Date of Graduation

Summer 8-2026

Document Access

Project/Capstone - Global access

Degree Name

Master of Public Health (MPH)

College/School

School of Nursing and Health Professions

Department/Program

Public Health

First Advisor

Sharon Tafolla, PhD, MPH, MSPH

Abstract

This policy analysis evaluated the effectiveness of current California regulations that were enacted after the STOP Act was passed to address silicosis incidence rates against Australia's complete ban on manufacture, supply, processing and installation of engineered stone with greater than 1% crystalline silica content. Silicosis is a deteriorating fibrotic lung disease caused by the prolonged or massive inhalation of crystalline silica (Dynamed, 2023). To assess the scope of the problem under the STOP Act, we used data from the California Department of Public Health (CDPH) surveillance from 2019 to present. We assessed incidence rates, mortality rates, and patient demographics. We also used data from the California Division of Occupational Safety and Health for employer/employee compliance, effectiveness and shop work safety. We assessed California's process based approach under the STOP Act and we found that scientific evidence, compliance records, and continuing disease burden prove the STOP Act to be insufficient to have positive outcomes in a vulnerable workforce. The policy alternatives to ban artificial stone in this analysis were evaluated for relevance, impact, political feasibility and effectiveness. The dependence California has in employers and employees to properly follow regulations and training has not proven sustainable. Over 90% of cases are among immigrants from Mexico and Central America, many of whom are likely undocumented (Fazio et al., 2023). Understanding the community impact helps explain why 48% of patients continued to fabricate stone after being diagnosed with silicosis (Fazio et al., 2023). Furthermore, 45% of patients reported the use of water suppression for dust mitigation, (a recommendation from CalOSHA for reducing silica exposure) and 19% of those still died. Following the STOP Act guidelines was not enough to save those patients. We propose California adopt Australia's complete ban on manufactured, supplied, processed and installed engineered stone with greater than 1% crystalline silica content and keep worker safety a priority. While there may be some lost revenue, this is offset by revenue from manufacturing alternative materials along with reduced worker disability and lost productivity. This ban will directly benefit at-risk populations and relieve the employees and employers of complete responsibility for stone related silica exposure.

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