The sleek, durable countertops that have become a fixture in modern American kitchens are at the center of a growing health crisis.

Engineered stone, commonly marketed as quartz countertops, has been linked to an incurable and often fatal lung disease called silicosis among workers who cut, polish, and install these popular surfaces.

As cases surge across the United States, medical professionals and occupational safety experts are calling for urgent action to protect vulnerable workers from what some describe as a preventable epidemic.

The hidden danger in engineered stone

Engineered stone differs dramatically from natural stone in one critical way: its silica content. While granite typically contains 10 to 45 percent crystalline silica and marble less than 5 percent, engineered stone contains more than 90 percent crystalline silica.

This manufactured material consists of crushed quartz bound together with resins and pigments, creating a uniform, customizable surface that has driven its popularity in residential and commercial construction.

When workers use power tools to cut, grind, or polish these slabs, they release massive quantities of respirable silica dust. These microscopic particles, once inhaled, lodge deep in lung tissue and trigger inflammation and scarring.

The result is silicosis, a progressive disease that gradually destroys the lungs’ ability to function. The condition makes patients more susceptible to infections, chronic obstructive pulmonary disease, autoimmune disorders, and lung cancer.

The scale of exposure in engineered stone fabrication far exceeds that of traditional stonework. Workers processing these materials face silica concentrations that can reach dozens of times the federally permitted exposure limit, even when standard dust control measures are in place.

The extremely high silica content, combined with the fine particle size of the dust generated, creates a uniquely dangerous occupational hazard.

A crisis unfolding in real time

California has emerged as the epicenter of what public health officials now characterize as a silicosis epidemic. The state’s Department of Public Health began tracking cases in 2019, and the numbers have climbed at an alarming rate.

As of November 2025, California has confirmed 432 cases of silicosis associated with engineered stone fabrication, including at least 25 deaths and 48 lung transplants. These figures likely represent only a fraction of the true burden, as many cases go undiagnosed or unreported.

The victims are predominantly young immigrant workers, many from Mexico and Central America. The median age at diagnosis is 46, and the median age at death is just 48. These workers often labor in small fabrication shops with inadequate safety equipment, minimal training, and limited access to healthcare. Many are undocumented, further complicating their ability to seek medical care or report unsafe working conditions.

Tyler Jordan, a 31-year-old Missouri man who worked in his family’s stone fabrication shop in Colorado, exemplifies the devastating impact of this disease. After developing chest tightness and pain in 2022, Jordan was diagnosed with silicosis. His condition deteriorated rapidly. By 2024, the silica exposure had caused his kidneys to fail, requiring a transplant from his father.

Now with lung function at 60 percent, Jordan can no longer work and has abandoned his dream of taking over the family business. He represents a generation of workers whose lives have been irrevocably altered by a preventable occupational disease.

When safety measures fall short

Federal and state regulations require employers to implement dust control measures when working with silica-containing materials. California’s emergency regulations, enacted in December 2023, mandate wet cutting methods, powered air-purifying respirators, regular dust monitoring, and prompt cleanup procedures. Yet enforcement remains inadequate.

The Occupational Safety and Health Administration has inspected only several hundred of the more than 10,000 U.S. employers in the countertop fabrication industry, and most inspected employers have failed to comply with existing silica regulations.

Even when shops implement required controls, they often prove insufficient. The sophisticated water-fed tools and ventilation systems necessary to adequately suppress silica dust can be prohibitively expensive for small fabrication businesses.

Moreover, the ultrafine particles generated by engineered stone can penetrate standard filter masks, leaving workers exposed despite believing themselves protected. Research has found that even with wet cutting methods, which are supposed to suppress dust, median silica exposure levels still exceed federal limits.

The technical challenges of controlling engineered stone dust have led some experts to question whether the material can be fabricated safely under any circumstances. Dr. Jane Fazio, who treats silicosis patients at UCLA Medical Center, notes that the silica particles are extremely toxic to the lungs, progressively reducing patients’ ability to breathe. Many workers she treats require oxygen therapy or lung transplants, and some have died waiting for donor organs.

Australia’s decisive response

Faced with hundreds of silicosis cases among engineered stone workers since 2015, Australia took a different approach. The country initially tightened regulations, implementing additional control measures, certification programs, inspections, and educational campaigns.

When a national task force found that hazardous silica dust exposure persisted despite these efforts, Australia became the first country to ban engineered stone entirely in July 2024.

The ban has not caused the economic disruption that critics predicted. Manufacturers have developed low-silica and silica-free alternatives for the Australian market, demonstrating that the building industry can adapt without collapsing. Workers remain employed, and consumers still get countertops for their renovations. The primary difference is that fabricators no longer face life-threatening exposure to crystalline silica.

Meanwhile, many of these same manufacturers continue selling high-silica engineered stone products in the United States and other countries without bans. Companies maintain that their products are safe when proper safety protocols are followed, though mounting evidence suggests that even rigorous adherence to existing safety standards cannot adequately protect workers from the material’s inherent dangers.

The path forward

Medical and occupational health experts are increasingly calling for the United States to follow Australia’s lead.

More than 600 occupational health physicians in the Western Occupational and Environmental Medical Association petitioned California authorities in December 2024, urging a statewide ban and asserting that engineered stone is too toxic to fabricate safely. They argue that education and enforcement alone cannot curtail what they characterize as an escalating health emergency.

California’s Division of Occupational Safety and Health estimates that between 1,000 and 1,500 stoneworkers in the state could develop silicosis within the next decade, leading to approximately 285 deaths.

With roughly 5,000 countertop fabrication workers in California alone, the potential for widespread illness and death looms large. Similar clusters of cases are emerging in other states, suggesting that California’s experience may be replicated nationwide as surveillance improves.

For homeowners with engineered stone countertops, experts emphasize that the finished product poses no health risk. The danger lies exclusively in the fabrication process. However, renovation or removal of these countertops can generate hazardous dust, and workers performing such tasks should use appropriate respiratory protection and dust suppression methods.

The silicosis epidemic among engineered stone workers represents a stark failure of the regulatory system to protect workers from known occupational hazards. Nearly a century after the Hawks Nest Tunnel disaster and Frances Perkins’s Stop Silicosis campaign, workers are still developing and dying from this entirely preventable disease.

Whether through comprehensive regulation, enforcement, or an outright ban, urgent action is required to ensure that no more workers sacrifice their health and lives for kitchen countertops.