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prohibit the use of AS containing silica, paired with expanded compensation, mandatory case reporting, and enhanced health and safety regulatory enforcement.
Prevention of AS Silicosis
Prevention of AS silicosis requires action across many domains, including those of the workplace, clinic, regulator, public health authority, and research laboratory. Measures to prevent silicosis should be developed according to the Hierarchy of Controls, beginning with elimination and substitution, followed by engineering controls, administrative measures, and, lastly, the use of personal protective equipment. See Box 2 for all recommendations. In accordance with the ILO and GPES, the goal should not be incremental reductions in risk but prevention of all cases. Widespread stakeholder engagement is essential for developing and enacting measures to protect workers, involving governments, industry, trade unions, consumers, health professionals, and researchers. Worker participation, however, must remain central, ensuring that those most affected have a voice in shaping prevention strategies.
Box 2. Committee Recommendations
• Prevention o Phase out of the manufacture of crystalline silica-containing artificial stone products o Strict adherence to and enforcement of occupational exposure limits o Prohibition of dry cutting of artificial stone products o Respirators that are properly selected, fitted, used, and maintained o Employer and worker education
• Surveillance o Widely accessible active screening for all current / former artificial stone workers that includes chest imaging, preferably computed tomography o Mandatory disease reporting o Improved public health infrastructure around disease reporting
• Worker / patient support o Accessible medical care o Improve access and coverage to workers’ compensation o Implementation of job retraining
• Coordinated action globally o Convening of a global task force under the International Labour Organization( ILO) or
World Health Organization( WHO)
Exposures during countertop fabrication routinely exceed regulatory limits, even with wet methods and ventilation. The toxicity of AS dust outstrips the capacity of current engineering controls, which remain both technically insufficient and financially inaccessible for small shops. Respirator use introduces further challenges, including vision and communication obstacles with full-facepiece respirators and heat stress during prolonged use. Taken together, these realities underscore that existing strategies are inadequate to protect workers from this highly hazardous exposure. There also needs to be further understanding of exposure risks and disease prevalence within manufacturing facilities.
Countries should phase out AS products containing crystalline silica and support industries to transition to safe alternatives. In response to the ongoing global outbreak of AS silicosis, the AS industry has begun developing and marketing products with considerably lower RCS content than the > 90 % RCS often associated
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