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Across the United States, workers are suffering from, and sometimes dying of, the severe lung disease known as silicosis because they are fabricating and cutting “engineered stone” countertops for our kitchens and bathrooms.

These countertops are made from a quartz-based composite product made to look like marble or granite. When cut or polished, the material releases silica dust, which can cause cancer and serious lung disease. When it comes protecting workers from exposure to engineered stone dust, the Occupational Safety and Health Administration (OSHA) is nowhere to be found.


The Centers for Disease Control and Prevention recently reported 18 cases of severe silicosis, including two deaths, in four states among workers producing these countertops. Sixteen of those affected are Hispanic and two are non-Hispanic African-Americans. More cases will undoubtedly appear, since wherever this material is used it has caused disease: Dozens of workers in Spain, Israel, and elsewhere are awaiting lung transplants, their ability to breathe destroyed by silica dust.

In Queensland, Australia, a state with 5 million people, public health authorities conducting active surveillance have identified 137 cases, though I recently learned from WorkSafe Australia (that country’s OSHA), that the number now stands at 169. Many of these workers are in their 30s and had no idea about the hazards of the silica dust they were breathing. The only reason the U.S. doesn’t have many more cases is that no one has looked for them.

The most shocking aspect of the U.S. outbreak is not the sudden appearance of cases — they were absolutely predictable — but the fact that the Trump administration has done nothing to stop them, even though OSHA was aware they were coming.


I led OSHA from 2009 through January 2017, until President Trump was inaugurated. OSHA’s old workplace standard for silica exposure dated from the early 1970s and even then was out of date for preventing silicosis. Under my leadership, the agency issued a strengthened silica exposure standard, greatly reducing the dust level allowed in a worker’s breathing zone. It also requires employers to provide medical monitoring to detect silicosis and other lung diseases before they become disabling, and to train employees to work safely with silica-containing products. The new standard didn’t go into effect until after the Trump administration took over, to give employers plenty of time to meet the new requirements.

Preventing silicosis had always been an OSHA priority. During the years I ran the agency, OSHA had a silica enforcement initiative that made it faster and easier to target inspections at workplaces where exposures were occurring. We knew that silica exposure levels in the small workshops where kitchen and bathroom countertops are fabricated were dangerously high, so high that they were illegal even under the old, weaker standard.

But when the new standard went into effect, instead of increasing inspections, the Trump administration abandoned the special enforcement initiative, and is only now slowly planning to issue a new one. Without a formal initiative, OSHA can inspect a workplace only if a worker complains. Many of the workers in dangerous jobs like these are immigrants, unlikely to ever call OSHA because they fear firing — or worse. This means the agency currently has almost no ability to focus inspections on the workshops where workers are being overexposed to silica dust and developing silicosis.

OSHA’s retreat on silica inspections is symbolic of a deeper problem: Under the Trump administration, the agency is suffering from malignant neglect. It has been almost three years since I stepped down, and OSHA still has no Senate-confirmed administrator and there is currently no nominee for the position. The previous nominee waited two years for Senate Majority Leader Mitch McConnell to bring his name up for a Senate vote, then pulled his name from consideration, no doubt recognizing that McConnell has prioritized confirming conservative federal judges over protecting the health and safety of the nation’s workers.

Almost half of OSHA’s senior executive positions are now empty and filled with “acting” staff, temporarily leading offices on short-term bases.

OSHA career staffers are deeply committed to the mission of the agency and are doing the best they can under difficult circumstances. In many instances, when inspectors leave the agency, they are not replaced. None were hired in 2017. OSHA currently has fewer inspectors than at any time in the agency’s almost 50-year history, and it has conducted a near-record low number of inspections targeting health hazards like silica.

At its current staffing level, it would take the agency 165 years to visit every workplace in the country just once. I’ve heard from OSHA field staff that inspectors are under great pressure to keep up their inspection numbers, so inspections are becoming shorter and more perfunctory, and therefore less effective.

According to the National Employment Law Project, in 2018 (the only year of the Trump administration with complete data available), the number of high-penalty cases dropped by 50% compared to 2016. The agency conducted one-third the number of inspections involving hazards causing musculoskeletal disorders, even though these are the most prevalent work-related illness reported by the Bureau of Labor Statistics. OSHA also cut by almost half the number of inspections to protect workers from dangerous levels of heat, although 2018 was one of the hottest years on record.

It has long been OSHA policy to conduct an inspection after a worker is killed or three or more are hospitalized. The number of these inspections increased 10% from 2017 to 2018, suggesting that fatal workplace injuries are on the rise.

Fourteen workers are killed on the job every day, and between 4 million and 5 million are injured every year. Many thousands are made sick by exposure to silica and other toxic substances, but we don’t know the number because we have no national registry of work-related diseases.

This toll is already unacceptably high and hollowing out OSHA will result in more families losing loved ones to preventable work injuries and illnesses.

It is not only workers and their families who will pay a price for OSHA’s demise. Many decent employers work hard to follow the law and protect their workers. The Trump administration is putting them at a financial disadvantage by having to compete with scofflaws who risk the lives, limbs, and lungs of their workers, knowing that an OSHA inspection is increasingly unlikely.

David Michaels is a professor in the Department of Environmental and Occupational Health at the Milken Institute School of Public Health at George Washington University. He was assistant secretary of labor for OSHA from 2009 to 2017, and is the author of “The Triumph of Doubt: Dark Money and the Science of Deception” (Oxford University Press, January 2020).

  • I am always a suspicious when I read statements like: “The hollowing out of of OSHA under the Trump administration can be seen in reports of severe silicosis among workers who make kitchen and bathroom countertops”.

    The reason for suspicion is that these types of problems do not magically appear in a single administration. There may indeed be concerns about reporting and about enforcement actions, but the implications that all of a sudden people are getting silicosis because of a change within the past three years – well – that just doesn’t happen.

    I looked at the CDC report you cited in this article and got only so far as the very first of the 18 cases cited in the report before spotting a problem: a 37 year old man from California who was hospitalized in 2017 and died in 2018. The key point is that he worked at a stone countertop fabrication facility from 2004 to 2013. His place of employment was found to have 22 times the acceptable limit for crystalline silica levels in 2009. While he died recently, his exposure happened many years ago and was terminated in 2013 4 years before Trump took office.

    Clearly silica exposure is a problem. It is also a problem that, like most environmental exposure problems, has existed for quite a period of time. Clearly, any hollowing out of OSHA in the timeframe of 2017-2019 did not create this problem.

    If your purpose was to identify an emerging problem that should be investigated and addressed, merely blaming the Trump administration for conditions that have existed for years before the 2016 election serves no purpose.

    If your purpose was to highlight concerning relaxation of standards within OSHA over the past 3 years, then focusing on a disease where the environmental causes occurred for a period of 9 years spanning two previous presidential administrations provides little support for your argument.

    • While I agree that it is a terrible health problem, I’m not sure that “it is a fact that nothing is being done”. The article does not describe what is being done or not being done. But is this the most pressing occupational illness that needs our attention? You would certainly not be able to figure that out from this article.

      Is silicosis the most significant cause of occupational mortality? Is it in the top ten? Is it increasing or decreasing? Do other occupational hazards merit more scrutiny? What guidelines are currently in place? Since chronic silicosis is a disease that can take decades to develop, how do we determine the effectiveness of any counter measures when the result won’t be seen for 10-20 years?

      Again, digging a little further, I found data from CDC indicating that the annual mortality rate for silicosis has dropped from over 1,100 in the 1970’s to less than 200 today. There were 164 deaths in 2001 and 101 in 2010. Just as a point of comparison, there are approximately 800 annual deaths due to workplace “violence and other injuries by persons or animals”. Maybe that requires more attention than silicosis.

      As far as nothing being done, well, I have not yet found out any particulars as to the detailed measures either already taken of being proposed around silicosis. I did find that the problem spans a lot of industries and I do not know why the article focused on manufactured countertops. Silicosis is a hazard for mining, steel, construction, plaster and drywall, glass, road repair, sandblasting, masonry, roofing, and farming.

      Maybe more can be done. It would be nice to actually see a proposal that suggests exactly what steps should be taken to further reduce the annual death rate to zero. That proposal should also make the case as to why this particular hazard deserves more attention than any other occupational hazard that results in a significant mortality rate. OSHA’s budget in 2009 was around $513 million. As of 2019 it is $557 million. Is that the right amount? Is it focused on the right problems?

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