Health experts are increasingly worried about silicosis, a deadly lung disease caused by exposure to tiny particles of silica dust. And it is trade people, working with engineered stone, who are bearing the brunt of it.
It's a kitchen and bathroom designer's dream.
Cheaper, more varied in colour and less porous than marble; better looking and more hard wearing than Formica; engineered stone is the material of choice when you're renovating.
But the workers who custom-cut it are paying the price - in the form of a deadly lung disease caused by breathing in tiny particles of silica.
Manufacturers have known about this for decades.
But it's taken an expose by Sydney Morning Herald investigative reporter Adele Ferguson to push the issue front and centre - to the extent that authorities there are now looking at a ban.
Ferguson speaks to The Detail about what triggered her 60 Minutes programme, and how, in spite of all the publicity, companies are still operating under unsafe conditions.
Perth's Curtin University has estimated 270,000 Australian workers are exposed to high levels of crystalline silica every day, and that 103,000 workers will be diagnosed with silicosis.
Ferguson backs a ban on engineered stone and doesn't believe the industry can be regulated.
"At the end of the day this is a vanity product. How much is it going to cost to properly regulate a lot of these small little businesses that the regulator doesn't even know exist? I've had respiratory physicians saying that they're getting people coming to them that aren't even on the books.
"You know, it's Chinese who are getting loaded up on buses, sent out to sites and workplaces...they get silicosis...and as soon as they get sick they get shipped back to their own country."
New Zealand health experts have been keeping a close eye on the situation in Australia, after realising it must also be going on under the radar here.
Occupational and environmental physician Dr Alexandra Muthu says in 2019, her industry group wrote to the ministers of health, ACC and social development and workplace relations raising red flags. She co-chairs the group that was subsequently formed, the New Zealand Dust Diseases Taskforce.
Work to identify and assess people at risk of accelerated silicosis began in September 2020. As of the end of last month, 140 claims had been lodged with ACC for assessment.
WorkSafe knows of about 600 current and former workers in New Zealand who fabricate engineered stone, who are at risk and potentially eligible for a health check - there will be other workers who've slipped through the gaps.
One of the problems is that there's no agency that specifically looks at health-related illness in the workplace.
"WorkSafe is very safety focused," she says. "There are no occupational health experts on the board or in the executive leadership team of WorkSafe New Zealand."
There is some recognition of illnesses that take a while to develop, Muthu says, but no one's looking at the horizon to respond to these new threats.
New Zealand hasn't done widespread screening of workers from, or who have left, the industry, but there is an ACC pathway to getting help.
"Of the people that we have done screening on, I saw an initial cohort of about 26 people in 2019. Of those, three people had significant disease and needed to stop working in the industry. About another 40 percent had significant history of exposure and had some early signs of lung disease."
There have so far been no known deaths.
"One of the problems with dust exposures, particularly silica exposure, is that you can have these diseases that look the same but are caused by other things," Muthu says.
"It's not until you are specifically asked about your workplace exposures that we know it's that."
GPs have an online portal with the information on silicosis available, but Muthu points out that GPs are extremely overwhelmed in our system - we have thousands of GPs around the country and about 1000 people exposed to silica dust, so it's unlikely the same doctors will be seeing multiple patients to the point where they can manage or assess cases.
New Zealand imports about 60,000 engineered stone slabs a year, and WorkSafe knows of 132 businesses that fabricate them into benchtops.
In 2019 it issued 113 notices to 64 businesses, including 21 prohibition notices and 71 improvement notices. But the very next year it issued 166 notices to 75 businesses - just three prohibitions, but 115 improvement notices.
Muthu says education doesn't last, and she'd like to see better regulation.
Overseas the levels of dust allowable in the air have been lowered, but New Zealand doesn't currently require workplaces to meet those lower levels.
"There needs to be a whole suite of regulations," she says.
"But WorkSafe needs to go further than that."
Hear more about what's been labelled the "silicosis epidemic" in the full podcast episode.
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