Episode 6: The Horrific Impact of Artificial Stone Silicosis
James Nevin: Hello everyone. Welcome back to another episode of From Dust to Verdict. I'm your host, James Nevin, a partner at the law firm of Brayton Purcell LLP. This podcast is dedicated to the epidemic of accelerated silicosis in artificial stone countertop fabrication workers. In each episode, we explore important topics and issues about this occupational health epidemic as well as the associated lawsuits.
Today in episode six, we will discuss the verdict part of our podcast title from Dust to Verdict. Why do jurors assess many millions of dollars in damages in favor of fabrication workers against artificial stone slab manufacturers and suppliers? Part of the answer is the horrific suffering that these brave workers endure from artificial stone silicosis.
As of today, Brayton Purcell LLP represents almost 600 fabrication workers in many states across the country in their silicosis cases against artificial stone slab manufacturers and suppliers. Last summer, we achieved the first and so far, only plaintiff's verdict in the first case to go to trial against artificial stone slab manufacturers and suppliers, and the jury assessed over $52 million in favor of plaintiff Gustavo Reyes Gonzalez.
Additionally, we have achieved millions of dollars in settlements for other artificial stone fabrication workers in their cases against the artificial stone slab manufacturers and suppliers. And so, to understand why the juries are assessing such significant damages in favor of artificial stone fabrication workers, we under need to understand the aspects of what is presented at trial about this horrific disease.
And as we've discussed in previous podcasts, the hierarchy of controls from NIOSH, that works reasonably well in preventing disease in natural stone according to published peer reviewed studies, does not work to prevent silicosis when fabrication workers are fabricating artificial stone.
And as we previously discussed, the end result is very high prevalence or incidents of silicosis among artificial stone fabrication workers compared to the almost zero incidents that we saw in fabrication workers in the eighties and nineties when only natural stone was used in the United States.
And as a result of that, in California, for example, the California Department of Public Health has tracked almost at this point, as of this week, 400 artificial stone workers who have developed silicosis from artificial stone. And we previously discussed the components of artificial stone compared to natural stone.
And therefore, whether you're in a fabrication shop that is perfectly clean and looks beautiful, or in a fabrication shop that's incredibly dusty with dust everywhere, we're finding a very high prevalence of silicosis in these workers who've been fabricating artificial stone.
As demonstrated by numerous published peer reviewed studies, when the particles from artificial stone, which are nano-sized, high content silica and various toxins and volatile organic compounds, is breathed into the lungs and goes down to the alveola air sacs, where we normally have healthy lungs with carbon dioxide and oxygen exchanging when the artificial stone particles reach to the terminal bronchioles, or essentially the very edges of our lungs where the oxygen exchange occurs, they reach the alveolar air sacs.
And if we take a cross section of one of those alveolar air sacs, we can see the very normally, very thin membrane between the alveolar air sacs and the capillaries where the gas exchange occurs. And in these air sacs, we have defense mechanisms called macrophages, which are cells that are pretty good at getting rid of most foreign bodies, say like a pollen grain.
However, the silica particles, particularly the nano size silica particles that are coated with various other toxins from artificial stone, they kill the macrophage. And so then the body has to upregulate fibroblasts, which are the tissue of the normally thin membrane of the lungs, and they lay down scar tissue to try to engulf those particles.
Now, traditionally from natural stone or other sources of silica, a worker after many, many, many decades might develop chronic silicosis. And that is essentially that those individual alveolar air sacs, many millions of them have slowly over time become scarred over leading to this scarring disease in the lungs that can be seen on typically on chest x-ray or on a CT scan.
Now, chronic silicosis was a pretty horrific disease in the twenties and thirties and forties in the United States such that the US government did extensive regulation. And so, by 1970s, 1980s particularly, for example, if we look at countertop fabrication workers, chronic silicosis was essentially eradicated.
Another type of silicosis is called lymph node silicosis. Lymph node silicosis is also known as the canary in the coal miner. Just like a canary in a cage, in a coal mine is a warning to the coal miners that there's been excess gas buildup and such that if the canary is being affected, next would be the workers. With lymph node silicosis, the silicosis of the lymph nodes, while not yet pulmonary, not yet the actual lung tissue, the lymph node is the first organ in the body to become silocotic, and thus serves as a marker that if the worker continues to be exposed to the source of silica, that they are eventually going to develop pulmonary silicosis.
Now, the first stage of pulmonary silicosis is called simple silicosis, and it's going to be seen on x-ray or much more often seen on a CT scan.
With simple silicosis, the worker is going to maybe be short of breath. They're going to be more susceptible to other diseases such as tuberculosis, pneumonia, and so forth. They might feel that they have symptoms similar to asthma or COPD, or they may have no symptoms at all. The last stage of silicosis is called complicated or complex, and is associated with progressive massive fibrosis or PMF.
With progressive massive fibrosis or complex silicosis, so much of those alveolar air sacs in the lungs have become scarred over that the worker is literally suffocating to death and it feels short of breath as very susceptible to additional diseases such as tuberculosis, COVID, pneumonia, and other problems. And generally really should not be working -- is unable to work.
Often still, these workers will still try to work to support their families. And so the end result is that the normal healthy sponge-like lung tissue has become so exceptionally scarred over that the worker's lungs are no longer working; they're no longer doing their job, oxygen and carbon dioxide can no longer diffuse back and forth between the alveolar air sacs in the lungs and the capillaries and the worker is under intense suffering.
Now, both simple and complex silicosis can be associated with chronic silicosis, developing over many, many decades and slowly progressing in intensity of disease.
However, the typical worker would live to an old age before the disease would ever progress that significantly. Moreover, as I mentioned, by the seventies, eighties, and nineties in the United States, silicosis, chronic, whether it be simple or accelerated, was pretty much eradicated in the United States. And if we look at fabrication workers, specifically, the incidents of disease in published peer reviewed studies from these fabrication workers that were still only fabricating natural stone, was almost zero.
However, starting in around 2010, when the artificial stone slab manufacturers and suppliers hijacked the existing natural stone fabrication market and injected this high content, nano size, silica, and other toxin, defective product into the fabrication market, according to published peer reviewed studies -- after that, we started to see an explosion in silicosis.
So instead of the largely eradicated chronic silicosis, that was mostly not a problem anymore in the United States, we now have what's known as accelerated silicosis -- meaning the fabrication worker, rather than take many, many decades to develop disease, if there would develop it at all, is now developing the disease after just a few years of exposure.
Additionally, some artificial stone fabrication workers develop acute silicosis, also known as PAP, which can occur after just a few months of exceptionally high exposure to particles from artificial stone. In addition to the extensive scarring associated with complex silicosis, particularly accelerated complex silicosis, with acute silicosis, we see extensive fluid buildup.
So the worker is essentially both suffocating and drowning. And so with accelerated silicosis, whether it's complex or acute, the only treatment is oxygen or a lung transplant. There is no cure. This is a fatal disease and the worker first is suffocating to such an extent that they need 24/7 oxygen and they're tethered to an oxygen tank. And when they get sick enough to qualify, they are able to get a lung transplant.
However, there are several problems with a lung transplant. First problem is a donor with healthy lungs has to die in some sort of accident and be matching to that worker. Secondly, the worker can't have any comorbidities. So if the worker is diabetic or obese or has had cancer, they're not likely to qualify for the lung transplant.
If they do qualify, and lungs become available, they have to be put on the transplant list and make it to the top. And then when lungs become available, they have to survive a very horrific surgery. And then the days and weeks and month following this surgery, they have to survive that as well, and hopefully don't get infection and other problems associated with such extensive surgery.
And finally, unlike say, a liver transplant or a kidney transplant, which work pretty well, our body does not like transplanted lungs, and so the worker has to go on extensive medications, as many as 50 medications a day, including various immunosuppressants to essentially try to stop the body from rejecting the lungs.
Additionally, the lung transplant recipient is especially susceptible to fungal infections and other infections, which can be an immediate death sentence. And despite all those immunosuppressants to try to stop the body from rejecting the lungs, eventually those immunosuppressants fail. And after approximately five years, some less, maybe as few as two or three or one for some workers, some more, maybe as many as seven or eight or nine or 10 years -- but on average five years, the transplanted lungs are going to fail.
They're going to be completely rejected, and the worker then will either die or they'll go through the entire lung transplant process again.
And therefore, you can imagine: if you're a fabrication worker and you are 30 years old and you manage to qualify for a lung transplant and get the lung transplant and survive the surgery and survive the weeks and months after the surgery and your body continues to fight rejection and you manage to not get complications like a fungal infection…
Well, after approximately five years, so now age 35, you now are going to die or start the process again with another lung transplant, that itself is only going to get you another average of say, five years. And so therefore, these fabrication workers are facing this new, manmade disease that according to published peer reviewed studies, is entirely caused by this unnecessary fashion product that was injected into an existing countertop fabrication market.
So these workers are dying from a horrible disease that is entirely unnecessary. And this is, well then therefore, one of the reasons that juries are assessing many millions of dollars, in the example of one of our trials, $52 million for these workers who have been subjected to this complete and unnecessary suffering by slab manufacturers and slab suppliers who are allegedly putting profits over people.
And additionally, as we previously discussed, accelerated silicosis is not the only disease caused by artificial stone. It also causes lung cancer, COPD, chronic kidney disease, various autoimmune diseases, the most common of which is rheumatoid arthritis causes sarcoidosis, and these workers who have silicosis are at significantly increased risk for tuberculosis and other fungal infections.
In later episodes where we analyze the verdict aspect of from dust to verdict, we'll discuss the causes of action, negligence, product liability, the legal aspect of these cases, and we'll discuss the knowledge. What did these artificial stone slab manufacturers and suppliers, what did they know and how long ago did they know it?
Thank you for tuning into this episode of From Dust to Verdict. I'm your host, James Nevin, from the law firm of Brayton Purcell, LLP. Remember to like and subscribe and share. For anyone who speaks Spanish, I encourage you to check out the Spanish language version of this podcast hosted by my good friend, Charlie Velasco Ariza. Thank you.
