The American Medical Association has formally backed a near-total ban on high-silica engineered stone, citing an incurable lung disease that continues to disable and kill workers across the United States.
The move by the nation’s largest physician group, which represents more than 250,000 members, adds significant momentum to a growing movement to regulate or eliminate the factory-made material. “Silicosis is preventable, and the most effective way to prevent silicosis is to use safer countertop materials containing less than 1% crystalline silica with appropriate dust control measures,” said Sheila Rege, an American Medical Association board member and radiation oncologist.
The medical community’s stance comes as cases of silicosis continue to rise among those who cut and polish artificial stone. In California alone, more than 680 stoneworkers have contracted the disease, with dozens of deaths and 75 lung transplants recorded since 2019, according to data from the California Department of Public Health.
“Workers are developing an incurable lung disease that can progress to respiratory failure and sometimes, death, often at a young age among workers,” said Sheila Rege, an American Medical Association board member and radiation oncologist.
The disease is often linked to the inhalation of fine silica dust generated during the fabrication of kitchen and bathroom countertops. While California currently maintains some of the strictest workplace regulations in the country—requiring water-based cutting and specialized ventilation—state inspectors have reported widespread compliance issues.
Research from Cal/OSHA suggests that even in shops that follow safety protocols, workers remain at risk. Projections indicate that between 1,000 and 1,500 California stoneworkers could develop silicosis within the next decade, resulting in nearly 300 deaths.
The American Medical Association’s new policy aligns with a broader push to phase out high-silica engineered stone, a material already banned in Australia as of 2024. California regulators are currently considering an emergency rule that would impose stricter limits on the stone’s silica content.
Industry manufacturers, however, have challenged the necessity of a total ban. Cambria, a leading U.S.-based producer, has advocated for federal legislation that would protect manufacturers from lawsuits while shifting the focus toward improved safety compliance at fabrication sites. The International Surface Fabricators Association, which receives support from major manufacturers, has petitioned the state to implement a mandatory licensing program for shops instead of restricting the material itself.
“Our disagreement is not with the medicine,” said Laurie Weber, CEO of the International Surface Fabricators Association. “It is with the idea that a product ban on fabrication, by itself, will protect the people doing this work.”
Robert Blink, an occupational medicine physician based in San Francisco, said the association's resolution shows a growing consensus that the material cannot be handled safely in common workplace environments.
The path toward a federal or state-wide prohibition remains uncertain. While the American Medical Association’s stance may spur federal and state regulation of high-silica engineered stone, the practical implementation of a ban involves balancing commercial interests with the health of a workforce that is predominantly composed of Latino immigrants.