2026年3月12日 / 美国东部时间凌晨5:00 / KFF健康新闻
37岁的塞萨尔·曼努埃尔·冈萨雷斯（César Manuel González）曾加工过一种经过特殊设计的石材：密度高、抛光的板材，旨在比安装它们的厨房更耐用。
人造石英台面在家庭装修市场中迅速流行，行业分析师估计全球人造石材市场规模约为300亿美元。随着石英表面在美国和全球范围内取代天然石材，这一市场仍在持续扩张。
冈萨雷斯工作时，切割石材产生的粉尘看起来并无异常。粉尘落在他的衣服上、头发里，以及整个车间的地面上。在一家小型台面加工厂，他先切割大理石和花岗岩，2008-09年经济衰退后，由于对廉价石英台面的需求激增，他转而加工人造石材。
但在切割和打磨人造石材时释放的结晶二氧化硅同样进入了他的肺部，造成不可逆的肺部瘢痕。最初的呼吸急促逐渐发展为矽肺病，一种会使肺部硬化的不可逆疾病，即使日常活动也变得异常艰难。
肺移植是他唯一的出路。虽然手术能延长生存期，但也重新定义了他的生活边界：每天服用抗排斥药物、持续监测、易受感染，以及意识到呼吸依赖于他人捐赠器官的脆弱接受。
医生和公共卫生官员表示，2023年被诊断出矽肺病的冈萨雷斯并非个例。这种曾被认为与矿工长期职业生涯相关的疾病，如今在年龄更小的工人（多为西班牙裔男性）中更为普遍。
图片说明： 一名石材台面加工者在佩戴口罩以保护免受空气传播颗粒（可能导致矽肺病）影响的情况下，在加利福尼亚州太阳谷的一家店铺中产生粉尘云。Brian van der Brug / 洛杉矶时报 / 盖蒂图片社
在美国，从加利福尼亚到德克萨斯、佛罗里达和东北部的台面加工厂中均出现病例。由于矽肺病并非全国法定报告疾病，各州监测情况不一，因此缺乏全面的全国统计数据。但治疗职业病的临床医生表示，过去十年中，在切割人造石材后被诊断出矽肺病的工人数量（多为30-40岁男性）急剧增加。
截至2026年3月初，加利福尼亚州自2019年以来已确认519例与人造石材相关的矽肺病病例，造成29人死亡。诊断时的中位年龄为46岁，死亡时为49岁。
医生们一致认为，加工人造石材会导致肺部瘢痕化。然而，制造商辩称，适当的通风、湿法切割和呼吸器可以确保加工安全。工人、医生和原告律师则反驳称，这种几乎完全由结晶二氧化硅组成的材料在大规模加工时无法安全处理。
“这类似于烟草行业声称香烟是安全的，”奥巴马政府劳工部副部长、前职业安全与健康管理局（OSHA）局长戴维·米切尔博士（Dr. David Michaels）表示。
已有超过370起诉讼由工人提起，他们指控人造石材制造商未就风险发出警告，或销售无法安全加工的产品。与此同时，国会议员正在考虑一项法案，该法案将在很大程度上免除制造商在这些案件中的民事责任，这将使一场工作场所健康危机演变为关于监管、责任和民事诉讼限度的全国性辩论。
36岁的古斯塔沃·雷耶斯（Gustavo Reyes）也卷入这场辩论。与冈萨雷斯类似，他职业生涯初期切割大理石和花岗岩，后来转向加工人造石材——一种含硅量高达95%的石英基材料，切割时产生的危险粉尘远多于天然石材。
他表示，在车间中，切割时使用水来控制粉尘，但打磨和塑形等精加工环节仍会产生大量粉尘。他佩戴一次性呼吸器或带过滤器的可重复使用弹性呼吸器，车间保持门开着，上方安装风扇通风。
2021年被诊断出矽肺病时，他并不了解这种疾病的含义。医生告诉他，目前尚无药物治疗，他可能只剩3-5年寿命。2023年，他接受了肺移植手术。
当被问及责任归属时，雷耶斯回答：“是那些制造人造石材的行业和产品。”制造商则否认这一说法。主要公司称，当雇主遵守OSHA的粉尘控制标准（包括湿法切割、通风和呼吸器使用）时，人造石材加工是安全的。
古老疾病，重塑登场
矽肺病并非新病，它曾与采矿灾难和喷砂作业紧密相关，最臭名昭著的是1930年代初西弗吉尼亚州霍克斯巢隧道悲剧：数百名工人在未受保护的情况下暴露于高硅岩粉尘中数月，引发急性矽肺病。1938年，劳工部长弗朗西丝·珀金斯（Frances Perkins）指出，如果认真实施粉尘控制，该疾病是可以预防的。
图片说明： 2016年的档案照片中，一名医生在X光片上指出矽肺病导致的肺部疾病。Themba Hadebe / 美联社
新的是疾病复发的行业背景。
人造石材（常被称为“石英”）通常由粉碎的石英与树脂和颜料粘合而成。与含硅量极低的大理石不同，人造板材含硅量极高。
切割改变了材料特性。
芝加哥职业与环境医学专家、西部分会职业与环境医学协会成员罗伯特·布林克博士（Dr. Robert Blink）解释道：“当你研磨或切割它时，你正在粉碎它。你正在‘武器化’二氧化硅。”
电动工具将表面分解为可吸入颗粒物，这些颗粒物小到足以深入肺部。反复接触会引发炎症和纤维化，一旦开始瘢痕化，便无法逆转。
如何识别矽肺病
在加利福尼亚州，医生们观察到这种疾病模式逐渐显现。
加州大学旧金山分校职业医学医生罗伯特·哈里森博士（Dr. Robert Harrison）在2019年帮助识别了加州首批人造石材矽肺病病例群——来自同一家台面加工厂的几名工人死亡或被诊断出该病。他将这场危机描述为“数十年来最大规模的矽肺病爆发”。当追溯工作史时，最初看似孤立的年轻男性不明原因肺瘢痕病例，最终被确认为可识别的职业流行病。
加州大学洛杉矶分校肺科医生简·法齐奥博士（Dr. Jane Fazio）回忆起曾为健康工人诊断出严重纤维化的病例：“他们有家庭，正常全职工作，”她说。部分患者在数年内出现呼吸衰竭。
医生对比工作史后，模式变得明确：许多男性曾在小型加工厂从事人造石材台面的切割和抛光工作。
图片说明： 2023年10月31日，加利福尼亚州太阳谷一家店铺内，一名石材台面加工者的手沾满粉尘。Brian van der Brug / 洛杉矶时报 / 盖蒂图片社
旧金山大学职业与环境肺科医生谢帕莉·甘地博士（Dr. Sheiphali Gandhi）警告称，实际患病情况可能更为严重：“我们遗漏了许多病例，目前尚无全国性监测系统。”
2025年，加州将矽肺病列为法定报告疾病。自2019年以来，全州监测已确认数百起与人造石材相关的病例。尽管数据可能低估了实际影响，但加州的监测系统使这种疾病的传播可见化。
加州以外地区尚无类似跟踪机制。
早期预警
加州并非首个出现此类问题的地区。
最早的现代警示来自以色列。1980年代末在基布兹创立的凯撒石公司（Caesarstone）推动了石英台面在全球的普及。
以色列医生早在1997年就开始记录年轻台面工人中出现的严重矽肺病病例。
“我们从未见过这样的情况，”退休肺科医生莫德查伊·克莱默博士（Dr. Mordechai Kramer）表示，他曾在以色列拉宾医疗中心工作。“典型矽肺病需要长期暴露（数十年），但这里的病例暴露时间短得多。”
一些患者需要肺移植。
尽管有这些警示信号，市场仍持续扩张。
澳大利亚在2010年代末也面临同样情况。
澳大利亚监管机构没有等待零星诊断，而是对人造石材工人开展基于CT的系统性筛查，发现疾病患病率远超预期。
莫纳什大学呼吸科医生兼职业健康研究员瑞安·霍伊博士（Dr. Ryan Hoy）描述了暴露时间相对较短的工人中出现的严重疾病。
当局调查了湿法切割、通风和呼吸器是否能充分降低暴露风险，最终得出结论：即使采取控制措施，高硅人造石材的加工仍存在不可接受的风险。
2024年，澳大利亚禁止生产、供应和安装含高结晶二氧化硅的人造石材。制造商转向低硅或零硅配方。
美国：责任归属
美国的人造石材加工仍遵循OSHA的二氧化硅标准，该标准依赖于暴露限值、湿法切割、通风和呼吸防护。制造商认为合规有效，问题在于未遵守规定的加工厂。
OSHA于1971年首次制定二氧化硅限值，当时的研究基于采矿、采石和铸造工作。尽管该机构在2016年更新了规则，但它对结晶二氧化硅进行广泛监管，未区分天然石材和高硅人造石英。
监管争议已延伸至国会。2025年9月，众议员汤姆·麦克林托克（R-Calif.）提出《石材板材产品合法商业保护法》，旨在大幅免除人造石材制造商和经销商因产品制造或销售引发的民事诉讼责任。麦克林托克办公室未回应置评请求。
该法案在2026年1月举行的众议院司法小组委员会听证会上成为焦点。
法案支持者认为，制造商不应为雇主未遵守OSHA标准导致的伤害负责。反对者警告称，取消诉讼压力将消除驱动产品改革的少数机制之一——如果材料本身无法安全处理的话。
前OSHA官员米切尔指出，诉讼推动变革：“看看石棉和烟草行业的历史就知道。”
原告律师则认为，遵守OSHA二氧化硅标准并不消除风险。
“这不是少数不良企业的问题，”已提起约200起矽肺病相关伤害案件并发起集体诉讼要求医疗监测的产品责任律师拉斐尔·梅茨格（Raphael Metzger）表示。他指出，问题在于产品成分，而非孤立的监管违规。
代表矽肺病工人的侵权律师詹姆斯·内文（James Nevin）将国会辩论描述为责任归属的斗争：“在因果关系方面，毫无疑问，”他认为，这波病例暴露出制造商寻求所谓“制造商救助”的原因。
2025年年中，凯撒石美国公司推出首款含硅量低于1%的产品。凯撒石发言人艾琳·威廉姆斯（Irene Williams）回应称：“公司不对此置评，因涉及未决诉讼。”
美国人造石材市场由少数大品牌主导——包括凯撒石、西班牙的Cosentino和美国的Cambria——同时亚洲制造商的板材进口量不断增长。
Cosentino也在转向低硅产品：“我们产品线的三分之一（包括大多数新系列）含结晶二氧化硅低于10%，”Cosentino发言人卡米拉·凯特斯（Kamela Kettles）表示。“Cosentino暂不提供更多评论。”
Cambria的沟通顾问马克·达菲（Mark Duffy）代表该公司回应称：“鲁莽雇主严重违法，让工人暴露在致命工作环境中。”他补充说，正确使用工程和管理控制措施可将暴露量降至OSHA限值以下，Cambria在其设施中保持暴露量低于OSHA行动水平。
虽然凯撒石和Cosentino总部位于海外，但Cambria位于明尼苏达州。根据联邦竞选财务记录，其首席执行官马蒂·戴维斯（Marty Davis）是共和党的主要政治捐赠者，向唐纳德·特朗普总统竞选活动及其他共和党候选人与政治行动委员会捐款数百万美元。戴维斯还向明尼苏达州众议员布拉德·芬斯塔德（R-Minn.）捐款，后者是该法案的共同提案人。芬斯塔德办公室未回应置评请求。
律师内文表示，该法案将赋予制造商“民事责任豁免权”。
他还质疑仅靠监管执行是否能解决问题。即使在特朗普政府削减资金和人员之前，“被闪电击中的概率比被OSHA检查更有可能”，他指出，在小型加工厂为主的行业中，检查频率太低，无法预防疾病。
借时呼吸
对冈萨雷斯而言，这场辩论发生在疾病确诊之后。他吸入的粉尘已彻底改变了他的生活。
雷耶斯移植的肺部可能维持数年，但非数十年。旧金山大学甘地博士称，肺移植后中位生存期约为8年。
雷耶斯希望消费者明白，购买人造石材“会伤害工人——那些切割和制造它的人。”
KFF健康新闻是一个深入报道健康问题的全国性新闻机构，是KFF（独立的健康政策研究、民调与新闻中心）的核心运营项目之一。
Silicosis, lung disease once linked to mining, hits workers in countertops industry
March 12, 2026 / 5:00 AM EDT / KFF Health News
César Manuel González, 37, used to work with stone that was engineered to endure: dense, polished slabs designed to outlast the kitchens in which they were installed.
Engineered quartz countertops have surged in popularity in the home renovation market, with industry analysts estimating the global engineered stone market at around $30 billion. It’s continuing to expand as quartz surfaces replace natural stone in kitchens in the United States and worldwide.
When González was working, the dust that rose from his saw didn’t look extraordinary. It settled on his clothes, in his hair, across the shop floor. In a small countertop fabrication shop, he cut marble and granite before shifting to engineered stone after the 2008-09 recession, when demand for cheaper quartz countertops surged.
But the crystalline silica released while the engineered stone was cut and polished also settled into his lungs, scarring them beyond repair. What began as breathlessness hardened into silicosis, an irreversible disease that stiffens the lungs until even ordinary movement becomes effort.
A lung transplant was his path forward. The procedure can extend survival, but it redraws the boundaries of a life: anti-rejection drugs every day, constant monitoring, vulnerability to infection, the knowledge that breathing depends on the fragile acceptance of another person’s donated organ.
González, who was diagnosed with silicosis in 2023, is not alone in dealing with a disease that once was associated with miners at the end of long careers. It’s now prevalent among the much younger, often Hispanic men who work in this industry, physicians and public health officials say.
File photo: A stone countertop fabricator creates a cloud of dust while wearing a mask to help protect against airborne particles which can contribute to silicosis at a shop in Sun Valley, California, on Oct. 31, 2023. Brian van der Brug / Los Angeles Times via Getty Images
In the United States, cases are appearing in countertop fabrication shops from California to Texas, Florida, and the Northeast. Because silicosis is not a nationally reportable disease and surveillance varies by state, no comprehensive national count exists. But clinicians who treat occupational lung disease say the number of workers — often men in their 30s and 40s — diagnosed after cutting engineered stone has risen sharply over the past decade.
As of early March, California had identified 519 confirmed cases of engineered-stone-associated silicosis and 29 deaths since 2019. The median age at diagnosis is 46; at death, 49.
Doctors don’t debate whether working with engineered stone can scar lungs.
Manufacturers argue, though, that proper ventilation, wet cutting, and respirators can make fabrication safe. Workers, physicians, and plaintiffs’ attorneys counter that a material composed almost entirely of crystalline silica may be impossible to handle safely at scale.
“This is comparable to the tobacco industry saying cigarettes are safe,” said Dr. David Michaels, an assistant labor secretary under President Barack Obama who led the Occupational Safety and Health Administration.
More than 370 lawsuits have been filed by workers who say engineered stone manufacturers failed to warn employees about the risks or sold a product that cannot be fabricated safely. At the same time, members of Congress are considering legislation that would largely shield manufacturers from liability in those cases, turning a workplace health crisis into a national debate over regulation, responsibility, and the limits of civil litigation.
Gustavo Reyes, 36, is part of that debate. Like González, he spent the early years of his career cutting marble and granite before shifting to engineered stone, a quartz-based material that can contain up to 95% silica and generates far more hazardous dust when cut.
In the shop, he said, cutting was done with water to control the dust. But finishing work — sanding and shaping — generated heavy dust. He said he wore disposable respirator masks or a reusable elastomeric respirator with filters. A door was kept open. Fans ran overhead.
When he was diagnosed in 2021, he did not know what silicosis meant. The doctor told him that there was no medication and that he had three to five years to live. He received a lung transplant in 2023.
Asked who he believes is responsible, Reyes answered: “The industries who created the artificial stone, the product.” Manufacturers dispute that characterization. Major companies say engineered stone can be fabricated safely when employers follow OSHA dust controls, including wet cutting, ventilation, and respirator use.
An old disease, reengineered
Silicosis is not new. It was synonymous with mining disasters and sandblasting, most notoriously in the Hawks Nest Tunnel tragedy, when hundreds of workers drilling through silica-rich rock in West Virginia in the early 1930s developed acute silicosis after months of unprotected exposure to dust. In 1938, Labor Secretary Frances Perkins advised that the disease could be prevented if dust controls were conscientiously applied.
A doctor points out a lung disease caused by silicosis on an X-ray in this file photo from 2016. Themba Hadebe / AP
What is new is the industry in which it has resurfaced.
Engineered stone, often marketed as “quartz,” is typically composed of crushed quartz bound with resins and pigments. Unlike marble, which contains little crystalline silica, engineered slabs contain very high levels of the substance.
Cutting changes the material.
“When you grind it, when you cut it, you’re pulverizing it,” said Dr. Robert Blink, an occupational and environmental medicine specialist who treats patients with advanced silicosis in Chicago and is a member of the Western Occupational and Environmental Medical Association. “You’re weaponizing the silica.”
Power tools fracture the surface into respirable particles small enough to lodge deep in the lungs. Repeated exposure triggers inflammation and fibrosis. Once scarring begins, it doesn’t reverse.
What happens when you look for it
In California, physicians say the pattern emerged gradually.
Dr. Robert Harrison, an occupational medicine physician at the University of California-San Francisco, helped identify the first cluster of engineered stone silicosis cases in California in 2019 after several workers from the same countertop fabrication shop died or were diagnosed with the disease. He described the crisis as “the largest outbreak of silicosis in decades.” What initially appeared as isolated cases of unexplained lung scarring in young men resolved into a recognizable occupational epidemic once work histories were examined.
Dr. Jane Fazio, a pulmonologist at UCLA, recalls seeing advanced fibrosis in otherwise healthy workers. “They have families. They were working full-time,” she said. Some experienced respiratory failure within a few years.
When doctors compared work histories, the pattern became unmistakable: Many of the men had worked in small shops cutting and polishing engineered stone countertops.
A stone countertop fabricator’s hands are covered in dust at a shop in Sun Valley, California, on Oct. 31, 2023. Brian van der Brug / Los Angeles Times via Getty Images
Dr. Sheiphali Gandhi, an occupational and environmental pulmonologist at UCSF, warned that the true burden remains uncertain. “We’re missing cases,” she said. “There’s no national surveillance system for this.”
California designated silicosis a reportable disease in 2025. Since 2019, statewide surveillance has identified hundreds of cases linked to engineered stone. The numbers probably underestimate the toll, though California’s dashboard makes the illness visible.
Outside California, there is no comparable tracking.
Early warnings
California was not the first place this happened.
The earliest modern alarm came from Israel. Caesarstone, a company founded on a kibbutz in the late 1980s, helped popularize quartz countertops globally.
Israeli physicians began documenting aggressive silicosis in young countertop workers as early as 1997.
“We had never seen this before,” said Dr. Mordechai Kramer, a retired pulmonologist who previously worked at Rabin Medical Center in Israel. “In classic silicosis, you expect long exposure, decades. Here, it was much shorter.”
Several patients required lung transplantation.
Despite the warning signs, the market continued to expand.
Australia confronted the same pattern in the late 2010s.
Rather than wait for sporadic diagnoses, Australian regulators launched systematic CT-based screening of artificial-stone workers. Disease prevalence was far higher than anticipated.
Dr. Ryan Hoy, a respiratory physician and occupational health researcher at Australia’s Monash University, described severe disease in workers with relatively short exposures.
Authorities examined whether wet cutting, ventilation, and respirators could reduce exposure sufficiently. They ultimately concluded that even with controls, fabrication of high-silica engineered stone posed unacceptable risk.
In 2024, Australia prohibited the manufacture, supply, and installation of engineered stone containing high levels of crystalline silica. Manufacturers pivoted toward lower- and zero-silica formulations.
In the United States: Who’s to blame?
Fabrication in the U.S. continues under OSHA’s silica standard, which relies on exposure limits, wet cutting, ventilation, and respiratory protection. Manufacturers argue that compliance works and that the problem lies with shops that fail to follow the rules.
OSHA first adopted silica limits in 1971 based on research from mining, quarrying, and foundry work. Although the agency updated the rule in 2016, it regulates crystalline silica broadly and does not distinguish between natural stone and high-silica engineered quartz.
The regulatory debate has now spilled into Congress. The Protection of Lawful Commerce in Stone Slab Products Act, introduced in September by Rep. Tom McClintock (R-Calif.), would largely shield manufacturers and distributors of engineered stone from civil lawsuits arising from the manufacture or sale of their products. McClintock’s office did not respond to a request for comment.
The bill was the subject of a January House Judiciary subcommittee hearing.
Supporters of the measure argue that manufacturers should not be held liable for injuries caused by employers who fail to follow OSHA standards. Opponents warn that removing litigation pressure would eliminate one of the few mechanisms capable of driving product reform if the material itself cannot be safely handled.
Michaels, the former OSHA official, sees the stakes as historical. “Litigation drives change,” he said, pointing to past battles over asbestos and tobacco.
Plaintiffs’ attorneys argue that compliance with the OSHA silica standard does not eliminate risk.
“It’s not a few bad actors,” said Raphael Metzger, a product liability attorney who has filed roughly 200 silicosis-related injury cases and a class action seeking medical monitoring. He said the issue is the product’s composition, not isolated regulatory noncompliance.
James Nevin, a tort attorney representing workers in silicosis cases, framed the congressional debate as a fight over accountability. “When it comes to causation, there’s no question,” he said, arguing that the wave of cases explains why manufacturers are now seeking what he calls “a manufacturer bailout.”
In mid-2025, Caesarstone US introduced its first products containing less than 1% silica. In response to questions, Irene Williams, a spokesperson for Caesarstone, said, “The company is not responding as these are matters of pending litigation.”
The U.S. engineered stone market is dominated by a handful of large brands — including Caesarstone, Spain-based Cosentino, and U.S.-based Cambria — while the volume of slabs imported from Asian manufacturers is growing.
Cosentino, too, is moving to low-silica products: “One third of the portfolio, including most new collections, contain less than 10% of crystalline silica,” said Kamela Kettles, a Cosentino spokesperson. “Cosentino will not be providing additional commentary at this time,” she said.
Commenting on behalf of Cambria, Mark Duffy, a communications consultant for the company, wrote, “Reckless employers are criminally violating the law, exposing workers to deadly working conditions.” He added that engineering and administrative controls, when properly used, are effective in reducing exposures below OSHA limits and said Cambria maintains exposures below the OSHA Action Level in its own facilities.
While Caesarstone and Cosentino are headquartered overseas, Cambria is based in Minnesota. Its chief executive, Marty Davis, has been a major Republican political donor, contributing millions of dollars to President Donald Trump’s election campaigns as well as to other Republican candidates and political action committees, according to federal campaign finance records. Davis has also contributed to the campaign of Rep. Brad Finstad (R-Minn.), a co-sponsor of the legislation. Finstad’s office did not respond to a request for comment.
Nevin, the attorney, said the bill would give manufacturers “free rein” from civil liability.
He also questions whether regulatory enforcement alone can address the problem. Even before the Trump administration’s funding and staffing cuts, “you had a better chance of being struck by lightning than being visited by OSHA,” he said, arguing that inspections are too infrequent to prevent disease in an industry composed largely of small shops.
Breathing on borrowed time
For González, the debate arrives after the fact. The dust he inhaled has already reshaped his life.
And Reyes’ transplanted lungs may last years, but not decades. The median survival time for transplanted lungs is about eight years, UCSF’s Gandhi said.
Reyes said he hopes people shopping for countertops understand that buying artificial stone “will harm the worker. The one who cuts it, the one who manufactures it.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
