{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:10:21Z","timestamp":1792811421594,"version":"4.5.0"},"reference-count":39,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec id=\"ab-ioi230050-4\"><jats:title>Importance<\/jats:title><jats:p>Silicosis associated with inhalation of respirable crystalline silica among engineered stone countertop fabrication workers is an emerging health concern.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230050-5\"><jats:title>Objective<\/jats:title><jats:p>To describe clinical, socioeconomic, and occupational characteristics of patients diagnosed with silicosis associated with engineered stone in California.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230050-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This case series included reported cases of silicosis associated with fabrication of engineered stone countertops, as identified by statewide surveillance by the California Department of Public Health (2019-2022). Data analysis was performed from October 2022 to March 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230050-7\"><jats:title>Exposures<\/jats:title><jats:p>Patient interviews and medical record abstractions were used to assess occupational exposure to respirable crystalline silica, including duration of work tenure and preventive measures undertaken.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230050-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Demographics, clinical characteristics, health care utilization, and clinical outcomes were obtained, including vital status, hypoxia, and lung transplant.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230050-9\"><jats:title>Results<\/jats:title><jats:p>This case series identified 52 male patients meeting inclusion criteria; median (IQR) age was 45 (40-49) years, and 51 were Latino immigrants. Ten (19%) were uninsured, and 20 (39%) had restricted-scope Medi-Cal; 25 (48%) presented initially to an emergency department. A delay in diagnosis occurred in 30 (58%) patients, most commonly due to alternative initial diagnoses of bacterial pneumonia (9 [30%]) or tuberculosis (8 [27%]). At diagnosis, 20 (38%) patients had advanced disease (progressive massive fibrosis) with severely or very severely reduced forced expiratory volume in 1 second in 8 (18%) and 5 (11%), respectively. Of the cases, 10 (19%) were fatal; median (IQR) age at death was 46 (38-51) years, and 6 patients (12%) were alive with chronic resting hypoxia. Eleven were referred for lung transplant: 3 underwent transplant with 1 fatality; 7 were declined transplant, with 6 fatalities; and 1 died prior to listing. Median (IQR) work tenure was 15 (10-20) years; 23 (45%) reported use of water suppression for dust mitigation, and 25 (48%) continued to fabricate stone after being diagnosed with silicosis.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi230050-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this case series performed in California, silicosis associated with occupational exposure to dust from engineered stone primarily occurred among young Latino immigrant men. Many patients presented with severe disease, and some cases were fatal.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2023.3295","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T15:32:57Z","timestamp":1690212777000},"page":"991","source":"Crossref","is-referenced-by-count":83,"title":["Silicosis Among Immigrant Engineered Stone (Quartz) Countertop Fabrication Workers in California"],"prefix":"10.1001","volume":"183","author":[{"given":"Jane C.","family":"Fazio","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California"},{"name":"Occupational Health Branch, California Department of Public Health, Richmond"},{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Olive View-UCLA Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheiphali A.","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Occupational Health Branch, California Department of Public Health, Richmond"},{"name":"Division of Occupational, Environmental, and Climate Medicine, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Flattery","sequence":"additional","affiliation":[{"name":"Occupational Health Branch, California Department of Public Health, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Heinzerling","sequence":"additional","affiliation":[{"name":"Occupational Health Branch, California Department of Public Health, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Kamangar","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California"},{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Olive View-UCLA Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawal","family":"Afif","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Olive View-UCLA Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin J.","family":"Cummings","sequence":"additional","affiliation":[{"name":"Occupational Health Branch, California Department of Public Health, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Occupational Health Branch, California Department of Public Health, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"9830","key":"ioi230050r1","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1016\/S0140-6736(12)60235-9","article-title":"Silicosis.","volume":"379","author":"Leung","year":"2012","journal-title":"Lancet"},{"issue":"12","key":"ioi230050r2","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1111\/resp.v24.12","article-title":"Silica-associated lung disease: an old-world exposure in modern industries.","volume":"24","author":"Barnes","year":"2019","journal-title":"Respirology"},{"issue":"2","key":"ioi230050r5","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1378\/chest.11-1321","article-title":"Artificial stone silicosis [corrected]: disease resurgence among artificial stone workers.","volume":"142","author":"Kramer","year":"2012","journal-title":"Chest"},{"issue":"1","key":"ioi230050r6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/oemed-2017-104428","article-title":"Artificial stone-associated silicosis: a rapidly emerging occupational lung disease.","volume":"75","author":"Hoy","year":"2018","journal-title":"Occup Environ Med"},{"issue":"4","key":"ioi230050r7","doi-asserted-by":"publisher","first-page":"568","DOI":"10.3390\/ijerph16040568","article-title":"Artificial stone associated silicosis: a systematic review.","volume":"16","author":"Leso","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"ioi230050r8","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1111\/resp.v25.5","article-title":"Artificial stone-associated silicosis in China: a prospective comparison with natural stone-associated silicosis.","volume":"25","author":"Wu","year":"2020","journal-title":"Respirology"},{"issue":"9","key":"ioi230050r10","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1080\/104732299302350","article-title":"Silica exposure during granite countertop fabrication.","volume":"14","author":"Simcox","year":"1999","journal-title":"Appl Occup Environ Hyg"},{"issue":"9","key":"ioi230050r14","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1002\/ajim.v65.9","article-title":"Elevated exposures to respirable crystalline silica among engineered stone fabrication workers in California, January 2019-February 2020.","volume":"65","author":"Surasi","year":"2022","journal-title":"Am J Ind Med"},{"issue":"12","key":"ioi230050r15","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1002\/ajim.v65.12","article-title":"Self-reported silica exposures and workplace protections among engineered stone fabrication workers in California.","volume":"65","author":"Spiegel","year":"2022","journal-title":"Am J Ind Med"},{"issue":"58","key":"ioi230050r16","first-page":"16285","article-title":"Occupational exposure to respirable crystalline silica: final rule.","volume":"81","author":"Occupational Safety and Health Administration (OSHA), Department of Labor","year":"2016","journal-title":"Fed Regist"},{"issue":"1","key":"ioi230050r17","first-page":"122","article-title":"Respirable silica dust suppression during artificial stone countertop cutting.","volume":"59","author":"Cooper","year":"2015","journal-title":"Ann Occup Hyg"},{"issue":"6","key":"ioi230050r18","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1093\/annweh\/wxx040","article-title":"Experimental evaluation of respirable dust and crystalline silica controls during simulated performance of stone countertop fabrication tasks with powered hand tools.","volume":"61","author":"Johnson","year":"2017","journal-title":"Ann Work Expo Health"},{"issue":"5","key":"ioi230050r21","first-page":"129","article-title":"Notes from the field: silicosis in a countertop fabricator - Texas, 2014.","volume":"64","author":"Friedman","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"38","key":"ioi230050r22","doi-asserted-by":"publisher","first-page":"813","DOI":"10.15585\/mmwr.mm6838a1","article-title":"Severe silicosis in engineered stone fabrication workers - California, Colorado, Texas, and Washington, 2017-2019.","volume":"68","author":"Rose","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"6","key":"ioi230050r23","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1164\/rccm.202008-3297LE","article-title":"Radiographic screening reveals high burden of silicosis among workers at an engineered stone countertop fabrication facility in California.","volume":"203","author":"Heinzerling","year":"2021","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"ioi230050r25","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1183\/09031936.05.00035205","article-title":"Interpretative strategies for lung function tests.","volume":"26","author":"Pellegrino","year":"2005","journal-title":"Eur Respir J"},{"issue":"3","key":"ioi230050r26","doi-asserted-by":"publisher","first-page":"e56","DOI":"10.1183\/20734735.012717","article-title":"The Global Lung Function Initiative (GLI) Network: bringing the world\u2019s respiratory reference values together.","volume":"13","author":"Cooper","year":"2017","journal-title":"Breathe (Sheff)"},{"issue":"11","key":"ioi230050r29","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.2105\/AJPH.2021.306485","article-title":"Severity of inpatient hospitalizations among undocumented immigrants and Medi-Cal patients in a Los Angeles, California, hospital: 2019.","volume":"111","author":"Ro","year":"2021","journal-title":"Am J Public Health"},{"issue":"9","key":"ioi230050r32","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1136\/oemed-2021-108190","article-title":"Demographic, exposure and clinical characteristics in a multinational registry of engineered stone workers with silicosis.","volume":"79","author":"Hua","year":"2022","journal-title":"Occup Environ Med"},{"issue":"1","key":"ioi230050r33","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1385\/COMP:31:1","article-title":"Diagnosing occupational lung disease: a practical guide to the occupational pulmonary history for the primary care practitioner.","volume":"31","author":"Banerjee","year":"2005","journal-title":"Compr Ther"},{"issue":"4","key":"ioi230050r34","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s00408-018-0129-3","article-title":"EBUS-TBNA is sufficient for successful diagnosis of silicosis with mediastinal lymphadenopathy.","volume":"196","author":"Shitrit","year":"2018","journal-title":"Lung"},{"issue":"11","key":"ioi230050r35","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1111\/resp.v25.11","article-title":"Respiratory surveillance for coal mine dust and artificial stone exposed workers in Australia and New Zealand: a position statement from the Thoracic Society of Australia and New Zealand.","volume":"25","author":"Perret","year":"2020","journal-title":"Respirology"},{"key":"ioi230050r27","first-page":"209","volume-title":"Pathology of Occupational Lung Disease","author":"Gibbs","year":"1998","edition":"2nd ed"},{"key":"ioi230050r3","unstructured":"Silicosis mortality, prevention, and control\u2014United States, 1968\u20132002. Accessed April 27, 2023. https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm5416a2.htm"},{"key":"ioi230050r4","unstructured":"Harris? K. Forty years of falling manufacturing employment: beyond the numbers. US Bureau of Labor Statistics. Accessed April 27, 2023. https:\/\/www.bls.gov\/opub\/btn\/volume-9\/forty-years-of-falling-manufacturing-employment.htm"},{"key":"ioi230050r9","unstructured":"DuPont. Material safety data sheet: Zodiaq quartz surfaces. Accessed December 11, 2022. https:\/\/www.parliament.nsw.gov.au\/lcdocs\/other\/12562\/Tabled%20Document%20-%20Du%20Pont%20Material%20Safety%20Data%20Sheet%20-%20regarding%20Zodiaq%20Quartz%20Surfaces.pdf"},{"key":"ioi230050r11","unstructured":"Freedonia Group. Engineered stone countertops: market size, market share, market leaders, demand forecast, sales, co profiles, market research, industry trends and companies. Accessed April 27, 2023. https:\/\/www.freedoniagroup.com\/industry-study\/engineered-stone-countertops-4395.htm"},{"key":"ioi230050r12","unstructured":"Research and Markets. US countertops market 2022-2026. Accessed May 17, 2023. https:\/\/www.researchandmarkets.com\/reports\/4995479\/us-countertops-market-2022-2026"},{"key":"ioi230050r13","unstructured":"Grand View Research. Engineered stone market size report, 2021-2028. Accessed April 27, 2023. https:\/\/www.grandviewresearch.com\/industry-analysis\/engineered-stone-market"},{"key":"ioi230050r19","unstructured":"Silicosis. WorkSafe.qld.gov.au. Published September 11, 2020. Accessed December 10, 2022. https:\/\/www.worksafe.qld.gov.au\/claims-and-insurance\/work-related-injuries\/types-of-injury-or-illness\/work-related-respiratory-diseases\/silicosis"},{"key":"ioi230050r20","unstructured":"Wise? R. QCEW industry codes and titles (for NAICS coded data). US Bureau of Labor Statistics. Accessed December 11, 2022. https:\/\/www.bls.gov\/cew\/classifications\/industry\/industry-titles.htm"},{"key":"ioi230050r24","unstructured":"ORDS: silicosis state reporting guidelines. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Published August 2, 2021. Accessed December 6, 2022. https:\/\/www.cdc.gov\/niosh\/topics\/surveillance\/ords\/statesurveillance\/reportingguidelines-silicosis.html"},{"key":"ioi230050r28","unstructured":"What is the difference between full scope and restricted scope benefits? Marin Health and Human Services. Accessed January 31, 2023. https:\/\/www.marinhhs.org\/faq\/what-difference-between-full-scope-restricted-scope-benefits"},{"key":"ioi230050r30","unstructured":"Immigrant access to Medi-Cal. Mental Health Advocacy Services. Published December 2014. Accessed May 25, 2023. https:\/\/www.mhas-la.org\/medi-cal-benefits\/immigrant-access-to-medi-cal"},{"key":"ioi230050r31","unstructured":"R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Accessed June 14, 2023. https:\/\/www.R-project.org\/"},{"key":"ioi230050r36","unstructured":"OSHA offices by state. Occupational Safety and Health Administration. Accessed April 28, 2023. https:\/\/www.osha.gov\/contactus\/bystate"},{"key":"ioi230050r37","unstructured":"State and territorial health departments\u2014STLT Gateway. Centers for Disease Control and Prevention. Published January 23, 2023. Accessed April 28, 2023. https:\/\/www.cdc.gov\/publichealthgateway\/healthdirectories\/healthdepartments.html"},{"key":"ioi230050r38","unstructured":"Silica safety resources for stone fabricators. California Department of Public Health Occupational Health Branch. Published February 8, 2023. Accessed March 8, 2023. https:\/\/www.cdph.ca.gov\/Programs\/CCDPHP\/DEODC\/OHB\/Pages\/SilicaStoneFabricators.aspx"},{"key":"ioi230050r39","unstructured":"Hierarchy of controls. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Published January 17, 2023. Accessed February 10, 2023. https:\/\/www.cdc.gov\/niosh\/topics\/hierarchy\/default.html"}],"container-title":["JAMA Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/articlepdf\/2807615\/jamainternal_fazio_2023_oi_230050_1693517078.94172.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T15:30:29Z","timestamp":1693927829000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2807615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":39,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamainternmed.2023.3295","relation":{},"ISSN":["2168-6106"],"issn-type":[{"value":"2168-6106","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9,1]]}}}