Occupational related disease and ethnic health inequalities: it’s time to ban artificial stone

Occupational causes of ill health are often overlooked and are a significant cause of ethnic health disparities. Artificial stone silicosis is a case in point and an artificial stone ban is needed to protect all workers, argue Dr Carl Reynolds and Dr Sheipahli Gandhi.

Sadly, though entirely preventable, occupational lung disease remains a problem. Research suggests that about 15% of lung cancer cases are occupational and similar proportions are seen for non-malignant lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), and lung fibrosis.

Over 10 years ago doctors became aware of a global outbreak of silicosis due to the use of a new material, artificial or engineered stone, often used in kitchen and bathroom worktops, that contain a high concentration of stone dust known as silica.

Artificial stone silicosis is scarring of the lungs from breathing in silica when working with artificial stone. It is a devastating, incurable, and entirely preventable disease. It kills and causes serious disability in people of working age. The risk is greatest when high concentrations of silica dust are breathed in which is why artificial stone, which often contains high concentrations of silica, is becoming a problem.

Analysis of cases of artificial stone silicosis seen in Israel, Australia, Spain, the USA, and the UK, reveal the disease is more common in Black, ethnic minority and migrant groups who often have jobs cutting and polishing artificial stone for kitchen worktops.  The NHS also lists several industry sectors which commonly pose higher risk of developing the disease.

Many are now calling for artificial stone worktops to be banned to protect workers from silicosis. Despite artificial stone being a common product in the kitchen worktop market in the UK, one supplier, Herringbone Kitchens, has voluntarily stopped selling it out of concern for workers health. Artificial stone is set to be banned in most parts of Australia this year.

In addition to silicosis, breathing in silica dust increases the risk of infectious diseases such as tuberculosis and pneumonia and autoimmune diseases. Patients with diseases due to artificial stone dust exposure are becoming more common. We have seen increased hospital admissions and looked after several patients, over the past 12 months, both in California and London.

Occupation is an extremely important contributor to disparities in respiratory disease, affecting financial status, health-care access, and exposure to hazardous substances. Although occupation and associated exposures are included in the socioecological models, hazardous work exposures are still persistently absent from research on health inequities and their contribution to health.

Occupational exposures are largely preventable through proper workplace controls, the recognition and risk of occupational causes of disease can provide an opportunity for interventions to bring about health equity.

Why ban artificial stone?

Artificial stone is commonly used in place of more expensive natural stone for products such as kitchen worktops. Clearly, existing regulations have failed to protect workers getting silicosis.

We believe that the best measure to prevent future artificial stone silicosis cases is an outright ban. A union supported campaign recently led to Australia becoming the first country in the world to ban artificial stone to protect workers. We urge that the UK follows suit.

The petition to support the UK of ban artificial stone worktops is available here. https://petition.parliament.uk/petitions/658335