California Regulators to Vote on Emergency Rules for Stonecutters' Safety

Jorge Estrella Moreno remembers the day he arrived at the studio apartment he shares with his wife and collapsed on the bed, weighed down by sadness and worry.

His wife asked him what was wrong. “I have bad news,” he recalled telling her as he cried.

That day nearly a year ago, a doctor had diagnosed him with silicosis, an often fatal lung disease. Estrella Moreno, who lives in San Francisco, had unknowingly inhaled toxic silica dust for years while power-cutting slabs of engineered stone to make kitchen countertops and floor panelings.

His lungs were irreversibly damaged, he remembers the doctor saying. There was no cure.

“It felt like my world fell apart,” the 48-year-old father of three told KQED in Spanish. “It’s very sad to live with this disease because I’m alive today, but tomorrow, who knows? And my family still needs me.”

On Thursday, a California occupational safety board is set to vote on approving new emergency regulations to protect countertop fabrication workers handling engineered stone, a factory-made product that can have a much higher silica content than natural stone. The material has been linked to an accelerated and more aggressive form of silicosis with a fatality rate of 19% in the industry, according to state workplace regulators.

Medical professionals have known the health risks of inhaling silica dust for centuries. Silica is a mineral found in the earth’s crust. Cutting granite, sandstone and other stones releases crystalline silica into the air. When inhaled, tiny particles can get lodged in the lungs and, over decades, lead to scarring and difficulty breathing.

But artificial stone, a popular and relatively new material in the U.S. market, is uniquely hazardous to stonecutters because it may contain more than 93% silica, according to officials with the California Division of Occupational Safety and Health, or Cal/OSHA.

Dozens of young to middle-aged countertop fabrication workers in California, overwhelmingly Latino immigrants, have been disabled or killed by the disease in recent years. Some died while awaiting lung transplants. Others must rely on oxygen machines, including a 27-year-old man featured in a KQED story in July.

Nationwide, 165 people died from silicosis between 2018 and 2021, said Nick Spinelli, a spokesperson for the Centers for Disease Control and Prevention, though the data is not specific to the countertop fabrication industry.

There were no silicosis cases associated with artificial stone recorded before 2010 in California, according to the state’s Department of Public Health. However, the agency identified 93 stone workers who had contracted the disease in the last five years. As of Nov. 30, at least 10 had died.

Hundreds more are expected to be diagnosed with silicosis if harmful exposures continue. That’s partly because most of the roughly 800 stone fabrication shops in California are small and often don’t have the capacity to comply with existing safety regulations, Cal/OSHA officials said. The agency is now working to streamline and strengthen rules to stall the risk of silica exposure, which can also cause lung cancer.

“It’s a public health disaster,” said Dr. Sheiphali Gandhi, an occupational pulmonologist at UCSF who participated in a Cal/OSHA advisory committee to bolster existing silica standards. “We will keep seeing patients because a lot of people have already been exposed. So I think that, really, we are looking to improve things like five to 10 years down the road.”

The emergency regulations, if approved by the Occupational Safety and Health Standards Board, would restrict the dry cutting of artificial stone with more than 0.1% crystalline silica and natural stone that contains more than 10%. Tasks such as power cutting or drilling would require the use of wet-cutting saws or other tools that cover a material’s surface with water to suppress the dust. Employers would also be required to provide workers with powered air-purifying respirators or other highly protective masks.

Current rules say employers must first complete sophisticated air monitoring of permissible silica levels before determining required protective steps.

“The fact that we’re actually defining high risk based on the type of work rather than the air monitoring is a huge step in the right direction,” said Gandhi, who has diagnosed several silicosis patients, including Estrella Moreno. “Ideally, the best thing is to eliminate the toxic substance altogether. But if we are working with it, how can we do it safely?”

Estrella Moreno began working as a stonecutter in San Francisco shortly after immigrating from Mexico more than two decades ago. He liked using his hands to carve stone and install projects in kitchens and living rooms.

At his home in the Lower Nob Hill neighborhood, Estrella Moreno’s eyes lit up as he pointed to the smooth stone tables he had made. He proudly pulled up photographs on his phone of modern chimney panels and kitchen countertops he had also crafted.

It’s an “honest job” that allowed him to raise his three kids in the U.S., he said, even though he doesn’t know how to read and write. His parents never sent him to school as a child. Even before Estrella Moreno was orphaned by age 11, he worked in agricultural fields sowing corn and other crops in Michoacan. He’s provided for himself ever since.

“One comes to this country to support one’s family, to get ahead. Unfortunately, this turned out to be a dangerous job,” Estrella Moreno said before burying his head in his hands.

Silicosis makes him feel like he’s asphyxiating when walking uphill. Talking requires loud breaths in between words. Exertion can make him dizzy, Estrella Moreno said. His family has been warned that he might need an oxygen machine or a lung transplant as the disease progresses.

Yet, Estrella Moreno has refused to quit his job as a stonecutter, where he earns about $28 an hour.

“I have no other option. I have to work to support my family and pay rent,” said Estrella Moreno, adding that one of his sons is struggling with mental illness and can’t work. He needs money to pay for his son’s care.

Estrella Moreno’s eldest daughter, Rosa Estrella, told KQED she has pleaded with her father to stop working. A medical assistant, she said she has watched in anguish as her dad can no longer do things they enjoyed together, like a carefree walk in the park.

She said she wanted to save money to pay for college and eventually become a nurse. Instead, she is looking for a second job to help her parents.

“I have to think of them first,” Rosa Estrella, 29, said. “It’s so hard to be in this situation and watch my dad go through this and struggle so much.”

Artificial stone workers in Israel, Spain, Australia and other countries have contracted a rapid onset of silicosis, which can start developing after only a few months of very high exposure.

In Australia, occupational safety authorities recently recommended a national ban on using all engineered stone, including newer products manufacturers have developed with 50% or less silica content.

Cal/OSHA officials warned that if widespread non-compliance with safety rules continues, the state should also develop plans to prohibit the use of engineered stone products, something major manufacturers and distributors vehemently oppose.

Public health officials in Los Angeles County, the state’s silicosis epicenter, recently concluded that a local ban, which would only apply to the county’s unincorporated areas, could help protect workers and encourage safer alternatives.

Major artificial stone manufacturers maintain the material is being handled safely when appropriate measures, such as wet cutting and ventilation, are followed and that a ban would unnecessarily kill jobs.

“Silicosis is entirely preventable,” said Eric Rose, a spokesman with the Stone Coalition, which represents manufacturers, distributors and fabricators. “Any contractor that follows Cal/OSHA’s guidelines ensures that any product cutting is done safely and with little risk to workers. Almost all experts agree that what is being cut matters less than how the stone is cut.”

Top manufacturers, such as Cosentino, a company based in Spain, and the Israel-based Caesarstone, have told California regulators that they support creating a licensing program to sell engineered stone slabs only to fabrication businesses equipped to handle them safely.

Engineered stone, also known as quartz, is made of crushed stone bonded with adhesives and resins compacted into slabs in factories. Demand for it skyrocketed in the U.S. over the last decade, becoming the top countertop material with a market size of $17.7 billion, according to a Cal/OSHA review.

Consumers prefer it because it’s usually cheaper than natural stones such as marble. Its nonporous surface makes it easy to clean and difficult to stain, and it comes in a variety of colors and patterns.

Estrella Moreno said he first cut engineered stone slabs in 2007. But he said he didn’t know until his diagnosis about the risk of inhaling the fine dust clouds as he worked. He said he wore an N95 mask, but those are less efficient at filtering silica particles than other respirators.

Estrella Moreno blames the manufacturers and suppliers of engineered stone that he and his wife have sued for damages. Almost 60 fabrication workers with silicosis in California are also suing, according to James Nevin, an attorney for Estrella Moreno and other plaintiffs.

The lawsuits allege that the largest manufacturers — Caesarstone, Cosentino and Cambria, which is based in the U.S. — failed to adequately label and warn of the hazards of their products and didn’t issue effective instructions on how to use them safely.

“These companies knew they were selling a deadly product that was going to kill workers who have to fabricate it before it gets to the consumer,” Nevin said. “If there’s not a more clear case for a lawsuit, I don’t know what is.”

Maria Valencia, Estrella Moreno’s wife, said she and her husband hope that by speaking up, they help prevent others from going through the suffering their family is experiencing.

“The companies that are producing those materials that are so toxic, that have so much silica, they just want to enrich themselves at the expense of so many people they are going to kill,” said Valencia, 49, who works as a manager at a fast food restaurant. “For me, it’s an injustice that they are putting people in that risk. It’s inhumane.”

Caesarstone, Cosentino and Cambria declined to comment on the lawsuits.

Earlier this year, the owner of Cosentino admitted negligence in a Spanish court for hiding the health risks of one of its best-selling artificial stone products, which allegedly led to nearly 1,900 workers developing silicosis. He agreed to pay 1.1 million euros to five stonemasons, one of whom had died and was given a six-month suspended sentence as part of a plea deal.

In the Bay Area, the father and son duo, who run a well-established stone fabrication facility in Santa Clara, are also calling for solutions, including a more regulated distribution market, stricter enforcement, and the sale of engineered stone products developed with a lower silica content.

Manny De Oliveira, who founded United Marble & Granite Inc. in 1998, and his son, Shawn, lamented what they described as a proliferation of slab yards and stone distributors along nearby highways that sell engineered stone to “anyone with a credit card.” That’s led to “poor guys that don’t even speak English that get taken advantage of” laboring in the back of a truck or store “with just a T-shirt pulled up to cover their nose,” said De Oliveira, 67.

The De Oliveiras estimate that a small fabrication shop, with just two or three workers, would need to invest hundreds of thousands of dollars in basic equipment and other measures to keep workers safe.

On a recent visit to the company’s cavernous workspace, a KQED reporter observed employees in hardhats operating large robotic saws neatly slicing stone slabs layered in water from a computer screen. Others held smaller tools, releasing a water flow as they cut pieces. And in a blocked-off area, two workers wearing white industrial coveralls and powered air-purifying respirators finished the edges of a countertop as a ventilation system sucked dust into a duct with a running water curtain.

“If you go to a lot of other shops, you’ll see this activity without the machines, without the suit. That’s the problem — guys are working dry without engineering controls, the equipment or protection,” Shawn De Oliveira, 42, said. “Everybody wants to be a fabricator, but nobody wants to do the safety part because it’s expensive. And the customer doesn’t even know what’s going on.”