California: the centre of the engineered-stone silicosis outbreak
Why California, what the numbers are, what the state has done, and where the litigation stands. Each figure carries its date and source.
The numbers
CDPH surveillance count as of 13 August 2026, as reported from the CDPH dashboard. HealioT2California Department of Public HealthT1 The peer-reviewed figure, published in NEJM Evidence in September 2026, is 592 cases through June 2026, with 65 transplants and 31 deaths. National Library of MedicineT1CIDRAP (University of Minnesota) / NEJM EvidenceT2 CDPH's earlier milestones: 432 cases on 13 November 2025 (Los Angeles County 226, Orange County 86); 519 in early March 2026; 560 by 21 May 2026. California Department of Public HealthT1KFF Health NewsT2Public Health WatchT2
Who is affected
Almost all patients are men, 98% are Latino, and the median age at diagnosis is 46, with a median of 22 years of occupational silica exposure; nearly a quarter have been referred for transplant. Nineteen per cent of the first 52 cases described in 2023 were uninsured and 58% were initially misdiagnosed, most often as pneumonia or tuberculosis. Cases are concentrated in Los Angeles County, where most of California's roughly 1,300 fabrication shops operate; a Cal/OSHA inspector told the Standards Board in May 2026 that cases were doubling every 13 months. HealioT2National Library of MedicineT1Public Health WatchT2 The research timeline holds the studies behind these figures.
What California has done
- Emergency silica standard, adopted 14 December 2023, in force 29 December 2023.
- Permanent silica standard, adopted 19 December 2024: six-monthly exposure assessment, medical removal protection, 24-hour reporting of confirmed cases.
- Silicosis made reportable from June 2025: providers must report within seven days.
- SB 20, the STOP Act, signed 13 October 2025 and in force 1 January 2026: dry fabrication of artificial stone prohibited, annual training attestations from 1 July 2026, artificial-stone silicosis treated as a serious injury, CDPH-to-Cal/OSHA referral within three business days.
- A ban in rulemaking. On 21 May 2026 the Standards Board granted in part a petition from occupational physicians to prohibit fabrication and installation of artificial stone over 1% crystalline silica, and directed Cal/OSHA to prepare an emergency finding. No rule text had been adopted at this project's last check.
Details, dates and sources for each are in the regulation register. Enforcement figures cited by the state in May 2026: more than 900 citations and about $1.9 million in proposed penalties under a special emphasis programme, and violations found at 95% of the 85 shops inspected in 2024. WorkCompWire (reprinting DIR release 2026-45)T2HealioT2
The litigation so far
| Verdict | Court | Outcome | Damages |
|---|---|---|---|
| 19 August 2026 | Superior Court of California, County of Orange | Plaintiff: Dal-Tile Distribution, LLC, Dal-Tile Tennessee, LLC, Paragon Industries, Inc. (Bedrosians) | $7,100,000 |
| 3 August 2026 | Superior Court of California, County of Los Angeles | Plaintiff: Dal-Tile LLC, Dal-Tile Distribution, LLC | $47,035,380 |
| 29 May 2025 | Superior Court of California, County of Los Angeles (Torrance) | Defense: Caesarstone Ltd., Caesarstone USA, Inc. | None |
| 7 August 2024 | Superior Court of California, County of Los Angeles | Plaintiff: Caesarstone USA, Inc., Cambria Company LLC, Color Marble, Inc. | $52,437,366 |
Four California trials to verdict, three for plaintiffs and one for the defense, plus one Colorado verdict; more than 370 cases filed nationally as of March 2026 according to plaintiff attorneys; a petition to coordinate the Los Angeles, Orange and San Francisco cases reported in 2025. Full records in the verdict tracker, litigation tracker and defendant index. A federal bill, H.R. 5437, that would end these suits was ordered reported by the House Judiciary Committee on 3 June 2026.
Recent events
- September 2026: NEJM Evidence publishes CDPH's 2019-2026 surveillance report
- 19 August 2026: Orange County jury awards $7.1 million against Dal-Tile and Bedrosians
- 13 August 2026: CDPH count reaches 631 cases, 74 transplants, 35 deaths
- 3 August 2026: Los Angeles jury assesses $47 million against Dal-Tile
- 1 July 2026: First SB 20 training attestations due to Cal/OSHA
- 26 June 2026: American Thoracic Society publishes its workshop report on artificial-stone silicosis
Full sequence in the California timeline.
For workers
The worker resources directory lists where to get a medical evaluation, how to report an unsafe shop anonymously, how to claim workers' compensation and where to find free legal aid. It is also available en español, as are guides to los síntomas and la piedra artificial.
This page is general information, not legal or medical advice. Figures change weekly; the date next to each number is the date it was true.