Washington, August 13: A new report documenting California’s rapidly growing silicosis epidemic among quartz countertop workers underscores the urgent need for a national effort focused on stronger surveillance, earlier diagnosis and policy interventions to protect workers from a preventable yet often fatal occupational lung disease.
The report, co-authored by David Michaels, professor in the Department of Environmental and Occupational Health at the George Washington University Milken Institute School of Public Health and former assistant secretary of labor for the U.S. Occupational Safety and Health Administration (OSHA), and experts from the California Department of Public Health and two California universities identified 592 cases of silicosis among quartz countertop fabrication workers between January 2019 and June 2026. Of those workers, 65 underwent lung transplants and 31 died. The number of cases is rising quickly.
Silicosis is an incurable lung disease caused by inhaling respirable crystalline silica dust. Engineered stone, commonly marketed as “quartz” countertops, typically contains more than 90% crystalline silica, placing workers who cut, grind and polish the material at particularly high risk. While safer alternatives are available, quartz remains the most popular countertop material in the U.S.
“Hundreds of workers have been sickened making quartz countertops, a product we do not need, especially when a safer alternative is available,” said Michaels. “Given the hundreds of diagnosed cases of silicosis in California, there are likely thousands of more cases across the country. Health care practitioners and public health departments should be on the lookout for cases and join the effort to stop this epidemic and save workers lives.”
The report highlights several alarming trends:
- Patients are being diagnosed with silicosis at relatively young ages after comparatively short periods of exposure.
- Many cases progress rapidly, often requiring lung transplantation.
- Workers frequently experience other silica-related illnesses, including autoimmune diseases and tuberculosis.
- Despite strengthened California regulations, hazardous workplace exposures continue.
The authors note that California’s tracking efforts have already prompted significant regulatory and legislative action, including stronger workplace silica standards. However, they caution that the true burden of disease is likely much higher because many workers remain undiagnosed or are diagnosed late.
The report also points to Australia’s nationwide ban on engineered stone containing crystalline silica as a model for preventing future cases.
The authors urge healthcare providers to routinely ask patients about occupational exposures, evaluate countertop fabrication workers for silicosis and report diagnosed cases to public health authorities.
The study, “Silicosis Epidemic Among Workers Fabricating Engineered Stone (“Quartz”) Countertops in California, 2019–2026,” was published in the New England Journal of Medicine Evidence and authored by researchers from the California Department of Public Health, the University of California, Los Angeles, the University of California, San Francisco, and the George Washington University Milken Institute School of Public Health.
Michaels and Robert Harrison, a senior attending physician in occupational health at the University of California, San Francisco and co-author on the paper, recently published an article in The Conversation on the public health impact of quartz countertops, spotlighting how most big-box stores continue to sell the countertops.