When you step into a store like Costco, Home Depot, or Lowe’s and place an order for a kitchen countertop, it’s likely that they’ll connect with a local fabrication shop to create it from a material known as engineered stone.
Commonly referred to as “quartz,” engineered stone is essentially a synthetic product that consists of up to 95% finely ground quartz mixed with polyester resins and dyes. The straightforward process for consumers to order it hides a troubling reality: the workers who cut, grind, and polish these countertops face serious health risks, including the potential for a devastating lung disease.
In California, over 550 workers have been diagnosed with silicosis due to exposure to engineered stone—a serious and preventable illness for which no cure exists. Among these, at least 100 have already had or are waiting for lung transplants, a major surgery that can prolong life but doesn’t eliminate the disease. Tragically, around 30 individuals have died from this condition between 2019 and 2026.
We are an epidemiologist and a physician who specialize in occupational diseases and have closely researched the risks associated with this material. We contend that the rise in silicosis cases represents a public health crisis. Unfortunately, this issue appears largely unnoticed outside California, as many states haven’t begun tracking the disease’s prevalence.
A popular yet perilous substance
Engineered stone, which has only been around for a few decades, has rapidly become the top choice for kitchen countertops, often more durable and typically cheaper than marble.
During the process of cutting, grinding, and polishing engineered stone countertops, workers release billions of tiny crystalline silica particles coated with resins and dyes. These particles, which workers inhale, can lead to a severe and fast-advancing form of silicosis.
Like asbestos, silica can cause serious respiratory issues and is linked to lung cancer. What’s alarming is the age demographic of those affected: many fabrication workers are relatively young, with a median age of 46 and a median age at death of 52. If they cease working with silica but manage to live longer, they face a heightened risk of developing lung cancer, kidney issues, and various autoimmune diseases.
Currently, about 100,000 workers are involved in countertop manufacturing in the U.S., and studies indicate that at least 20% or more may develop silicosis. Treatment can amount to millions for each affected person, predominantly funded by Medicaid and public assistance—costs borne by taxpayers.
Sadly, many of those working in fabrication lack proper access to healthcare, let alone specialists skilled in diagnosing and treating silicosis.
Major retailers still promote quartz over alternatives made from crushed glass, which is significantly less toxic since it involves amorphous silica rather than crystalline silica. Consumers often know little about the availability of safer options.
Ikea ceased selling engineered stone countertops in 2025, while Home Depot, Lowe’s, and Costco continued selling products containing crystalline silica as of June 2026.
Increasing cases and lawsuits
Back in 2016, while one of us (David Michaels) served as assistant secretary of labor for the Occupational Safety and Health Administration (OSHA), the agency lowered the permissible limit of airborne silica dust exposure.
However, meeting the federal OSHA guidelines is insufficient to protect workers from the severe toxic outcomes of engineered stone exposure.
After the Centers for Disease Control and Prevention noted 18 silicosis cases attributed to engineered stone work in several states in 2019, California epidemiologists began monitoring the disease among fabrication workers. Each subsequent year has seen an increase in cases reported compared to the last. Clearly, as long as crystalline silica-based engineered stone is utilized in kitchen countertop production, numerous young workers will receive silicosis diagnoses each year.
Silicosis cases have also emerged in other states, including Massachusetts, Illinois, New York, Florida, Utah, Washington, New Mexico, and Colorado. However, since many fabrication workers aren’t screened for silicosis, countless undiagnosed individuals are likely suffering from the disease.
Now, hundreds of ill workers across the U.S. are filing lawsuits against manufacturers and distributors of these hazardous countertops, along with the stores that sell them. Some early cases were settled before reaching court. In 2024, a lawsuit went to trial in which a 36-year-old worker with silicosis, who had undergone a double lung transplant while on life support, was awarded $52 million.
A global issue on the rise
The emergence of silicosis has paralleled the global production of engineered stone countertops.
Caesarstone, hailing from Israel, was one of the initial promoters of this material. Between 1997 and 2010, 25 Israeli workers using its products were recommended for lung transplants.
Silicosis cases linked to engineered stone soon surfaced in Spain, where 5,900 cases were reported from 2007 to 2024. In 2023, the owner of a Spanish firm named Cosentino acknowledged efforts to conceal the risks associated with the material and was sentenced to six months in prison for multiple counts of serious injury through gross negligence, according to news reports.
As engineered stone sales rose globally, silicosis cases began to emerge in the U.S. in 2014, Australia in 2015, and recently in Britain, China, and Taiwan.
As cases of silicosis continue to rise globally due to engineered stone usage, the situation is becoming more alarming.
In May 2026, in reaction to the deaths of young workers from silicosis, the UK introduced new guidelines prohibiting dry cutting of engineered stone products and announced plans to inspect 1,000 fabrication shops.
Australian health officials began tightening workplace safety standards in 2021, and after realizing those measures were inadequate in curbing exposure to the dangerous dust, the government banned imports of engineered stone products containing over 1% crystalline silica.
To remain in the Australian market, manufacturers like Caesarstone and Cosentino have shifted towards marketing slabs made from crushed glass instead of quartz.
Addressing engineered stone silicosis in the U.S.
In 2024, California’s OSHA implemented a workplace standard tougher than federal guidelines. However, the problem is that enforcement—both at the state and national levels—lacks necessary resources. Federal OSHA can only inspect each workplace approximately once every 191 years.
Also, many manufacturing workers are considered independent contractors, which places them outside OSHA’s regulatory scope.
In a move similar to Australia’s, California’s OSHA has begun emergency rulemaking to ban the fabrication and installation of engineered stone products containing more than 1% crystalline silica. However, countertop manufacturers are pushing back by advocating for national legislation to protect themselves from lawsuits, enabling them to market engineered stone without facing liability risks.
Unless manufacturers halt production and retailers, following Ikea’s example, stop offering engineered stone countertops made with crystalline silica in the U.S., many workers will continue to be exposed to hazardous dust—resulting in preventable cases of silicosis and cancer.
