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Silica Safety Resources for Stone Fabricators

Occupational Health Branch

Silica Safety Resources for Stone Fabricators

Información en español: Fabricantes de Encimeras y Enfermedad Pulmonar

Workers in California are getting silicosis – a deadly disease – doing stone countertop fabrication

In 2018, two California workers died at the ages of 36 and 38 from severe silicosis. Both had jobs at a stone countertop fabrication company working on engineered stone. Since then, the California Department of Public Health has learned of dozens of other workers in California who are suffering from severe or "accelerated" silicosis from their work in this industry. The California Artificial Stone and Silicosis (CASS) Project was created to promote awareness in the industry and among health care providers, so we can identify workers who are at risk and help make their workplaces safer.

NIOSH poster about silicosis in stone fabrication workers

Silica, silicosis, and other health effects
Crystalline silica is found in many materials. Sand, stone, concrete, mortar and artificial stone contain silica. Silica dust particles small enough to breathe in are created when workers cut, saw, grind, drill or crush these materials. Abrasive blasting with sand is another source of silica dust.

When very small particles of silica dust get in the air, they can be breathed into the lungs and cause silicosis. Silicosis is an incurable lung disease that can lead to disability and death. Silica dust can also cause lung cancer, kidney disease and autoimmune disease.

Poster from the National Institute for Occupational Safety and Health, or NIOSH

Stone Fabrication Worker Silicosis Alert

NEW! Stone Fabrication Worker Hazard Alert (PDF 1.39MB) | Spanish | Chinese Traditional - frequently asked questions about silica dust

Safety Resources to help prevent silica exposures in countertop fabrication

NEW! Workplace Air Monitoring for Silica: Employer Guide (PDF 2.4MB) | Spanish – easy-to-use guide to get started
NEW! Cal/OSHA Silica Standard Overview (PDF 1.20MB) | Spanish – one-page at-a-glance guide for employers
Hazard Warning for Employers (PDF) - prevention tips for employers
Hazard Warning for Workers (PDF) | Spanish | Chinese - fact sheets for workers
Silicosis Outbreak in Engineered Stone Fabrication Workers—18 Cases in 4 States (PDF) - Occupational Health Alert
Health Advisory on Stone Fabrication Hazards (PDF) - OHB advisory on severe lung disease
Control of Silica Exposure in Engineered Stone Fabrication Facilities Training Modules - Safety, Health, Environmental Services (SHES) at Georgia Tech

For help measuring silica exposure or complying with the Cal/OSHA silica standards:

Contact your workers' compensation insurance company.
Call Cal/OSHA Consultation at (800) 963-9424 for a free, confidential visit | Find a local office.
Find an industrial hygienist through a searchable list of consultants provided by the American Industrial Hygiene Association.

Information for Providers

Workers with silicosis often present with non-specific respiratory symptoms, such as cough and shortness of breath; they may also be asymptomatic in early stages of disease.

Providers should ask patients about their work and consider silicosis in both asymptomatic and symptomatic countertop fabrication workers. Silicosis can be diagnosed using imaging, such as chest x-ray and chest CT, and pulmonary function tests, such as spirometry and diffusing capacity. Pulmonary and occupational medicine providers should be included in diagnosis and care.

Providers are asked to report any silicosis cases to CDPH via one of the following methods:

By filling out this form
By phone: 800-970-6680
By fax: 916-636-6153
By email: silicosis@cdph.ca.gov

Please ensure that any emails containing protected health information are sent via a secure email system. If you do not have access to a secure email system, please contact us at the above email address and we will provide a secure method of transmission.

Additional Resources for Providers

Silicosis in Countertop Fabrication Workers: What Providers Need to Know – one-page overview of silicosis in countertop fabrication workers, including information about diagnosis, medical surveillance, and treatment.

Global Epidemic Comes to California: Silicosis in Countertop Workers – CDPH health advisory with information for California health care providers and local health departments

Silicosis: An Update and Guide for Clinicians – clinical review, including occupational background and clinical guidance on managing silicosis

Silica Exposure, Silicosis, and the New Occupational Safety and Health Administration Silica Standard. What Pulmonologists Need to Know – summary of workers at risk of silicosis and occupational health considerations for clinicians

Adverse Effects of Crystalline Silica Exposure (PDF 3.5 MB)– American Thoracic Society position statement describing the health effects of respirable crystalline silica exposure

Silicosis and Crystalline Silica Exposure: What Physicians Need to Know – fact sheet about silicosis from the New York State Department of Health

Crystalline Silica: Medical Monitoring – National Institute for Occupational Safety and Health (NIOSH) information about silicosis and silica medical examinations

Professional publications

NEW! Silicosis among countertop workers in California - case investigation article, July 2023 Silicosis article summary (PDF)
Self-reported silica exposures and workplace protections among engineered stone fabrication workers in California – letter to journal editor, October 2022
Elevated exposures to respirable crystalline silica among engineered stone fabrication workers in California, January 2019–February 2020 – journal article abstract, July 2022
Radiographic Screening Reveals High Burden of Silicosis among Workers at an Engineered Stone Countertop Fabrication Facility in California – journal article, March 2021
Outbreak of Silicosis among Engineered Stone Countertop Workers in Four States – NIOSH Science blog "visual abstract" (poster format) – MMWR report, October 2019
Severe Silicosis in Engineered Stone Fabrication Workers — California, Colorado, Texas, and Washington, 2017–2019 – MMWR report, September 2019
Silica – Notes from the Field: Silicosis in a Countertop Fabricator – Texas, 2014 – MMWR, February 2015

General silica prevention resources, including Construction

Silica safety website for controlling silica exposure in construction
NIOSH silica topic page
Toxic Dusts – Silica (PDF) | Spanish - BuildSafe tailgate training safety cards

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