A rapidly escalating public health crisis is unfolding in California’s artificial stone countertop fabrication industry, where nearly 300 workers — most of them Latino immigrants — have been diagnosed with a severe and often fatal form of silicosis, according to state data quoted by a law firm.
The lung disease, caused by inhaling fine silica dust, has already led to 15 deaths and at least 31 lung transplants. Dozens more workers have been referred for transplant evaluation, the California Department of Public Health (CDPH) reported in April. The median age of diagnosis and death is 46.
High silica content and ultrafine particles driving crisis
The outbreak has been tied to engineered stone, often marketed as quartz countertops, which can contain more than 90% crystalline silica by weight—far higher than traditional natural stones like granite or marble. When slabs are cut or ground during fabrication, they release ultrafine dust particles that can lodge deep in the lungs, even when dust suppression systems are in place.
Studies from the National Institute for Occupational Safety and Health and others have documented airborne silica concentrations in fabrication shops that exceed legal limits by factors of four to 13.
Accelerated disease progression and missed diagnoses
Unlike traditional silicosis, which often develops after decades of exposure, this form progresses quickly—sometimes within just a few years or months on the job. Many affected workers first seek care in emergency rooms, often in critical condition. Delayed or incorrect diagnoses are common, with early symptoms often mistaken for infections or other respiratory illnesses.
By the time accurate diagnoses are made, irreversible lung damage has often occurred. Lung transplants remain the only viable treatment in many cases, though access is limited by language barriers, insurance gaps, and financial constraints.
Latino immigrant workers disproportionately affected
The majority of those affected are young, Spanish-speaking men from Mexico and Central America, employed by small businesses or as independent contractors. Many do not have health coverage and are unaware of their legal rights. Some continue working in the industry after diagnosis, driven by the need to support their families.
More than 95% of U.S. silicosis patients linked to artificial stone are Latino immigrants, studies show. Several families have lost primary earners within a few years of exposure, leaving them financially devastated.
California tracks surge in cases
The CDPH has launched a dedicated surveillance dashboard to monitor the crisis. As of April, it reported:
- 294 confirmed cases
- 15 deaths
- 31 lung transplants
- 26 additional transplant referrals
International response and calls for a ban
Australia, facing a similar surge in cases, banned all engineered stone in 2024 following a national review. Regulators concluded that engineering controls could not protect workers adequately.
In the U.S., calls for a ban are mounting. “The more that I learned, the more that I read, the more that I take care of these patients, the more that I have no confidence that this material can be worked with safely,” said Dr. Jane Fazio, a pulmonary and critical care physician at Olive View UCLA Medical Center in Sylmar, who identified the outbreak in the San Fernando Valley.
Even one major slab manufacturer, Cosentino, has called for a prohibition on products with silica content exceeding 40%, noting that lower-silica alternatives could meet market needs.
Legal claims fill the insurance void
For many workers, legal action is the only path to care. Some countertop shops have failed to carry workers’ compensation insurance, leaving victims unable to claim benefits. Civil lawsuits have become a primary avenue for accessing life-saving transplants and covering medical costs.
Advocates are pushing for expedited court proceedings due to the rapid progression of the disease, which can leave workers unable to testify or access compensation before their health declines.
Brayton Purcell LLP, a California-based law firm specializing in occupational disease litigation, is leading multiple silicosis-related lawsuits in the state. The firm has previously handled high-profile cases involving asbestos and other industrial toxins.
“Legal action may be the only chance for workers to survive this,” said a firm representative.
