The Rapid Rise of Silicosis in Victoria, Australia Associated With Artificial Stone Countertop Industry Work

Background: The fabrication and installation of artificial (engineered) stone countertops is a relatively new cause of silicosis. Our aim was to investigate silicosis rates in Victoria, Australia, and the association with stone countertop industry work. Methods: Workers' compensation claims for silicosis from January 1, 1991 to December 31, 2022 were analyzed across 8-year time periods. Incidence rates per 100,000 persons were calculated by time period, age, and sex. Additionally, incident silicosis cases were reported to a clinical registry by respiratory physicians from May 1, 2019 to December 31, 2022, and analyzed by referral source and occupational history. Results: Over 32 years, there were 536 workers' compensation claims for silicosis (98.9% male, median age 40 years). In total, 482 (89.9%) were received between 2015 and 2022, a 27-fold increase from the previous 8-year period. The incidence rate for silicosis claims in the adult population increased from 0.12 per 100,000 in 1991–1998 to 2.38 per 100,000 in 2015–2022. In the clinical registry there were 210 incident cases between 2019 and 2022; 97% worked in the countertop industry, 95% with artificial stone. Almost all (89%) cases had been referred following participation in a government screening program for stone countertop industry workers. Conclusion: There has been a major rise in compensation claims for silicosis in Victoria. Active screening of stone countertop workers led to the diagnosis of almost all registered incident silicosis cases. This underscores the risk to stone countertop workers and highlights the potential for under-recognition of silicosis without screening at-risk workers, especially in countries where artificial stone has become popular.