Outrage of the Month: The Epidemic of Artificial-Stone-Associated Silicosis in the United States
Health Letter, October 2026
By Robert Steinbrook, M.D.
Director, Public Citizen's Health Research Group
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Silicosis is an occupational lung disease that is irreversible, incurable and deadly, yet preventable. Over the last decade, physicians have recognized a global epidemic of silicosis cases associated with the cutting and grinding of artificial stone, an affordable and aesthetic alternative to natural stone for kitchen and bathroom countertops. Workers, not consumers, are at risk.
The ongoing public health crisis is highlighted in a new Public Citizen report, which calls for the United States to ban artificial stone with more than 1% crystalline silica content to protect workers from life-threatening silicosis. At present, workers in countertop-fabrication shops, many of whom are young Latino men, are exposed to high levels of crystalline silica and are dying from silicosis at young ages. The report explains how existing occupational regulations, even when strictly followed, fall short and why a national ban is urgently needed on the importation, manufacture, distribution, sale and commercial fabrication of artificial stone with more than 1% crystalline silica content.
Artificial stone, which is also known as engineered stone, is a composite material made of crushed quartz stone bound together with a polymer resin to create a solid surface. Artificial-stone-associated silicosis is caused by exposure to fine crystalline silica dust, known as respirable crystalline silica. Resin and metals added to the artificial stone also may contribute to the rapid development of silicosis.
In California, silicosis is a mandatory reportable disease. The state’s statistics underscore the importance of a national ban. As of Sept. 24, 2026, there have been 657 reported and confirmed cases of artificial-stone silicosis, 75 workers have received a lung transplant, and 35 workers are known to have died. Of the cases, 99.8% were in men and 98% in Latinos. The median age at diagnosis was 46 years and the median age at death 52 years.
In 2024, Australia banned the use and manufacture of artificial stone. In the United States, California has taken the lead by establishing workplace standards to limit exposures, strengthening occupational regulations and requiring educational training for workers and fabrication shop owners.
In September 2026, California went further, releasing draft regulations to prohibit the manufacture and fabrication of artificial stone with more than 1% crystalline silica. The state’s Occupational Safety and Health Standards Board is expected to vote on these regulations as soon as October 2026.
Although there is no known safe level of crystalline silica in artificial stone, regulatory agencies have focused on products with greater than 1% crystalline silica content. Although it calls for implementing a ban, our report also suggests other measures.
- The U.S. Occupational Safety and Health Administration should strengthen regulations for the fabrication of stone products and exposure to respirable crystalline silica.
- Silicosis reporting by all states should be required and a national surveillance system established.
- A national artificial-stone-associated silicosis screening and prevention program should be established and funded.
- The National Institute of Occupational Safety and Health should be directed and funded to conduct research on the safety profile of newer artificial-stone products with less than 1% crystalline silica content.