THE first time 27-year-old Cameron Harper speaks to me, he stops talking several times to cough and wheeze.
"Sometimes I'll lose my breath, and I have to cough and just restart my sentence," he explains apologetically, "I've lost a fair amount of my lung capacity. Just everyday breathing is a bit of a struggle."
Just over a year ago Cameron, a former stonemason from Melbourne, was diagnosed with silicosis - a progressive, irreversible lung disease caused by prolonged exposure to respirable crystalline silica or quartz dust.
Traditionally associated with the mining industry, silicosis causes scarring of the lungs leading to progressive respiratory impairment. Some sufferers eventually require a lung transplant and it may lead to death.
Across the globe, annual deaths from silicosis are dropping. However, Australian medical and legal experts are alarmed to note a recent spike in new cases of life-threatening silicosis. This spike has been attributed to occupational exposure (often by tradies) to so-called engineered or artificial stone products often used for kitchen benchtops.
Back in September 2015, Cameron simply thought he had a persistent chest infection. The cough refused to budge despite several courses of antibiotics and his GP sent him for an x-ray and subsequently to a specialist.
"It [the diagnosis] came as a big shock. I knew that the results were probably going to show something bad, but I didn't realise how bad or permanent," Cameron reflects.
"Since I got diagnosed, my illness has actually gotten worse. There's more scarring showing up on my lungs.
"It is a bit of a mystery illness. You don't really know how it's going to progress," Cameron says.
What isn't a mystery is how Cameron contracted silicosis. Until recently, he was a stonemason.
For 40-50 hours a week, Cameron was working with engineered stone products and inhaling the dust: "I'd be making bench tops for kitchens and bathrooms, and doing a lot of dry cutting and a bit of polishing."
"When I changed companies in 2015, there [was] a lack of care. I was there for a year, and I didn't have the proper PPE (personal protective equipment) so I got acute silicosis from extremely large levels of dust exposure," he says.
At the time, Cameron only had "a slight idea" the silica dust might pose a health risk. Now he's is paying the price for his previous employer's lax safety standards.
Even though he describes himself as "a pretty relaxed guy," he worries about the future. In particular Cameron wonders about how the silicosis will affect his fiancee, Nicole.
"In the last year or so, I reckon I've probably had seven or eight chest infections," he says, "It's a bit scary for her to see. There's been a couple of times where she's wanted to take me off to emergency because I'm really struggling to breathe."
Dr Ryan Hoy is respiratory physician at the Cabrini Medical Centre in Melbourne and a member of the Lung Foundation of Australia. He's aware of seven new cases of silicosis caused by exposure to artificial stone across NSW, Queensland and Victoria diagnosed in the last five years, "six of which have advanced disease, known as progressive massive fibrosis."
"Some of the patients that we've seen have been developing this disease over five years, which is a much shorter period of time than silicosis which is generally seen in mining, which is usually over 10 [or] 20 years of exposure," he says.
Artificial stone, he continues, "has only been available in Australia since the early 2000s" and is manufactured "by crushing silica containing rock to a fine consistency which is then mixed with an adhesive and hardened."
"As kitchen bench-top fabricators cut slabs of this artificial stone extremely high levels of fine silica dust can potentially be generated. Inhaling this dust carries a high risk of developing silicosis," Dr Hoy says.
According to Dr Hoy, the risk increases with the intensity and duration of silica exposure (so even though wearing protective equipment is a great idea, you are unlikely to get silicosis by doing a one-off DIY job in your kitchen or bathroom).
Theodora Ahilas is national practice leader and principal of the asbestos and dust diseases department at legal firm, Maurice Blackburn.
She tells news.com.au the firm is currently representing 12 clients with silicosis caused by exposure to man-made stone.
"Two years ago we had nil such clients so … that's quite a spike in that area," she says.
Ms Ahilas has been working in the area of litigation and dust disease for nearly 30 years. Decades ago, her clients who contracted silicosis were "working in ill-educated jobs using jack hammers for construction of tunnels and for construction of the big buildings in the [Sydney] CBD."
"That's not what we're seeing today. We're seeing a different cohort of workers," she says.
Referencing both the recent Queensland inquiry into lung diseases - including silicosis - and also the NSW Review of the Dust Disease Support Scheme, Ms Ahilas says: "We've been asleep at the wheel to an extent."
"I think we thought those diseases [like black lung] were gone … that that was history. That there were protections and people were adhering to them," she continues.
Ms Ahilas says her current cohort of silicosis clients as "people between 40 and 50 years of age who have been working hard doing renovation type work or commercial work. Building kitchens, bathrooms … or wherever the man-made stone is used.
"Some of these people have very good careers in these industries and they're in the prime of their life," she says, and goes on to describe the multiple impacts of the disease on her clients as "horrendous" and "absolutely debilitating."
"It's not just the physical effects but we've also got the psychological and psychosocial effect of … learning to live with a progressive disease that could take your life," Ms Ahilas says, "And remember we're talking about something that can be avoided."
"Not everyone who works with it is going to develop a disease. What we're trying to do is avoid the exposure," Ms Ahilas says.
"I want to stop people getting sick. I think that's got to be the end game. We don't want people to be sick from going to work."
The way Dr Hoy sees it, the responsibility lies firmly with employers "to make sure that they're providing a safe workplace for their employees."
"All occupational lung diseases are preventable by eliminating the cause at the workplace. Employers need to ensure that all possible measures are in place to minimise dust exposure when cutting and grinding artificial stone."
Such safety measures include effective ventilation and water to suppress dust generation, he says, adding that: "Use of face masks alone are not sufficient to protect workers."
Since leaving his former employer - who can't be named for legal reasons - Cameron is retraining as a plumber. These days he's hyper vigilant, especially when he sees other tradespeople "just creating dust out on the work site without a mask on, just breathing it in and not knowing what the outcome can be. I actually tell them to put a mask on."
Before his illness Cameron used to play competitive baseball and even represented Australia at a junior level. Although he dreams of taking up the sport once again, this has become an impossibility. Just getting by is hard enough: "I feel like my lungs are exhausted by the end of the day."
If he could turn the clock back, Cameron says, "I'd spend all the money in the world just to get a proper mask that was going to stop this from happening. I'd go and work for a better employer who took their safety standards more seriously."
Although Cameron is taking legal action against his former employer and hopes to gain compensation, he'd prefer simply to have his health back.
"At the end of the day … all the money in the world isn't really enough to compensate for this kind of illness," he says.
For Dr Hoy's part, he would like to see regular, mandated health screening for employees exposed to respirable crystalline silica. He also supports the development of an occupational disease registry where doctors and other health professionals would notify a central agency.
"Most of our knowledge about the occupational lung disease … that are occurring comes through Workers' Compensation statistics. And by the time those workers have developed disease, by the time those statistics are available, we've really missed the boat," he says.
For more information about silicosis, read the Lung Foundation's fact sheet.
Ginger Gorman is an award-winning print and radio journalist. Follow her on Twitter @GingerGorman or support her work on Patreon.