MADDIE SOFIA, HOST:
You're listening to SHORT WAVE...
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SOFIA: ...From NPR.
Maddie Sofia here with NPR science correspondent Nell Greenfieldboyce.
NELL GREENFIELDBOYCE, BYLINE: Hello.
SOFIA: So, Nell, you've been working on this story for months. You were joking with me recently that you knew everything there is to know about this topic, and that topic is countertops.
GREENFIELDBOYCE: That's right, specifically, like, sort of stone and engineered-stone countertops...
GREENFIELDBOYCE: ...Which is really strange because my personal countertops at home are wood.
GREENFIELDBOYCE: So, like, I didn't know anything about this subject before I started looking into it. But increasingly, people have turned to this product known as quartz. So if you go to any sort of, like, TV show with remodeling and they update the kitchen, they have these new white countertops that sort of look like marble.
SOFIA: I know about it. I watch HGTV all the time.
GREENFIELDBOYCE: But they're often not marble. It's often quartz...
GREENFIELDBOYCE: ...Which is a composite material. And it's thought to be a little more advantageous than granite or marble because it doesn't chip or stain as easily. That's what the manufacturers say.
SOFIA: Right. And this story is not about home design. It is about something that happens in the process of cutting that material, that quartz, so that it can fit in your cool, updated kitchen.
GREENFIELDBOYCE: Right, because when you cut quartz, if you're not careful, it can create lots and lots of dust. And that dust gets everywhere.
JOSE MARTINEZ: Your nose, your ears, your hair, all your body, your clothes - everything, everything.
GREENFIELDBOYCE: Jose Martinez did this kind of cutting job for years. So did another guy I spoke with named Juan (ph). We just used his first name for medical privacy.
JUAN: (Through interpreter) At first, you don't feel the changes a lot. Then later, with time passing, your body starts telling you that you're missing air, that you're suffocating and you're tired.
SOFIA: So this dust damages their lungs.
GREENFIELDBOYCE: Exactly. So here's another guy I talked to, Ublester Rodriguez.
UBLESTER RODRIGUEZ: In the beginning, I wasn't understanding why that I was getting tired so easily. I was just thinking, oh, maybe I'm getting older.
SOFIA: He kind of took, like, a big breath in there.
GREENFIELDBOYCE: Right. So he and those other two guys - they all have a disease called silicosis as in silica, which is found in all that quartz dust. It causes irreversible scarring and damage to the lungs. So, you know, they're young, and they can't run or play with their kids. And, you know, eventually, as the disease progresses, they're probably going to need a lung transplant. There's no other cure for this disease. Here's Jose again.
MARTINEZ: You know, when I go to sleep, I think about it every night - that if I'm going to die in three or four or five years. And I have four kids, my wife - because, to be honest with you, every day, I feel worse.
GREENFIELDBOYCE: So there was a recent report in the MMWR. That's this weekly publication put out by the Centers for Disease Control and Prevention. And it described 18 cases, including these. These are instances of silicosis in workers - countertop workers in California, Texas, Colorado and Washington. And among those 18 cases, there were two deaths.
SOFIA: So today in the show, what we know about this emergence of silicosis and why investigators are worried it may just be the tip of the iceberg.
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SOFIA: So, Nell, we're talking about quartz countertops. Cutting them creates silica dust that causes silicosis, but the danger really starts in the process of making those countertops. So how are they actually made?
GREENFIELDBOYCE: All right. So granite countertops - that's natural stone - that also contains silica but a lot less.
GREENFIELDBOYCE: Quartz countertops have a ton of it because of how they're made. Whether it's Silestone or Caesarstone or any other brands, they basically all get created in the same way.
SUMMER: Cambria - this is Summer (ph). How can I help you?
GREENFIELDBOYCE: So this company called Cambria invited me to its manufacturing plant in Minnesota. And when you walk in, over the entrance, it says, through these doors walk the finest countertop makers in the world.
MARTY DAVIS: How are we doing?
GREENFIELDBOYCE: The CEO there is Marty Davis, and he showed me the entire factory. It churns out about 30,000 slabs of quartz countertop material every month.
GREENFIELDBOYCE: That means every day, 20 to 30 trucks unload these huge, white sacks full of quartz - I mean, everything from, like, powdery stuff to, like, little, tiny pebbles.
DAVIS: It's about 30 million pounds of quartz a month, so about a million pounds a day.
GREENFIELDBOYCE: A million pounds of quartz a day.
SOFIA: So we haven't moved into the actual cutting phase of the countertops yet. This is just the manufacturing. But obviously, dust is involved in this, too.
GREENFIELDBOYCE: Right, 'cause they're using the stuff to make the materials. And so Marty told me his factory has millions of dollars' worth of air-handling systems to control dust.
DAVIS: There's no good dust - zero.
SOFIA: So this dust is silica dust. Tell me what silica is exactly.
GREENFIELDBOYCE: Well, silica is what makes up most of the Earth's crust. You know, it's like rocks and quartz. I mean, quartz is just a form of silica. And what's worrisome in terms of health are tiny microscopic bits of silica that can be inhaled deep into the lungs. So at Marty's factory, you know, we had to put on these white disposable respirators. And, you know, they have signs warning of silica. And then you go into this huge room filled with big mixers. That's where the quartz gets combined with pigments and a binder that makes it all kind of stick together. And it gets spread out onto a giant baking sheet. Then it goes through this machine that kind of vibrates and thumps it. And the result is a compressed slab that's sort of soft.
DAVIS: You can touch it and feel how it is right now.
GREENFIELDBOYCE: It feels like cookie dough almost.
DAVIS: Yeah. That's exactly what it is.
GREENFIELDBOYCE: So when it gets heated, the slab hardens. And then it cools down, and they polish it up. And we walked past rows and rows of these things, these big colorful slabs, and they're all ready to be sent out to countertop makers, which will cut them to fit customers' kitchens and potentially generate dust. So my question to Marty Davis was this. What responsibility does a manufacturer like him have for making sure that people cut all this material safely?
DAVIS: You know, how do you police your customers?
SOFIA: So he's kind of saying, like, they're making it, but they can't really force countertop makers to cut it safely.
GREENFIELDBOYCE: Yeah. He says they have thousands of customers.
GREENFIELDBOYCE: It's going to thousands of shops.
SOFIA: Right. But something about this that I was surprised by now is that silica and silicosis and the danger of working with this stuff is not a new thing.
GREENFIELDBOYCE: No. It's, like, one of the oldest known occupational hazards.
GREENFIELDBOYCE: So, like, stone cutters and stuff throughout history...
GREENFIELDBOYCE: ...Have been known to get lung disease, and there've been regulations and guidance on the books for decades. I mean, there was this movie made in the 1930s called "Stop Silicosis." And basically, people have known for a long time that anytime you cut through rock or demolish brick or concrete, you can be exposed to silica dust.
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UNIDENTIFIED PERSON: A wave of fear was sweeping the country. Silicosis was taking its toll from the ranks of American workers. Cause of the disease - dust. The results of the disease - disablement, poverty, death.
SOFIA: OK. So I'm listening to this old-timey silicosis tape. It seems like this has been around for a long time. Why are we suddenly hearing about it in the countertop industry?
GREENFIELDBOYCE: So that's an interesting question. Public health workers believe it could be because this quartz, this sort of composite stone which has this higher silica content...
GREENFIELDBOYCE: ...You know, about twice as much silica as natural granite - has really taken off in the last decade. And it's become more and more popular.
SOFIA: Can I just say I watch HGTV, and they're constantly pushing quartz. They're like, it's less expensive. It's just as strong. But I'm telling you, like, when I heard the story, it was like, wow. I have heard this over and over again on those shows.
GREENFIELDBOYCE: Well, there's a lot of people working in this industry now.
SOFIA: Right, yeah.
GREENFIELDBOYCE: You know, there's an estimated hundred thousand people in the United States working in the countertop industry. And the concern is that, look. You know, these people are now cutting through material that has really, really high silica content. And they are quickly coming down with severe disease - disease, I should add, that is entirely preventable
SOFIA: Right, right.
GREENFIELDBOYCE: I mean, you just control the dust, and people do not get silicosis. And you can find countertop businesses out there that are doing things the right way. So for example, I visited Capitol Granite near Richmond, Va. And Paul Menninger is the owner. And he showed me around, and we watched these big, computer-controlled machines cutting through slabs. And as they did, they were dumping up to 35 gallons of water a minute on the blade...
GREENFIELDBOYCE: ...To keep down the dust.
PAUL MENNINGER: We do not do it any dry work whatsoever. That's the only way that you can eliminate any risk affiliated with silicosis in the shop.
GREENFIELDBOYCE: So, you know, you look around his business, and machine operators and folks doing touch-ups with hand-held tools - I mean, they were not wearing masks or respirators. And that's because he knows the air in there is OK. He had the Occupational Safety and Health Administration come in and do tests. But he told me there's a lot of shops and, you know, outlets, especially smaller operations that the Occupational Safety and Health Administration, OSHA, never gets to. And the stone cutting industry is basically unlicensed.
MENNINGER: It's not like plumbing or electrical or HVAC or any of the other trades, whereby there seems to be a standard or an international code.
SOFIA: OK. So without these regulations, there are people that are cutting these countertops who don't have all this advanced equipment for their employees, who just cut it kind of dry. And the dust gets everywhere, and it's really dangerous.
GREENFIELDBOYCE: Exactly. Like the experience of one of the workers we heard from earlier, Juan. So he's from Washington state, and he spent about four years cutting countertops. He told me they did a lot of quartz.
JUAN: (Through interpreter) Well, in the company where we worked, we cut a lot. We had a lot of production. A lot of us worked there. We cut about 30 to 40 slabs a day.
GREENFIELDBOYCE: He says he wore a simple face mask that didn't provide enough protection and that no one told him about silica or the danger. So in 2016, he got this bad cough that just wouldn't go away. And when he went to the doctor, he insisted on tests to check his lungs, even though the doctor was like, oh, you don't really need these.
JUAN: (Through interpreter) When he did the tests, the doctor almost cried. He says, I'm sorry. You're right. Your lungs are very damaged.
MENNINGER: So he's 38 years old. He's got a wife and three kids, and he's exhausted just walking from his house to his car. I mean, he can't even carry in groceries.
JUAN: (Through interpreter) After this happened, they made lots of changes in the company. Now they don't cut like they used to. They bought a lot of machines, and the machines do most of the work.
SOFIA: OK. So now what needs to change for this to basically stop happening?
GREENFIELDBOYCE: So that is the question.
GREENFIELDBOYCE: A lot of people point to OSHA, that safety agency - the workplace safety agency at the Department of Labor, and they say it needs to do more workplace inspections and enforcement. But, you know, that agency has a pretty limited budget.
GREENFIELDBOYCE: And it's in charge of, like, all workplaces all over the country, not just countertop makers. Now, you know, workers can always make complaints.
GREENFIELDBOYCE: Like, inspectors will go in if workers make complaints, but you may have noticed that it seems to be mainly affecting Hispanic or Latino workers.
GREENFIELDBOYCE: And, you know, there's concerns that there may be language differences. If there's any issues with documentation of, you know, immigration status...
GREENFIELDBOYCE: ...Right? - they may not want to speak up.
SOFIA: 'Cause you could imagine that there are more people out there that just haven't been found.
GREENFIELDBOYCE: That's right.
GREENFIELDBOYCE: So, you know, how to get the word out and how to, you know, really understand the extent of the problem here is really uncertain right now.
SOFIA: Is there anything that you, as a consumer, can do to kind of try to make sure that you're getting a countertop from a place that doesn't do just, you know, like, dry cutting only.
GREENFIELDBOYCE: I mean, I think just being aware that this is a potential issue and just having it in the back of your mind is something you can ask about.
GREENFIELDBOYCE: Like, you know, a lot of times people are only interested in, like, price per square foot.
GREENFIELDBOYCE: Right? These are not cheap countertops...
GREENFIELDBOYCE: ...Right? You have choices about who produces these things for you. And it's worth asking some questions about, like, exactly what their processes are and how they know that they're doing it safely.
SOFIA: All right, NPR's Nell Greenfieldboyce.
Thank you, Nell.
GREENFIELDBOYCE: Thank you.
SOFIA: I'm Maddie Sofia, and we're back tomorrow with more SHORT WAVE from NPR.
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