Finding of Emergency Section 5204 , Occupational Exposures to Respirable Crystalline Silica Business Meeting : December 14 , 2023 Page 9 of 36
diagnosed with bacterial pneumonia or tuberculosis . Only 7 % of workers with silicosis in the artificial stone countertop industry received workers compensation .
These workers live with significant economic insecurity : there is no evidence to suggest that they are represented by a labor union . They face the possibility of retaliation if they report workplace hazards to California Division of Occupational Safety and Health ( Cal / OSHA ) or file workers ’ compensation claims . 32 , 33 They have little ability to advocate with their employer for workplace improvements , including in preventing exposure to RCS .
10 ) The dust from artificial stone dust is uniquely hazardous , compared to natural stone .
A 2020 epidemiological study by Na Wu , et al . reported on 18 patients with artificial stoneassociated silicosis and 63 with natural stone-associated silicosis . 34 The median duration of exposure prior to the onset of symptoms of silicosis was about six years for patients who had been exposed to artificial stone dust versus about 30 years for onset of symptoms for patients who had been exposed to natural stone , a five-fold difference . Four of the 18 patients ( 22 %) exposed to artificial stone experienced rapid deterioration in lung function over the follow-up period of just six to 12 months . About 40 % of the patients with artificial stone-associated silicosis were in need of lung transplants , and 28 % died , whereas about 3 % of natural stoneassociated silicosis cases needed lung transplants , and none died . The investigators concluded that , compared to natural stone-associated silicosis , artificial stone-associated silicosis was characterized by short disease latency , rapid radiological progression , accelerated decline in lung function and high mortality .
In a 2020 epidemiological study by Antonio León-Jiménez , et al ., investigators followed 106 workers with advanced silicosis that had resulted from exposure to dust generated during the manufacture and installation of artificial stone countertops . 35 All patients were removed from exposure ; however , one-third of workers with simple pneumoconiosis advanced to progressive massive fibrosis after an average of only four years . The proportion of workers with abnormal spirometry also increased from one-quarter to nearly one-half of all workers over the same time period . These high rates of disease progression are in contrast to the lower rate seen in
32
Moyce SC , Schenker M . Occupational exposures and health outcomes among immigrants in the USA . Curr Environ Health Rep ( 2017 ); 4:349 – 54 . https :// pubmed . ncbi . nlm . nih . gov / 28812286 /. Accessed May 8 , 2023 .
33
Rose C , et al ( 2019 ). Severe silicosis in engineered stone . op . cit . https :// www . cdc . gov / mmwr / volumes / 68 / wr / mm6838a1 . htm .
34
Wu N , et al . Artificial stone-associated silicosis in China : A prospective comparison with natural stone-associated silicosis . Respirology ( 2020 ) 25 , 518 – 524 . https :// www . ncbi . nlm . nih . gov / pmc / articles / PMC7187561 /. Accessed August 16 , 2023 .
35
León-Jiménez A , et al . Artificial stone silicosis : rapid progression after exposure cessation . Chest ( 2020 ); 158 ( 3 ): 1060-1068 . https :// pubmed . ncbi . nlm . nih . gov / 32563682 /. Accessed August 16 , 2023 .