Ban artificial stone, researchers urge European governments

A group of researchers from the Netherlands and UK urge European governments to ban artificial stone to prevent lung disease caused by silica dust exposure.

From BMJ 13/08/24

Illustration by Superinnovators x AI.

The UK and the European Union should follow Australia’s lead and ban the kitchen worktop favourite and cause of irreversible and rapidly progressive lung disease—artificial stone silicosis—urge researchers in an editorial, published online in Occupational & Environmental Medicine.

And until a ban comes into force, all possible control measures should be legally enforced to minimise workers’ exposure to the harmful crystalline silica dust generated during its manufacture and fitting, insist the authors.

Artificial stone (also known as engineered stone) is widely used for surfaces in kitchens and bathrooms as a low-cost alternative marble and granite.

Although mainly used for kitchen countertops, it is also used for vanity units, walls, and flooring.

Artificial stone products have become so popular that the global market for them is estimated to be worth around US$25 billion a year, point out the authors.

Prompted by the rapid emergence of the irreversible progressive lung disease, artificial stone silicosis, among people working with artificial stone, Australia has banned its use, supply, and manufacture since July this year.

“This far-reaching policy is the first of its kind in the world and is similar to the bans on the use of asbestos and asbestos products that are in place in many countries worldwide (currently 70),” say the authors.

Eleven cases of artificial stone silicosis have now been reported in the UK.

While alternatives, such as marble and granite, also generate fine crystalline silica dust when produced and used, they have a much lower crystalline silica content and are probably better regulated, so have not been associated with a heightened risk of silicosis, say the authors.

“Regulators have often resorted to banning chemicals or products in workplaces to protect the health of workers,” note the authors.

Illustration by Superinnovators x AI.

“And it is certainly the most appropriate strategy when control of exposure in workplaces is difficult to achieve.”

But there is some resistance to an outright ban, note the authors, citing an article in the official magazine of the British Occupational Hygiene Society (BOHS).

This suggested that the risks presented by engineered stone could be adequately controlled by applying the principles of good occupational hygiene control practice.

“We disagree, mainly because of the nature of the hazard presented by these materials and the difficulty in ensuring all employers and workers understand the risks and abide by the necessary control measures,” argue the authors.

“Furthermore, according to the hierarchy of control, elimination and/or substitution with less hazardous materials is most effective when reducing risks.”

“Early evidence from Australia suggests that the ban has already resulted in innovations by the sector to develop new products with no or very low silica content,” they point out.

The authors support the introduction of a phased ban, which could work well in the UK and Europe, they suggest.

“For example, there could be an initial ban on products containing more than 30% crystalline silica, moving to a ban on more than 5% after 5 years.”

A UK ban could be achieved by amending the Control of Substances Hazardous to Health (COSHH) Regulations, they suggest.

But stronger preventive action is needed in the interim, they insist.

“In the meantime, all possible control measures should be taken to keep exposures to [respirable crystalline silica] as low as possible.”

“We believe that this proposal is proportionate and would protect the health of European workers and other workers from across the globe, while encouraging the industry to continue to develop safer products.”