The California Department of Public Health (CDPH) Occupational Health Branch launched its Engineered Stone (ES) Silicosis Surveillance Dashboard to track a disease that was barely on the radar in the U.S. seven years ago. As of May 15, 2026, it shows 560 confirmed cases. In 2019, there were 13. The workers getting sick are predominantly young Latino men, most of them employed in countertop fabrication shops where cutting, grinding, and polishing engineered stone generates silica dust at concentrations the material's composition makes almost impossible to control without strict engineering controls. Engineered stone, commonly sold as quartz countertops, can contain 93% or more crystalline silica.
The dashboard pulls from multiple data sources: statewide hospital records, voluntary reporting by healthcare providers and community members, public health follow-up from mandated medical testing after workplace investigations, and doctors' reports of occupational illness. Data is updated weekly. The confirmed case count carries a caveat the dashboard itself acknowledges: the real number is almost certainly higher, because silicosis is underdiagnosed, workers with exposures are not always connected to the healthcare system, and not all cases reach the reporting mechanisms the dashboard aggregates.
What the Confirmed Cases Show About Disease Severity and Geographic Concentration
The median age at diagnosis is 46. The median age at death is 48. Of the 243 confirmed engineered stone cases documented through 2024 in peer-reviewed surveillance research, 25% were referred for lung transplant and 12% received one. At least 31 California workers are known to have died. Los Angeles County accounts for 288 of the confirmed cases, with Orange County at 240 and San Diego at 52. Silicosis became a reportable disease in California in June 2025, a designation that is expected to improve case identification going forward but does not retroactively capture the workers who were already sick before the reporting requirement existed.
Cal/OSHA's Permanent Silica Standard and the STOP Act
California's Division of Occupational Safety and Health (Cal/OSHA) made its emergency temporary silica standard permanent in December 2024, covering all operations involving engineered stone with more than 0.1% crystalline silica. The permanent standard prohibits dry cutting and dry sweeping, requires wet methods during high-exposure tasks, mandates respiratory protection, and gives inspectors authority to immediately shut down operations if they observe imminent hazards. In January 2026, an NPR investigation found that Cal/OSHA inspections of more than 100 fabrication shops found no workers using the appropriate level of respiratory protection during high-risk tasks, and roughly 25% of shops were still dry-cutting stone.
The Silicosis Training, Outreach, and Prevention (STOP) Act goes further. Starting July 1, 2027, fabrication shops must hold a valid three-year certification to legally operate. Employers are also now required to report confirmed silicosis cases to both Cal/OSHA and CDPH within five days of identification. Australia banned engineered stone outright in July 2024. California has stopped short of a ban, focusing instead on fabrication practices rather than the product itself.
