New York City Department of Health and Mental Hygiene (DOHMH) issued its 2026 Health Advisory 24, Acute and Accelerated Silicosis in Engineered Stone Workers, on September 3, 2026. It was directed to clinical staff across pulmonology, radiology, critical care, primary care, urgent care, emergency medicine, occupational medicine and transplant medicine.
The advisory follows identification of at least seven suspected silicosis cases among workers exposed to engineered stone in New York State, including one recent death in New York City. It is a clinical and public-health advisory, not a ban and not a new workplace regulation.
The clinical alert
DOHMH describes engineered stone, also called artificial stone or quartz countertops, as containing greater than 90% crystalline silica. The advisory says that is more than double the concentration found in natural granite. It states that engineered-stone workers can develop silicosis at younger ages and after shorter exposure than workers with other silica exposures.
Accelerated silicosis can occur within 5 to 10 years of exposure and often progresses rapidly to lung transplant or death. The advisory was signed by Toni Eyssallenne, MD, PhD, Chief Medical Officer, and Madhury Ray, MD, MPH, of the Bureau of Environmental Surveillance and Policy. Alister F. Martin, MD, MPP, is Commissioner.
For clinical evaluation, the advisory asks providers to consider silicosis in people with occupational histories in construction, mining or blasting, especially engineered-stone work. It also points to patients with TB or non-tubercular mycobacterial infection, nodular or fibrotic imaging, or restrictive spirometry.
Clinical actions in the advisory
- Collect an occupational history, including protective-equipment use.
- Use confidentiality and interpretation because workers may conceal work histories over retaliation, termination or immigration concerns.
- Report suspected cases to the New York State Occupational Lung Disease Registry within 10 days under Part 22 of the State Sanitary Code.
- Refer patients to a New York State Occupational Health Clinic, including Mount Sinai Selikoff Centers or Bellevue/NYU Occupational & Environmental Medicine Clinic.
Screening and reporting
The advisory identifies high-resolution CT, or HRCT, as the gold standard. Chest X-rays can be used for screening, but may miss small nodules.
DOHMH also emphasizes that every employee in New York State has equal rights to workers' compensation and medical care regardless of immigration status. Its instruction to use interpretation and preserve confidentiality is linked to the risk that workers may not disclose exposure histories when they fear workplace or immigration consequences.
Exposure context
The advisory cites California experience to explain the severity of the concern. About 25% of engineered-stone silicosis cases reported there since 2019 required lung-transplant evaluation; approximately 5% resulted in death, and the median age at death was 52. Diagnosis was often delayed because clinicians focused on infectious causes.
For exposure reduction, the advisory says to avoid engineered-stone work if possible. Otherwise, workers should use all workplace safety and exposure controls, properly fitted and maintained approved respirators, and remove dust-covered clothing before leaving the worksite. It also states that smoking compounds the effects. These directions concern exposure reduction and clinical awareness, rather than a material prohibition.
California's regulatory discussion is separate. California's draft ban concerns a proposed emergency rule for engineered stone above 1% crystalline silica; it remains a draft and is not in force. New York City's advisory does not itself prohibit fabrication, installation or product use.
Specifications can also be discussed alongside low-silica and sintered stone alternatives and a natural stone vs engineered quartz comparison. Those sourcing questions are distinct from the advisory's request that clinicians recognize, report and refer suspected disease.
What it means for buyers
Specifiers and importers in the largest US East Coast market should expect more questions about silica content, fabrication controls and alternatives. The advisory makes engineered-stone work a named occupational-history focus for clinicians, which increases the relevance of material documentation in project conversations.
Supplier SDS and silica-content documentation should be available when a project team asks how a surface is classified. That is particularly relevant because the advisory characterizes engineered stone as greater than 90% crystalline silica, while the California proposal uses a different, proposed more-than-1% threshold.
Fabrication planning remains material to sourcing discussions. The advisory's references to occupational history, protective equipment, respirators and dust-covered clothing make fabrication controls a practical question alongside a slab's appearance, availability and intended application.
