Silicosis

People usually call us with a working life rather than a legal theory: the years of cutting slabs, the edges ground by hand, the sink cutouts, the dust that covered everything by the end of a shift — and then, much later, a chest scan and a word nobody in the family had said out loud before. Whether that history adds up to a claim turns on the work, the materials and the medical record, and finding that out is our half of it rather than yours.

What is silicosis?

Silicosis is an occupational lung disease caused by inhaling respirable crystalline silica.

Crystalline silica is a naturally occurring mineral found in materials including:

• Stone
• Sand
• Concrete
• Brick
• Mortar
• Granite
• Engineered or artificial stone
• Other rock and mineral products

Simply being near a solid piece of stone is not the same as breathing respirable silica. The danger arrives when work processes turn solid material into extremely small airborne particles. Cutting, sawing, grinding, drilling, crushing and polishing silica-containing materials can all generate respirable crystalline silica dust.

Those particles can be small enough to travel deep into the lungs. Over time — or after a particularly intense exposure — silica can cause inflammation and permanent scarring of lung tissue. That disease is silicosis, and federal health agencies describe it as incurable, progressively disabling and potentially fatal1.

The hazard is not the stone. It is what the work does to the stone.

Countertop fabricators face a serious silica hazard

The growth of engineered stone countertops has created a serious occupational-health concern.

Products marketed as engineered stone, artificial stone or quartz countertops can contain very high concentrations of crystalline silica. Some countertop products contain more than 90% crystalline silica, and engineered stone and quartzite carry the highest concentrations of any countertop material1.

When workers fabricate those slabs, dust can be generated by activities such as:

• Cutting
• Grinding
• Polishing
• Drilling
• Sanding
• Chipping
• Edge finishing
• Making sink and faucet cutouts
• Installing and modifying countertops onsite
• Cleaning areas where silica dust has accumulated

The danger is not limited to the person holding the saw or the grinder. Workers performing maintenance, cleaning, quality control and other jobs near dust-generating operations can also be exposed, which is why OSHA and NIOSH address the whole shop rather than one job title — the agencies identify workers who manufacture, finish and install natural and engineered stone countertops as a group at risk of silica exposure1.

The people behind the countertops

A finished countertop is polished and spotless. The shop where it was made can be a very different environment.

Behind engineered-stone countertops are workers who measure slabs, operate saws, grind edges, polish surfaces, cut openings and make the final adjustments during installation. Many have done that work for years.

Public-health researchers have documented serious silicosis among immigrant workers in the U.S. stone-fabrication industry, including relatively young workers who were already severely ill when they were diagnosed.

What one statewide case series found

52 workers

A case series published in JAMA Internal Medicine described 52 silicosis patients identified through California surveillance of engineered stone countertop fabrication workers between 2019 and 20222.

Median age 45

The median age at diagnosis was 45 years, and nearly all of the patients were Latino immigrant men2.

Advanced at diagnosis

Diagnosis was delayed in 58% of the patients, 38% already had progressive massive fibrosis — advanced scarring — when they were identified, and 19% died2.

What the numbers are not

A published case series describes the people in it. It does not establish what caused any other person’s illness, and it is not a substitute for one worker’s records. It is here because it is the reason this work is being looked at closely.

Those are other people’s cases, gathered by researchers rather than by lawyers. Yours would be read on its own facts.

Some workers may never have been told what silica was. Some may not have understood that the dust around them could permanently scar their lungs. Some may have worked without effective dust controls or adequate respiratory protection.

If that sounds like your work, or the work of someone in your family, we want to hear from you. You do not need to know the scientific name of the material you handled. Tell us what you did.

Engineered stone, quartz and natural stone

The amount of crystalline silica varies significantly between materials.

How much silica the material holds

Engineered stone

Engineered or artificial stone is manufactured by combining crushed stone or minerals with materials such as resins and pigments. Some engineered stone products contain extremely high concentrations of crystalline silica — more than 90%1.

Quartzite

Certain natural quartzite products can also contain very high levels of crystalline silica1.

Granite

Granite contains crystalline silica, although concentrations generally differ from engineered stone and vary with the particular stone.

Marble and limestone

Calcium carbonate-based stones such as limestone and many types of marble generally contain much less crystalline silica than high-silica engineered stone or quartzite.

The material matters. So does what happened to it at work.

Cutting, grinding and polishing are what turn a silica-containing material into airborne respirable dust. That is why an exposure history is about tasks and conditions as much as it is about product names.

You do not have to be a countertop worker

Silica exposure occurs in many occupations — the American Lung Association estimates that roughly 2.3 million U.S. workers are exposed to silica on the job5. Workers who may encounter respirable crystalline silica include people working in:

• Countertop fabrication
• Countertop installation
• Construction
• Concrete cutting and finishing
• Demolition
• Masonry
• Brick and block work
• Stone cutting
• Quarrying
• Mining
• Tunneling
• Road construction
• Foundries
• Glass and ceramic manufacturing
• Abrasive blasting
• Hydraulic fracturing
• Rock drilling
• Other jobs involving silica-containing materials

Job titles do not always tell the whole story. What matters is the work you actually performed and the dust that work created.

What does silica exposure look like?

Someone may not remember being told, “you are being exposed to silica.” They may remember something much simpler: dust everywhere.

• Dust coming off a saw
• Dust thrown up while grinding an edge
• Dust hanging in the air inside a fabrication shop
• Dust covering clothing at the end of a shift
• Dust created when someone nearby was cutting stone
• Dust swept up from the floor
• Dust raised while making adjustments during an installation

Those details matter when a work history has to be reconstructed years later. If you do not know whether the material contained silica, tell us what you remember working with.

Silicosis can develop in different ways

Silicosis does not always follow the same timeline.

Chronic silicosis

Chronic silicosis generally develops after longer-term exposure to respirable crystalline silica.

Accelerated silicosis

Accelerated silicosis can develop after shorter periods of exposure to higher concentrations of silica dust. This form has become an important concern among workers fabricating high-silica engineered stone.

Acute silicosis

Extremely high silica exposures can cause acute silicosis, which can develop much more rapidly.

The type and the progression of the disease depend on the nature and intensity of the exposure and on the individual worker’s circumstances.

Signs and symptoms

Silicosis can exist before a worker notices obvious symptoms. When symptoms do develop, they can include:

• Shortness of breath
• Persistent cough
• Fatigue
• Weakness
• Chest discomfort
• Difficulty performing physical activity

These symptoms occur with many different medical conditions and do not by themselves establish that someone has silicosis. A medical professional should evaluate respiratory symptoms and decide what testing and treatment are appropriate.

If you have worked around silica-containing dust, make sure your healthcare provider knows about your occupational history. It is the single piece of information most likely to change how your symptoms are worked up.

How doctors evaluate silicosis

There is no single symptom that identifies silicosis. Doctors generally consider a patient’s occupational history together with medical findings. Evaluation can include:

Occupational history

A physician may ask about the patient’s jobs, the materials worked with, the tasks performed and how long the work continued. For countertop workers, it can be particularly important to tell the doctor about work cutting or finishing quartz or engineered stone.

Chest imaging

Chest X-rays may show changes associated with silicosis. CT imaging can provide more detailed images of the lungs and may be considered when silicosis is suspected.

Pulmonary function testing

Pulmonary function tests measure how well the lungs are working.

Other medical evaluation

Depending on the patient’s circumstances, doctors may perform additional testing to evaluate symptoms and to rule out other conditions.

Silicosis is permanent

The lung damage caused by silicosis cannot currently be reversed. Silicosis cannot be cured, and treatment generally focuses on relieving symptoms, preventing additional exposure and monitoring or treating complications5.

Advanced disease can severely impair lung function. Some people with severe silicosis are ultimately evaluated for lung transplantation. That is why preventing and recognising silica exposure early matters so much.

Silica exposure can cause more than silicosis

Respirable crystalline silica is associated with several serious health conditions. Workers who inhale it are at risk of:

• Silicosis
• Lung cancer
• Chronic obstructive pulmonary disease (COPD)
• Kidney disease

Silicosis can also increase susceptibility to tuberculosis and certain other respiratory infections15.

A worker who is worried about silica exposure should tell their healthcare providers about that exposure even if silicosis has not been diagnosed.

What employers can do to control silica dust

Silica exposure is not simply an unavoidable part of working with stone. OSHA has established workplace standards for respirable crystalline silica — one for general industry and maritime, one for construction — that set an exposure limit and require employers to assess exposures and control dust34. The permissible exposure limit is 50 micrograms of respirable crystalline silica per cubic metre of air, averaged over an eight-hour day, with an action level of 251.

Depending on the work being performed, the methods used to control silica dust can include:

• Applying water where cutting or grinding generates dust
• Local exhaust ventilation
• Tools connected to HEPA-filtered vacuum systems
• Enclosing or isolating dust-generating processes
• Avoiding dry sweeping of silica dust
• Appropriate respiratory protection when it is required
• Worker training
• Exposure monitoring
• Medical surveillance for certain exposed workers

For countertop fabrication, wet cutting and other engineering controls matter most, because they reduce the amount of airborne silica dust the work generates in the first place rather than relying on a respirator to catch it.

A countertop worker’s story may start years before a diagnosis

How the sequence usually runs

1. The work

   A worker begins cutting, grinding, polishing or installing stone.

2. The dust

   Repeated work generates respirable crystalline silica, and the exposure may continue for months or years.

3. The lungs

   Microscopic particles reach deep into the lungs, where repeated exposure can cause inflammation and permanent scarring.

4. Symptoms

   The worker may develop shortness of breath, coughing, fatigue or a reduced ability to do physical work. Some workers have no noticeable symptoms at first.

5. Medical evaluation

   Doctors review the occupational history and may order chest imaging, pulmonary function tests and other examinations.

6. Diagnosis

   The worker may ultimately be diagnosed with silicosis or another silica-related disease.

7. Looking back at the job

   Only then do the worker and the family usually begin asking what was being cut, how much dust was in the shop and what protections were in place.

If you worked in a countertop shop, tell us what you remember

You do not need to know the brand of countertop. You do not need to know the percentage of silica in the slab. You do not need the technical name of every tool. Start with your work.

• Were you cutting slabs?
• Grinding edges?
• Polishing countertops?
• Making sink cutouts?
• Drilling holes?
• Installing countertops?
• Cleaning the fabrication shop?
• Working nearby while someone else did those jobs?
• Was the cutting done wet or dry?
• Was dust visible in the air?
• Were you given respiratory protection?
• How many years did you do this work?

Those are the kinds of details that begin telling the story. Tell us your story and we will take it from there.

Para los trabajadores de habla hispana

Muchos trabajadores de fabricación e instalación de piedra en los Estados Unidos hablan español. Queremos escuchar su historia.

Si usted ha trabajado cortando, puliendo, perforando, fabricando o instalando encimeras de cuarzo, piedra artificial, granito u otros materiales de piedra, puede haber estado expuesto al polvo de sílice.

No necesita saber el nombre exacto del producto. No necesita tener todos sus documentos. No necesita entender los términos médicos antes de hablar con nosotros.

Cuéntenos qué trabajo hacía, dónde trabajaba y qué recuerda sobre el polvo y los materiales. Cuéntenos su historia.

Medical and employment records

Information that can help document a silica-exposure history or a medical condition includes:

• Employment history
• Names and addresses of employers
• Jobsite information
• Job descriptions
• Coworker information
• Photographs of the workplace
• Information about stone or countertop products
• Respirator or safety-equipment information
• Workplace exposure records
• Chest X-rays
• CT scans
• Pulmonary function tests
• Pulmonology records
• Hospital records
• Occupational-medicine records
• Pathology records, where applicable

Health insurance and continuing medical care

People diagnosed with silicosis may need continuing medical care, including monitoring by pulmonary specialists, respiratory testing, imaging and treatment of complications. The care required varies considerably with the individual and the severity of the disease.

Health insurance coverage, provider networks, deductibles, authorisation requirements and other benefits vary between plans. Questions about a particular patient’s treatment belong with the treating clinicians, and questions about specific coverage belong with the insurer or plan administrator — but if a denial letter or a lien notice does not make sense, bring it to us.

You did the work. Tell us what the job was really like.

Maybe you spent years cutting countertops. Maybe you polished edges, made sink cutouts or installed finished slabs. Maybe you swept the shop at the end of the day. Maybe you worked construction, concrete, stone or another trade and only recently learned that the dust around you contained silica.

And maybe nobody ever told you that breathing that dust could permanently scar your lungs.

At CBW Law we want to hear from the people who did the work. You do not need to know the legal terminology, the exact silica content of the material, or have every medical and employment record in front of you. Tell us where you worked, what you did and what happened. Tell us your story — we will start there.

Plain English

Medical, Health & Insurance

A silicosis review needs more than the word “silicosis.” It needs the imaging, the lung function numbers, the dates, and a work history detailed enough to show where the dust came from — and all of that arrives in two vocabularies, neither of them yours: the clinical language in the chart, and the coverage language in the letters from the health plan. Here is what the words mean, so the paperwork is readable before it becomes decisive.

The dust and the disease

Crystalline silica

A naturally occurring mineral found in stone, sand and many other materials.

Respirable crystalline silica (RCS)

Extremely small particles of crystalline silica, small enough to be inhaled deep into the lungs. Respirable dust is the hazard; a solid slab sitting on a rack is not.

Silicosis

An incurable lung disease caused by inhaling respirable crystalline silica.

Fibrosis

Scarring of tissue. Silicosis causes fibrosis in the lungs, and scarring does not reverse.

Progressive massive fibrosis (PMF)

An advanced form of lung fibrosis that can occur in severe silicosis.

The materials, in plain English

Engineered stone

A manufactured material commonly used for countertops, also called artificial or manufactured stone. Some engineered stone products contain very high concentrations of crystalline silica.

Quartz countertop

A common consumer term for certain engineered-stone countertops, made using quartz-containing material combined with resins and other ingredients.

Occupational exposure

Exposure to a substance or hazard that happens through a person’s work.

Engineering controls

Workplace systems or equipment designed to reduce a hazard at its source — water suppression or local exhaust ventilation used to control silica dust, rather than a respirator worn to cope with it.

How the disease is documented

Pulmonary function test (PFT)

Testing used to measure how well the lungs are working. Serial tests over time are often more informative than a single set of numbers.

Chest CT

Computed tomography imaging, which provides more detailed images of the lungs than a plain chest X-ray.

Occupational history

The written account of the jobs, materials and tasks a person worked with. In a silica case this is medical evidence as much as it is background.

Medical surveillance

Periodic medical examinations offered to workers exposed above certain levels. Where an employer ran surveillance, those records exist and can usually be obtained.

Insurance, billing and continuing care

Authorization for release of records

The signed form that lets a provider send records to someone else. Expect to sign more than one, because facilities and physician groups hold separate files.

Prior authorization

A plan’s approval before it will pay for a test or a treatment. A denial at this stage can be appealed, and the appeal file is worth keeping.

Explanation of benefits (EOB)

Not a bill. It is the health plan’s account of what was billed, what it allowed, what it paid and what it says is still owed. Together, a stack of them maps where treatment happened.

Subrogation and liens

A health plan or program that paid for treatment may assert a right to be repaid out of any recovery. Finding those claims and negotiating them down is part of the case rather than an afterthought.

Educational only. These are plain-language summaries of words that turn up in charts, letters and bills — not clinical definitions, not medical advice, not a diagnosis of anyone, and not a description of what any particular policy covers. For what a diagnosis means, ask the clinician who made it. For what a plan covers, read the plan, and bring it to us if it is not clear.

Questions

Frequently asked silicosis questions

The questions callers actually open with, answered the way we would answer them on the phone.

What is silicosis?

Silicosis is an incurable lung disease caused by breathing respirable crystalline silica dust. The particles can reach deep into the lungs and cause inflammation and permanent scarring.

What is silica?

Crystalline silica is a common mineral found in materials including stone, sand, concrete, brick, mortar, granite and engineered stone.

Are countertop workers at risk?

Yes. OSHA and NIOSH specifically identify workers who manufacture, finish and install natural and engineered stone countertops as being at risk of exposure to respirable crystalline silica.

Why are engineered stone countertops a concern?

Some engineered stone products contain very high concentrations of crystalline silica — more than 90% in some products. Cutting, grinding, polishing and drilling them can generate respirable silica dust.

Is engineered stone the same as quartz?

Products marketed as quartz countertops are commonly a type of engineered stone. The exact composition varies by product.

Do only people who cut countertops face exposure?

No. Workers doing other jobs near silica-generating operations may also be exposed, including people involved in installation, maintenance and housekeeping.

Can natural stone create silica dust?

Yes. Natural materials including granite and quartzite can contain crystalline silica. The concentration varies substantially with the type of stone.

Can construction workers develop silicosis?

Yes. Construction work involving concrete, mortar, brick, stone and other silica-containing materials can generate respirable crystalline silica.

What if I do not know what kind of stone I worked with?

Tell us what you remember. The work you performed, the employer, the jobsite, the tools used and the appearance of the material can all help reconstruct an exposure history.

What if I worked around the dust but was not operating the saw?

Tell us anyway. Workers near cutting, grinding, polishing and other dust-generating operations can also be exposed.

Can silicosis develop quickly?

It can. Silicosis occurs in chronic, accelerated and acute forms, and high-intensity exposure can produce disease that develops far more rapidly than traditional chronic silicosis.

Is there a cure for silicosis?

There is currently no cure that reverses the lung damage silicosis causes. Treatment focuses on managing the disease, preventing further exposure and addressing complications.

Can silica exposure cause lung cancer?

Occupational exposure to respirable crystalline silica is associated with an increased risk of lung cancer, and also with COPD, kidney disease and tuberculosis.

What if I was exposed but have not been diagnosed with silicosis?

If you are concerned about past or current silica exposure, tell your healthcare provider about your occupational history.

If you also want to tell CBW Law what happened at your workplace, we want to hear it. A review is free, and we will say plainly whether there is anything here.

What if I am not sure whether my employer protected me properly?

You do not need to work that out before contacting us. Tell us what work you did, what the workplace was like and what you remember about dust control, ventilation, water systems and respiratory protection.

Do I need all my medical and employment records before contacting CBW Law?

No. Start with what you know. Collecting records is our job, and waiting until the file is complete only costs time.

This page is general information about silicosis and silica-exposure claims. It is not legal advice, it does not create an attorney-client relationship, and it is not medical advice about anyone’s diagnosis or treatment. If something here sounds like your work history, the useful next step is a conversation about the facts.