Episode 3: Understanding Silicosis

Episode 3: Understanding Silicosis

From Dust to Verdict is a podcast dedicated to the new epidemic of accelerated silicosis in artificial stone countertop fabrication workers hosted by James Nevin, a partner at Brayton Purcell LLP. 

In this episode, we dive deep into silicosis, the world’s oldest known occupational disease. From the slaves who built the Egyptian pyramids to 20th-century laborers at the Hawks Nest tunnel, and now to modern-day artificial stone fabrication workers—this preventable disease has devastated countless lives over millennia.

We trace the timeline of silicosis, starting with its early recognition, leading up to a surge of cases in Israel in the late 1990s allegedly tied to artificial stone fabrication. Fast forward to the U.S. in 2024, and we're facing a disturbing epidemic. The California Department of Public Health reports over 330 confirmed cases of accelerated silicosis in artificial stone workers, with dozens needing lung transplants—and many dying waiting for one.

What makes artificial stone especially dangerous to fabricators is its ultra-high silica content (up to 95%) and its nano-sized, toxin-coated particles. When these are inhaled, they scar the lungs’ air sacs, making breathing difficult at first and, with continued exposure, impossible without oxygen supplementation.

Listeners will learn how Respirable Crystalline Silica (RCS) from artificial stone causes damage more aggressively than natural stone. Silicosis is progressive and comes in stages—starting with lymph node silicosis, then simple silicosis, and finally complex silicosis or progressive massive fibrosis (PMF). Many workers exposed to artificial stone move through these stages rapidly, developing severe disease within just a few years or even months.

We explain the limitations of current treatment options. Lung transplants, often seen as a last resort, are not cures—they extend life temporarily, but are inaccessible to many due to strict eligibility, organ shortages, and complex post-surgery medication requirements.

The episode concludes with an alarming discussion of disease prevalence: peer-reviewed studies show silicosis rates in fabrication workers range from 11% to over 50%, with some estimates—including our own data—indicating up to 80% of workers may be affected.

Silicosis isn’t the only concern for artificial stone workers. Artificial stone silica exposure is also linked to lung cancer, COPD, chronic kidney disease, autoimmune disorders like rheumatoid arthritis, and other life-altering diseases like tuberculosis and sarcoidosis.

Silicosis is not a relic of the past. It's a modern crisis affecting artificial stone fabrication workers around the world.