioned he wore disposable respirator masks or a reusable elastomeric respirator with filters. A door was saved open. Fans ran overhead.
When he was identified in 2021, he didn’t know what silicosis meant. The physician advised him that there was no treatment and that he had three to 5 years to reside. He obtained a lung transplant in 2023.
Asked who he believes is accountable, Reyes answered: “The industries who created the artificial stone, the product.” Manufacturers dispute that characterization. Major firms say engineered stone may be fabricated safely when employers comply with OSHA mud controls, together with moist reducing, air flow, and respirator use.
An Old Disease, Reengineered
Silicosis just isn’t new. It was synonymous with mining disasters and sandblasting, most notoriously within the Hawks Nest Tunnel tragedy, when a whole lot of staff drilling by way of silica-rich rock in West Virginia within the early Thirties developed acute silicosis after months of unprotected publicity to mud. In 1938, Labor Secretary Frances Perkins suggested that the illness may very well be prevented if mud controls had been rigorously utilized.
What is new is the business by which it has resurfaced.
Engineered stone, usually marketed as “quartz,” is usually composed of crushed quartz certain with resins and pigments. Unlike marble, which accommodates little crystalline silica, engineered slabs include very excessive ranges of the substance.
Cutting adjustments the fabric.
“When you grind it, when you cut it, you’re pulverizing it,” mentioned Robert Blink, an occupational and environmental medication specialist who treats sufferers with superior silicosis in Chicago and is a member of the Western Occupational and Environmental Medical Association. “You’re weaponizing the silica.”
Power instruments fracture the floor into respirable particles sufficiently small to lodge deep within the lungs. Repeated publicity triggers irritation and fibrosis. Once scarring begins, it doesn’t reverse.
What Happens When You Look for It
In California, physicians say the sample emerged steadily.
Robert Harrison, an occupational medication doctor on the University of California-San Francisco, helped establish the first cluster of engineered stone silicosis circumstances in California in 2019 after a number of staff from the identical countertop fabrication store died or had been identified with the illness. He described the disaster as “the largest outbreak of silicosis in decades.” What initially appeared as remoted circumstances of unexplained lung scarring in younger males resolved right into a recognizable occupational epidemic as soon as work histories had been examined.
Jane Fazio, a pulmonologist at UCLA, remembers seeing superior fibrosis in in any other case wholesome staff. “They have families. They were working full-time,” she mentioned. Some skilled respiratory failure inside a couple of years.
When medical doctors in contrast work histories, the sample turned unmistakable: Many of the lads had labored in small retailers reducing and sharpening engineered stone counter tops.
Sheiphali Gandhi, an occupational and environmental pulmonologist at UCSF, warned that the true burden stays unsure. “We’re missing cases,” she mentioned. “There’s no national surveillance system for this.”
California designated silicosis a reportable illness in 2025. Since 2019, statewide surveillance has recognized a whole lot of circumstances linked to engineered stone. The numbers most likely underestimate the toll, although California’s dashboard makes the sickness seen.
Outside California, there is no such thing as a comparable monitoring.
Early Warnings
California was not the primary place this occurred.
The earliest trendy alarm got here from Israel. Caesarstone, an organization based on a kibbutz within the late Nineteen Eighties, helped popularize quartz counter tops globally.
Israeli physicians started documenting aggressive silicosis in younger countertop staff as early as 1997.
“We had never seen this before,” mentioned Mordechai Kramer, a retired pulmonologist who beforehand labored at Rabin Medical Center in Israel. “In classic silicosis, you expect long exposure, decades. Here, it was much shorter.”
Several sufferers required lung transplantation.
Despite the warning indicators, the market continued to broaden.
Australia confronted the identical sample within the late 2010s.
Rather than await sporadic diagnoses, Australian regulators launched systematic CT-based screening of artificial-stone staff. Disease prevalence was far larger than anticipated.
Ryan Hoy, a respiratory doctor and occupational well being researcher at Australia’s Monash University, described extreme illness in staff with comparatively brief exposures.
Authorities examined whether or not moist reducing, air flow, and respirators might cut back publicity sufficiently. They in the end concluded that even with controls, fabrication of high-silica engineered stone posed unacceptable danger.
In 2024, Australia prohibited the manufacture, provide, and set up of engineered stone containing excessive ranges of crystalline silica. Manufacturers pivoted towards lower- and zero-silica formulations.
In the United States: Who’s To Blame?
Fabrication within the U.S. continues beneath OSHA’s silica customary, which depends on publicity limits, moist reducing, air flow, and respiratory safety. Manufacturers argue that compliance works and that the issue lies with retailers that fail to comply with the principles.
OSHA first adopted silica limits in 1971 based mostly on analysis from mining, quarrying, and foundry work. Although the company up to date the rule in 2016, it regulates crystalline silica broadly and doesn’t distinguish between pure stone and high-silica engineered quartz.
The regulatory debate has now spilled into Congress. The Protection of Lawful Commerce in Stone Slab Products Act, launched in September by Rep. Tom McClintock (R-Calif.), would largely protect producers and distributors of engineered stone from civil lawsuits arising from the manufacture or sale of their merchandise. McClintock’s workplace didn’t reply to a request for remark.
The invoice was the topic of a January House Judiciary subcommittee hearing.
Supporters of the measure argue that producers shouldn’t be held chargeable for accidents brought on by employers who fail to comply with OSHA requirements. Opponents warn that eradicating litigation stress would get rid of one of many few mechanisms able to driving product reform if the fabric itself can’t be safely dealt with.
Michaels, the previous OSHA official, sees the stakes as historic. “Litigation drives change,” he mentioned, pointing to previous battles over asbestos and tobacco.
Plaintiffs’ attorneys argue that compliance with the OSHA silica customary doesn’t get rid of danger.
“It’s not a few bad actors,” mentioned Raphael Metzger, a product legal responsibility lawyer who has filed roughly 200 silicosis-related harm circumstances and a category motion in search of medical monitoring. He mentioned the difficulty is the product’s composition, not remoted regulatory noncompliance.
James Nevin, a tort lawyer representing staff in silicosis circumstances, framed the congressional debate as a struggle over accountability. “When it comes to causation, there’s no question,” he mentioned, arguing that the wave of circumstances explains why producers are actually in search of what he calls “a manufacturer bailout.”
In mid-2025, Caesarstone US launched its first merchandise containing lower than 1% silica. In response to questions, Irene Williams, a spokesperson for Caesarstone, mentioned, “The company is not responding as these are matters of pending litigation.”
The U.S. engineered stone market is dominated by a handful of enormous manufacturers — together with Caesarstone, Spain-based Cosentino, and U.S.-based Cambria — whereas the amount of slabs imported from Asian producers is rising.
Cosentino, too, is shifting to low-silica merchandise: “One third of the portfolio, including most new collections, contain less than 10% of crystalline silica,” mentioned Kamela Kettles, a Cosentino spokesperson. “Cosentino will not be providing additional commentary at this time,” she mentioned.
Commenting on behalf of Cambria, Mark Duffy, a communications advisor for the corporate, wrote, “Reckless employers are criminally violating the law, exposing workers to deadly working conditions.” He added that engineering and administrative controls, when correctly used, are efficient in decreasing exposures beneath OSHA limits and mentioned Cambria maintains exposures beneath the OSHA Action Level in its personal services.
While Caesarstone and Cosentino are headquartered abroad, Cambria is predicated in Minnesota. Its chief govt, Marty Davis, has been a serious Republican political donor, contributing millions of dollars to President Donald Trump’s election campaigns in addition to to different Republican candidates and political motion committees, based on federal marketing campaign finance information. Davis has additionally contributed to the marketing campaign of Rep. Brad Finstad (R-Minn.), a co-sponsor of the laws. Finstad’s workplace didn’t reply to a request for remark.
Nevin, the lawyer, mentioned the invoice would give producers “free rein” from civil legal responsibility.
He additionally questions whether or not regulatory enforcement alone can deal with the issue. Even earlier than the Trump administration’s funding and staffing cuts, “you had a better chance of being struck by lightning than being visited by OSHA,” he mentioned, arguing that inspections are too rare to stop illness in an business composed largely of small retailers.
Breathing on Borrowed Time
For González, the controversy arrives after the actual fact. The mud he inhaled has already reshaped his life.
And Reyes’ transplanted lungs could final years, however not many years. The median survival time for transplanted lungs is about eight years, UCSF’s Gandhi mentioned.
Reyes mentioned he hopes folks purchasing for counter tops perceive that purchasing synthetic stone “will harm the worker. The one who cuts it, the one who manufactures it.”
