Latino men who cut artificial-stone countertops in California are falling ill from an incurable and deadly lung disease at an alarming rate, a new study finds.
These workers are developing silicosis, a condition in which microscopic silica dust contained in the stone slabs they grind and polish is cutting up the inside of their lungs until the organs fail. Life expectancy can be extended through a lung transplant, but even then the fatal disease will continue to progress.
The number of silicosis cases reported in California has increased more than tenfold in less than four years — from 2019 through 2022 there were 47 cases; from 2023 through August of this year, there have been 571, according to data from the state Department of Public Health.
Workers are also falling ill younger and experiencing a more severe and rapid progression of the disease, according to an analysis of the state’s data published in the New England Journal of Medicine.
“It’s become clear that this product engineered stone countertops … cannot be manufactured safely and economically,” said David Michaels, professor of environmental and occupational health at George Washington University and co-author of the study. “This is a product that we do not need that is damaging the lungs of hundreds of workers [in California] and probably thousands of workers across the country.”
Latino men account for about 98% of cases, and about half of the cases have been reported in L.A. County, according to the California Department of Public Health. The San Fernando Valley is the epicenter of California’s artificial-stone-cutting industry, where dozens of shops are clustered.
The state health agency identified 32 workers who had died of the disease since 2019. The median age of workers who were diagnosed with silicosis is 46, and the median age at death is 52.
“Silicosis among these workers is progressing much more rapidly than silicosis we’ve seen in other occupations,” which includes the construction and mining industries, said Michaels, who is also the former assistant secretary of labor for the Occupational Safety and Health Administration.
The affected workers identified in the study reported 16 to 25 years of silica dust exposure while on the job. The state has tracked data for 72 workers who have undergone lung transplants and 51 workers who have been referred for lung transplant evaluations.
“It’s leading to earlier deaths and severe disability,” Michaels said. “The percentage of workers who have either received lung transplants or who are awaiting lung transplants is astoundingly high.”
He said when OSHA first issued an industry standard of occupational exposure to silicia in 2016, the fabrication of artificial-stone countertops was still very new.
“There was no investigation into those exposures,” Michaels said, “and the understanding of how much more severe these exposures were … has become very apparent in the last decade.”
In 2019, the California Department of Public Health identified the first known case of silicosis in a countertop fabrication worker.
Public awareness about the dangers of the disease began to spread more broadly in 2022 and 2023, but while lawmakers have called for new steps to protect workers, progress has been slow.
A proposed bill to tighten safety protocols at stone fabrication shops and publish reports of compliance was put on hold in 2024.
Then in 2025, California Senate Bill 20 expanded the state public health agency’s role in silicosis surveillance, outreach and education, and the department designated silicosis as a mandatory reportable condition in California.
Under this law, employers are required to take steps to protect workers, such as providing protective respirators and using water to suppress dust, when employees are cutting, grinding or polishing slabs. It also eliminated an earlier loophole that allowed stonecutting manufacturers to dodge safety requirements by claiming that protective steps weren’t feasible.
But some health professionals say more serious action is needed.
Looking at the rising numbers of silicosis cases, the Western Occupational & Environmental Medical Assn. submitted a petition to the California Occupational Safety and Health Standards Board in December seeking more meaningful change.
The association noted that although Cal/OSHA established an emergency regulatory framework for silica products in December 2023, compliance rates at artificial-stone fabrication shops are low.
“Cal/OSHA has cited 94% of inspected shops for violations, and 20% required emergency shutdown orders,” the petition states. “The roughly 140 shops inspected represent only about 10% of the estimated 1,342 fabrication operations statewide.”
The medical association pointed to the success of Australia’s nationwide prohibition of artificial stone containing more than 1% crystalline silica. Although Cal/OSHA doesn’t have the authority to ban the sale of the product, the association argued that it ought to ban its production and fabrication in the state.
In late May, the standards board voted to approve the petition and move forward with steps to enact emergency regulations. Staff are now working to draft language to prohibit the fabrication of engineered-stone countertops and similar products, which will need to be reviewed by stakeholders and approved by the board before it can be implemented.
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