This is part 4 of a series on silicosis.
For 22 years, Daniel Aguilar Morales cut stone countertops five to six days a week at B Y Marble Inc. in the City of San Fernando. He would have happily continued another 22 years had his health not taken a drastic turn.
Seemingly overnight, Aguilar Morales began having difficulty breathing and felt himself getting weaker. The large stone slabs he once carried with ease onto the cutting table were impossible to move. He developed a cough – sometimes even coughing up blood – and felt as though he was losing his voice.
“I wasn’t able to have a conversation for more than three minutes,” Aguilar Morales said. “I would pick up my phone and couldn’t respond. I would try really hard [to speak] and it was like my voice was closing up.”
In February 2024, the 42-year-old spent a week in the hospital before being diagnosed with advanced acute silicosis, a fatal occupational lung disease.
Stone fabrication workers who cut, grind and polish engineered stone can inhale crystalline silica dust that cuts up their lungs, essentially suffocating them.
Aguilar Morales now carries oxygen to help with his breathing and has difficulty climbing the stairs to his second-floor apartment in Panorama City.
“When I walk, I get agitated if I’m not using oxygen, and I start coughing because of my lungs,” he said. “I can only move things for two or three minutes [before I get tired].”
He is currently on a waitlist for a lung transplant, a complicated procedure that prolongs workers’ lives by an average of only six years, according to Dr. Jane Fazio, pulmonary physician at Olive View UCLA Medical Center in Sylmar.
“Silicosis is not a disease that has any known cure. It’s a progressive disease,” said Fazio during a presentation for the Los Angeles Health Commission. “We really don’t have much to offer patients once we diagnose them with silicosis medically, besides supportive care and prevention of other diseases that can occur with silicosis.”
An Epidemic Among Young Latinos
The change has been difficult for Aguilar Morales, who emigrated from Mexico when he was 19 years old. His first two weeks in the United States were the only time he didn’t have work. Days that used to fly by at the fabrication shop now drag on in the confines of his one-bedroom apartment.
“I liked my job. It was nice because I never stopped learning,” said Aguilar Morales. He proudly pointed out several of his table designs nestled around his home.
When he first started working in the industry, Aguilar Morales said he only worked with natural stone. Around 10 years ago, engineered stone began taking over the market. With four times the amount of silica, this manufactured stone has skyrocketed silicosis cases among fabricators.
“When I was working with natural stone, I didn’t feel like this,” said Aguilar Morales.
“The smell of the material is released when cutting it on the machine. The artificial stone has a strong smell,” because of the chemicals it’s made with, he said, adding that he believes the material should be removed from the market.
The California Department of Public Health has confirmed 294 cases of silicosis, 30 lung transplants and 15 deaths in the state – nearly all (98%) of which are Latino men.
The Northeast San Fernando Valley is the epicenter of cases in California because of the high concentration of fabrication shops. Aguilar Morales said he knows about seven other workers also diagnosed with the disease, but that there must be more cases since most people he knows are reluctant to get checked.
“This is serious, it’s not a game,” said Aguilar Morales. “You [fabricators] need to get checked, so what happened to me doesn’t happen to you.”
With at least 20-30% of the workforce estimated to be affected, there may be over 1,200 silicosis cases in California.
Workers’ Compensation Falls Short
As silicosis cases soar among young Latino workers in California, many are not being properly compensated by insurance.
“The cost of this disease should be borne out by workers’ compensation because it’s a 100% occupational disease, but we’re not seeing that in the data,” said Fazio.
Workers’ compensation is a state-mandated insurance program that provides employees who suffer work-related injuries or illnesses with benefits.
“The average cost for hospitalization is about $27,000 per patient, and 65% of that is paid for by public insurance, and only 5% of that is paid for by workers’ compensation insurance,” Fazio said.
Attorney Barry Rodich, a partner at Rodich Law, represents stone fabrication workers in silicosis-related workers’ compensation cases.
“Of the 30 to 50 cases, I think there’s probably four that are accepted and the others remain denied [by insurance],” said Rodich.
Aguilar Morales, who is covered by Omaha National, was one of the few to have his case accepted. Other cases that are almost identical to his have been rejected, said Rodich.
“Just because the case is accepted, doesn’t mean it’s easier,” he added. “It just means they get benefits while they suffer. It just means they’re able to support themselves, so they don’t have to go back to work in the stone shops or borrow from family and friends.”
“How could I make it without working? They [my family] depend on me. My kid depends on me,” said Aguilar Morales. “Imagine if I didn’t have this assistance, what would I do?”
A 2023 study published by Fazio and other researchers found that only 13% of analyzed cases had workers’ compensation benefits. Without another means of providing for themselves or their families, almost half of the patients kept working in the industry after receiving their diagnosis.
Silicosis is a lifelong disability, which means it is a very high payout for insurance companies. Aguilar Morales is on oxygen, awaiting a transplant, unable to return to work. He is considered 100% disabled.
“That means he gets paid his disability benefit every two weeks for the rest of his life until he dies. That will probably be $600 to $700 thousand in benefits over the course of his life, assuming he lives [a full lifespan],” said Rodich. “Plus, the medical treatment should be covered by workers’ compensation.”
A single lung transplant can cost up to a million dollars. A double lung transplant, or combined with other organ transplants, can cost well over one million. Aguilar Morales requires a liver transplant as well as a lung transplant.
When a client dies, insurance may be required to pay a statutory death benefit to their spouse or dependents, but for the insurer, it is the difference between “a few million dollars, compared to $250,000 to $320,000,” said Rodich.
Many insurance companies push back on accepting responsibility for the claim or tie up cases in lengthy legal battles to avoid the high costs, he said.
“I believe a lot of them are paralyzed by the valuation,” said Rodich. “They do these comparative analyses of ‘okay, if we drag this case out, what’s the likelihood that the client is going to die?’”
With a high morbidity and mortality rate, this is sadly a bet the insurance company is likely to win.
“The average time from diagnosis to death is less than four years,” said Fazio.
So while insurance companies weigh out their profits, these workers are returning to the fabrication shops to earn a living, continuing to be exposed to toxic dust, worsening their disease and in many cases passing away.
Although Aguilar Morales is realistic about his condition, he continues life with a smile on his face and hope for his future.
“Money doesn’t buy lives. Cuando le toca, le toca. [When it’s your turn, it’s your turn],” said Aguilar Morales. “I try and enjoy every day more, appreciate it more, because I don’t know what’s going to happen.”
Omaha National refused a request for comment.
Next week: Life after a double lung transplant.
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