Incurable and unconscionable: How immigrants are contracting deadly lung disease making kitchen countertops

In the state of California, Latino immigrants are dying from silicosis, an incurable disease that has been known for centuries to be a hazard to workers who are exposed to airborne particles of crystalline silica.  

Silicosis is a problem in California for the immigrant workers who make engineered quartz kitchen countertops. Quartz contains very high levels of silica — more than 90 percent. Cutting, breaking, crushing, drilling, grinding or abrasive blasting of quartz to shape it into countertops produces fine silica dust that the workers breathe it into their lungs.  

On Dec. 14, 2023, the California Occupational Safety and Health Standards Board announced that around 4,040 workers are exposed to silica dust in California’s stone fabrication shops. It estimates that between 500 and 850 of them will get silicosis and between 90 and 160 will die from it.

This is unacceptable. 

Workers can be protected with a combination of engineering controls, proper work practices, protective equipment, and other measures that reduce exposure to silica particles. Though temporary emergency rules have recently been put into place, they won’t save lives unless California ensures that employers provides their workers with respirators that will protect them from dangerous levels of silica particles — and that they are used.

Background information 

During the Great Depression, silicosis killed hundreds of workers who drilled a tunnel in West Virginia.  

The tunnel project attracted thousands of men, hoping to find work. “To these men, going to West Virginia was like going to heaven — a new land, a new promised land — and when they got here, they found that they had ended up in a hellhole,” says Matthew Watts, a minister and amateur historian. 

The International Labor Organization (ILO) and the World Health Organization (WHO) launched a program to eliminate silicosis worldwide by 2030, calling for a number of measures to protect workers from exposure to dangerous amounts of silica dust.  

But the threat never disappeared, and new types of silica exposure arose. 

The risk of silicosis from artificial stone was first identified in Israel in 2012, and the first case of silicosis linked to engineered stone in the United States was identified in Texas in 2015. Since then, California has become an epicenter of the disease. 

Many of the engineered stone workers in California are non-English speaking, undocumented immigrants, which makes them particularly vulnerable to having to work under unsafe conditions. Some unscrupulous employers use the threat of immigration enforcement to create an atmosphere of coercion and exploitation in which undocumented workers are reluctant to complain about working conditions. 

There are three types of silicosis:  

Acute: Symptoms such as a nagging cough, phlegm and trouble breathing occur in a few weeks or in up to two years after exposure to a large amount of silica; 

Chronic: Symptoms may not show up until decades after exposure to low or moderate amounts of silica. The symptoms may be mild at first and slowly worsen; 

Accelerated: Symptoms occur between 5 to 10 years after heavy exposure to silica. They worsen quickly. 

Workers exposed to silica also are at increased risk of TB, lung cancer, chronic obstructive pulmonary disease, kidney disease, and autoimmune disease. Silicosis is incurable because the damage done by inhaling crystalline silica dust can’t be reversed, though treatments are available that can improve lung function, quality of life and life span. The expected outcome for silicosis patients depends on the extent of their exposure to silica dust.  

Preventing silicosis 

According to Brayton Purcell, a law firm with expertise on the prevention of silicosis, the current CAL-OSHA and federal OSHA standard requires wet-cutting methods, exhaust ventilation and dust masks, half-face canister respirators and full-face canister respirators when fabricating natural stone. These standards, however, are based on the low content of silica particles in natural stone that are sized in the low micron range, not the high volume of ultrafine or nanosized silica particles contained in quartz engineered stone. Workers in engineered stone fabrication shops are exposed to an average of 227 ug/m3, which is 4.5 times the OSHA Permitted Exposure Limit for silica; and the required measures do not reduce silica exposures to being below that level.  

The only methods capable of fully preventing silicosis are air-fed positive pressure respirators or a ban on the manufacture and sale of engineered stone. 

If California is not willing or instantly able to require employers to provide adequate protection, it should consider making it illegal to produce countertops that expose workers to dangerous levels of silica dust. This is what Australia has done. In December 2023, the Australian government banned the use, supply and manufacture of all engineered stone benchtops, panels and slabs.  

But such a ban would not save workers who already have silicosis. How will they support themselves and their families and pay their medical bills when they become disabled and can’t work? 

As was the case with the miners in West Virginia during the depression, the undocumented immigrant workers in California whose lungs have been destroyed by exposure to silica dust thought they were coming to the promised land, but they ended up in a hell hole.   

Nolan Rappaport was detailed to the House Judiciary Committee as an Executive Branch Immigration Law Expert for three years. He subsequently served as an immigration counsel for the Subcommittee on Immigration, Border Security and Claims for four years. Prior to working on the Judiciary Committee, he wrote decisions for the Board of Immigration Appeals for 20 years.