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There is an increasingly popular material that's used to make kitchen and bathroom countertops. It's a kind of artificial stone. And public health experts say it has been linked to deaths and lung injuries in workers who have cut and polished it. NPR's Nell Greenfieldboyce reports that thousands of workers could be at risk.
NELL GREENFIELDBOYCE, BYLINE: Jose Martinez is 37 years old. He used to work at a countertop maker, at the kind of place that takes slabs of natural and artificial stone and cuts and polishes them to order. He says all that cutting produced dust, and the dust got everywhere.
JOSE MARTINEZ: Your nose, your ears, your hair, all your body, your clothes - everything. Everything. When you walk out of the shop, you can see your step on the floor because of the dust.
GREENFIELDBOYCE: After years of this, he started feeling dizzy and weak.
MARTINEZ: I can't play with my kids outside because I get tired really easy.
GREENFIELDBOYCE: Doctors told him he has silicosis - an untreatable, sometimes progressive lung disease. It's caused by breathing in silica dust. Silica is a mineral found in natural and artificial stone. Now Martinez is worried because he's heard from former co-workers that two other employees of that company died of silicosis last year.
MARTINEZ: And when I go to sleep, I think about it every night - if I'm going to die in three or four, five years. And I have four kids, my wife. Because to be honest with you, every day I feel worse. Nothing is getting better.
GREENFIELDBOYCE: His experience and those two deaths are described in a new report on 18 silicosis cases. All occurred in countertop fabrication workers in California, Colorado, Texas and Washington.
AMY HEINZERLING: I am concerned that what we may be seeing here may just be the tip of the iceberg, that there likely are more affected workers who have yet to be identified.
GREENFIELDBOYCE: Amy Heinzerling is an epidemic intelligence service officer with the Centers for Disease Control and Prevention who's assigned to the California Department of Public Health.
HEINZERLING: We know that there are thousands of shops and nearly 100,000 workers in this industry in the United States.
GREENFIELDBOYCE: They also know that more and more these workers are cutting engineered stone. This option for countertops has really taken off in the last decade. It's a composite made of bits of quartz bound together by a resin. Manufacturers say it's less likely to crack or stain the natural stone, but it contains a lot of silica, and cutting it creates silica dust.
HEINZERLING: Engineered stone typically contains over 90% silica. That's compared to other natural stone materials. So granite, for instance, usually contains less than 45% silica. Marble usually contains less than 10%.
GREENFIELDBOYCE: A spokesperson for a trade organization that represents major engineered stone manufacturers told NPR that dust-related diseases can come from unsafe handling of many different materials, that the risks are not specific to engineered stone. But Heinzerling thinks it's significant that all of the sickened workers in the U.S. were exposed to dust from engineered stone. Not all of them actually cut the stone. Cecile Rose is a lung specialist at National Jewish Health. She's recently seen seven patients with silicosis from this industry. Two of them worked as cleaners who would sweep up the worksite.
CECILE ROSE: So they were exposed to the silica particles that were suspended in the air just with housekeeping duties.
GREENFIELDBOYCE: Almost all of the sick workers described in the new report are Hispanic, and almost all have progressive, severe disease.
ROSE: What's so alarming about these cases is that the age in many of these workers is quite young. And of course, the real tragedy here is that it's preventable.
GREENFIELDBOYCE: Simply controlling the dust eliminates the risk. Some countertop manufacturers are both aware of the danger and taking action. David Scott owns and operates Slabworks of Montana, in Bozeman.
DAVID SCOTT: I have upwards of 8-, 900 slabs of stone in stock, in inventory, physically.
GREENFIELDBOYCE: When his workers cut them, they use wet cutting techniques to keep down dust. He first tested airborne silica levels in his shop about five years ago. They were only marginally acceptable. So he brought in a floor scrubber and installed air handling systems with filters.
SCOTT: And we brought our silica levels, at times, down to undetectable.
GREENFIELDBOYCE: A safety agency at the Department of Labor called OSHA says that employers are responsible for keeping the workplace free of known hazards. A former head of that agency says it could be doing more. David Michaels is now an epidemiologist at George Washington University. He says, in 2015, OSHA issued a hazard alert about the risk for countertop workers after there'd been one U.S. case of silicosis and multiple cases overseas. And in 2016, OSHA cut the amount of airborne silica allowed in the workplace.
DAVID MICHAELS: But there hasn't been any follow-up. OSHA hasn't done inspections in these facilities to give the message to this industry that, unless new equipment is brought in, unless silica exposures are controlled, people are going to get sick and people are going to die.
GREENFIELDBOYCE: He says OSHA's ability to do those inspections is hampered by the fact that, in 2017, the Trump administration ended a safety program that put a special emphasis on silica.
Nell Greenfieldboyce, NPR News.
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