A new epidemic of an ancient disease

We have all become very aware and frankly tired of epidemics and pandemics - Covid beginning in 2019 and ongoing to this very day, now being joined by Monkeypox. Pandemics of infectious disease are notorious and receive worldwide attention and funding, but there are other epidemics and pandemics as well, including occupational disease epidemics. Simultaneous with Covid, but receiving relatively little attention, is a resurgence of an ancient epidemic - silicosis.

Silicosis is a fibrotic lung disease that results from the inhalation of respirable particles of crystalline silica. Silicon is the second most abundant element on Earth, after oxygen. The health risks associated with exposure to crystalline silica dust have been known to the stone industry for millenia. Evidence of silicosis dates back to ancient Egypt and Greece. Stonecutters, builders and masons all exhibited signs of silicosis, as they were the workers who built the ancient cities.

In 1556, Agricola wrote a treatise on mining in which he described a lung disease afflicting stonecutters and miners. In 1700, Bernardino Ramazzini, the “father of occupational medicine,” identified silicosis in stone cutters by observing a “sand-like” substance in their autopsied lungs.

In the early 1900s, Dr. Alice Hamilton documented silica related illnesses among granite workers in Vermont. In 1917, the U.S. Public Health Service called attention to the prevalence of silicosis in foundry workers. In 1918, the U.S. government published a study reporting that the industry with the greatest hazard of silica dust inhalation and disease was the abrasive industry.

By the early 1930s, industrial journals and periodicals were replete with articles discussing hazards of silica, especially as it related to sandblasting. By the mid-1930s it was well known to industry that silicosis is an occupational disease caused by the inhalation of tiny particles of quartz dust in the lungs. In 1937, the U.S. Department of Labor hosted a National Silicosis Conference.

During the great depression in the early 1930s, a three-mile-long diversion tunnel was dug through Gauley Mountain to reach the New River to construct a hydroelectric power dam. The only dust control used was a 2-hour period to let the dust settle after blasting through the rock. Of the 1200 men who worked underground for just two months, 760 died within 5 years, with 2000 eventually dying from silicosis. This debacle (called the Hawk’s Nest disaster), prompted a Congressional call to action and in 1938 the Secretary of Labor initiated a campaign to “Stop Silicosis.”

From 1968 to 2002, silicosis was recorded as the underlying or contributing cause of death on approximately 74 million U.S. death certificates. Of these deaths, 98% were among men.

In 1996, the Secretary of Labor began a new campaign to encourage safer work practices called “It’s Not Just Dust,” and initiated a special program to “reduce and eliminate the workplace incidence of silicosis from exposure to crystalline silica.” In addition, the Occupational Safety and Health Administration (OSHA), the National Institute for Occupational Safety and Health (NIOSH), and the American Lung Association held a conference called “The Campaign to End Silicosis.”

In 2007, OSHA estimated that more than two million employees are exposed to silica in general industry, construction, and maritime industry. NIOSH acknowledges that an unknown number of the 3.7 million workers in 2002 engaged in agriculture had exposure to silica from dust-generating activities. According to the U.S. Bureau of Mines, silica is present in nearly all mining operations.

It was not until 2011 that OSHA’s proposed guidelines made it to the Office of Management and Budget (OMB), and wasn’t until 2013 and after a group of congressmen sent a letter urging the OMB to “take prompt action” that the rulemaking was listed on OSHA’s regulatory agenda. Finally, on March 24, 2016, after more public hearings, debates and reviews, OSHA announced its final rule to protect workers from respiratory exposure to crystalline silica dust. In 2017, OSHA’s new silica regulations became effective for the construction industry. In 2018, OSHA extended its regulations to maritime industries and in 2021, the regulations became effective as to the oil and gas industry to address the hazard of silica exposure from hydraulic fracturing.

Meanwhile, a new silicosis epidemic emerged contemporaneously with Covid. In about 2010, a new silica-containing product began to be widely used throughout the world - synthetic stone. While granite contains about 30% silica and natural marble contains only about 3% silica, synthetic stone contains upwards of 90% silica! Synthetic stone also creates more dust when it is cut and polished. The result is a new pandemic of silicosis among workers exposed to synthetic stone used to make countertops in our kitchens and bathrooms. The workers who are so exposed include “cutters” who cut large slabs of synthetic stone to size, “fabricators” who cut holes for faucets, detergent dispensers, and water returns in countertops and who edge fabricated countertops, and “installers” who cut holes for electrical outlets and install and polish the finished product in homes.

In September 2019 – about the same time that the Covid epidemic began in China – the Centers for Disease Control (CDC) published a study regarding a silicosis epidemic among synthetic stone fabrication workers in California, Colorado, Texas and Washington, documenting 18 cases of silicosis among synthetic stone fabricators in these states. In 2020 and 2021, approximately 30 additional studies regarding this new occupational epidemic were published throughout the world, documenting a new pandemic - the most recent of a centuries-long series of silicosis epidemics.

Covid has afflicted millions of people and silicosis from occupational exposure to synthetic stone dust is now afflicting tens of thousands of workers worldwide. While the misery of pandemics never ends, unlike Covid victims who rarely have legal remedies, synthetic stone workers do have legal remedies for their respiratory diseases in civil cases that are now being brought against the manufacturers and suppliers of these deadly products under traditional products liability theories.