California has reported nearly 600 cases of silicosis, a severe lung disease, among workers involved in making engineered-stone countertops since early 2019, as highlighted in a recent public health report.
The findings were released by the California Department of Public Health on Wednesday in an article published in NEJM Evidence. Of the 592 reported cases, there were 31 fatalities and 65 individuals who required lung transplants.
According to the report, “Silicosis is a progressive, incurable fibrotic lung disease caused by inhalation of respirable crystalline silica.” It further notes that, over the last two decades, the risk has been increasingly recognized among those fabricating engineered stone countertops that contain crystalline silica.
The report points out that engineered-stone slabs, commonly referred to as quartz countertops, may have at least 90% crystalline silica. Workers can be at risk when they are cutting or finishing these countertops.
Health officials observed that the cases reported from January 2019 to June 2026 included relatively young patients with brief exposure periods whose diseases progressed rapidly. The median age at which workers were diagnosed was 46, while those who succumbed to silicosis had a median age of 52.
Additionally, nearly all diagnosed individuals were men, with about 98% being Latino, as stated in the report.
The state’s surveillance program ramped up after it identified its first known case of silicosis in a countertop fabricator in 2019; this worker was diagnosed at 32 and passed away from respiratory failure at 38.
Although California has implemented stronger silica regulations and increased surveillance efforts, challenges in enforcing workplace rules remain. The report highlights, “Despite these interventions, hazardous worker exposures persist in California.” While silicosis surveillance has been expanded, it suggests that the real extent of the disease’s impact is likely underestimated due to the system largely depending on passive reporting. Even though case identification has improved through better awareness among workers and clinicians, screening efforts are uneven, and misdiagnosis continues to be an issue.
