NPR’s latest reporting adds to growing public health evidence that silicosis tied to quartz countertop dust is appearing across the country, while regulators, doctors, manufacturers, and injured workers continue to fight over whether high-silica engineered stone can be fabricated safely at scale.

Why the quartz countertop silicosis risk matters now

Silicosis is an incurable lung disease caused by inhaling respirable crystalline silica dust. The dust can be released when workers cut, grind, drill, shape, or polish materials that contain silica.

The current concern centers on engineered stone, often sold as quartz countertops. The National Institute of Occupational Safety and Health (NIOSH) states that engineered stone typically contains more than 90% respirable crystalline silica content, putting countertop fabricators at risk of silicosis.

Finished countertops sitting in a home are not the cause of concern. The hazard is concentrated during fabrication and installation work, when power tools can turn silica-containing stone into fine dust that workers breathe.

The new warning: this is not only a California problem

California has the clearest numbers because it has actively tracked engineered-stone silicosis cases. That makes California the warning sign, not the boundary of the problem.

The California Department of Public Health (CDPH) reported that, as of November 13, 2025, it had confirmed 432 silicosis cases among California countertop workers since 2019, including at least 25 deaths and 48 lung transplants. The agency also warned that case counts likely underestimate the true burden of disease.

By April 2026, KQED reported that California had confirmed more than 540 stoneworker cases, with dozens of lung transplants and 29 deaths. KQED also reported that cases had been identified in Colorado, Florida, Illinois, Massachusetts, Utah, and other states.

California’s numbers are visible because surveillance is stronger there. In many other states, the disease may be harder to detect because silicosis is not tracked the same way.

Why cases may be missed outside California

A worker can develop shortness of breath, cough, fatigue, or abnormal imaging without immediately connecting the illness to countertop work. The CDPH has warned that some workers may be asymptomatic, suggesting that medical providers should ask patients about work history and that countertop workers should be tested, including those without symptoms.

Silicosis can be misread as another lung condition, especially when a doctor does not know the patient spent years cutting or finishing engineered stone. A diagnosis may require careful occupational history, imaging, pulmonary testing, and specialist evaluation.

This lack of awareness is why states without active surveillance may have sick workers who are not being counted in silicosis statistics.

Why engineered stone is different

Silica exposure is not new. Workers in mining, construction, foundries, sandblasting, and masonry have faced silica hazards for generations.

What is different is the material and the workforce now being harmed. Engineered stone can contain very high levels of crystalline silica. When workers cut or polish it, the process can release fine particles small enough to lodge deep in the lungs. KFF Health News reported that cases are appearing in countertop fabrication shops from California to Texas, Florida, and the Northeast, and that no comprehensive national count exists because surveillance varies by state.

Many affected workers are relatively young. The CDPH reported a median age of diagnosis of 46 and a median age of death of 48 among California cases. The agency also described the affected workers as primarily immigrant men, predominantly from Mexico and Central America.

These are not cases of disease appearing at the end of a long career. Many involve workers in their 30s, 40s, and 50s who developed severe lung disease during their working years.

The safety debate is becoming harder to ignore

Manufacturers and industry groups often argue that engineered stone can be fabricated safely when employers follow Occupational Safety and Health Administration (OSHA) standards, use wet methods, control dust, monitor air, train workers, and provide proper respiratory protection.

Worker advocates, occupational physicians, and some public health experts argue that those controls may not be enough in real-world fabrication shops, especially where dust can spread through sanding, edge finishing, cleanup, clothing, vehicles, and shop surfaces.

KQED reported that California regulators are weighing whether to prohibit fabrication of artificial stone containing more than 1% crystalline silica. The same report noted that even some shops investing heavily in compliance may not be able to eliminate the danger.

This debate determines whether the response focuses only on employer compliance, or whether manufacturers, distributors, product design, warnings, and lower-silica alternatives also become central.

What workers and families should watch for

A stone fabrication worker should not ignore breathing symptoms, especially if they have worked with engineered stone. Warning signs can include:

• Shortness of breath
• Persistent cough
• Chest tightness
• Fatigue
• Reduced ability to work or exercise
• Abnormal chest X-ray or CT findings
• A diagnosis described as pulmonary fibrosis, pneumoconiosis, or possible occupational lung disease

Workers should tell medical providers about their full work history, including countertop cutting, grinding, polishing, installation, cleanup, and the brands or types of stone used when known.

Families should also keep records. Work history, job sites, employers, product names, safety training, respirator use, wet cutting practices, ventilation, air monitoring, medical records, imaging, and coworker information can all matter.

What legal questions may arise after a silicosis diagnosis

Every case depends on the facts. A silicosis diagnosis may raise questions about:

• Whether the worker handled engineered stone or another high-silica material
• Whether manufacturers or distributors provided adequate warnings
• Whether product design contributed to the exposure risk
• Whether employers followed required dust-control practices
• Whether workers received proper training, respirators, fit testing, and medical surveillance
• Whether unsafe dry cutting, grinding, or cleanup occurred
• Whether the worker was exposed at multiple shops or job sites
• Whether the worker’s illness was diagnosed late because occupational history was missed

These cases can involve workers’ compensation, product liability, negligence, failure-to-warn claims, medical monitoring issues, and wrongful death claims. The available legal options depend on factors such as the state, work history, companies involved, and timing of the diagnosis.

The takeaway for workers outside California

California’s high number of silicosis cases should be taken as a warning about what can happen when a high-silica product becomes common in small fabrication shops across the country.

The most dangerous assumption is that a worker outside California is safe because their state has not reported many cases. Low reporting does not mean low risk. It may simply mean the state is not looking closely enough.

For workers who cut, grind, polish, or install quartz countertops, the important question is whether they have been screened for silicosis, and whether anyone has connected their lung symptoms to engineered stone dust.

McEldrew Purtell is reviewing silicosis cases involving stone fabrication workers, countertop installers, and occupational silica exposure. If you or someone in your family was diagnosed with silicosis after working with quartz, engineered stone, granite, concrete, or other silica-containing materials, contact McEldrew Purtell for a free consultation. We can help evaluate what happened, what records matter, and whether a legal claim may be available.