The true extent of the deadly lung disease affecting stonemasons who cut engineered stone kitchen benchtops is hidden and the entire workforce should be urgently medically tested, an international expert has warned.

Key points: A silicosis cluster was discovered amongst stonemasons cutting engineered stone benchtops in Queensland in September

A silicosis cluster was discovered amongst stonemasons cutting engineered stone benchtops in Queensland in September New cases have been discovered in NSW, Victoria and the ACT

New cases have been discovered in NSW, Victoria and the ACT A national register is being set up to track the scale of the crisis

The warning comes as the number of stonemasons in Queensland diagnosed with silicosis has doubled.

The health crisis emerged in September when dozens of cases of silicosis were identified in Queensland among stonemasons cutting engineered stone benchtops.

Last month, a 7.30 investigation revealed new cases in New South Wales, the ACT and Victoria, prompting the Morrison Government to set up a national register to track the scale of the crisis.

Since the silicosis cluster was discovered in Queensland, there has been widespread health screening of the local workforce.

7.30 can reveal 53 stonemasons have now been diagnosed with silicosis there, including 11 with the most serious form of the disease — progressive massive fibrosis.

In Queensland, WorkCover has received more than 500 requests for health screening from stonemasons.

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Cluster could be tip of the iceberg, expert says

Dr Robert Cohen wants to see the entire stonemason workforce to be medically tested. ( ABC News: Michael Atkin )

Dr Robert Cohen, a leading international expert on occupational and environmental medicine, specialising in lung disease, has been a key adviser to the Queensland Government.

"This is a disease that we know is 100 per cent preventable," he said.

"These regulators need to be pro-active and incredibly active in getting out there so we're not having parliamentary investigations and retrospective regrets for not having protected this workforce.

"If there are people out there who are dry cutting, or even wet cutting but with very poor local exhaust ventilation, and they're cutting this very, very high silica dust material, creating that dust, there's got to be more cases there."

Dr Cohen believes the true extent of the problem is hidden because national health screening has not occurred.

He is backing calls from the Royal Australasian College of Physicians and the Thoracic Society for an urgent medical program.

"One severe case is a sentinel health event. It means that you have a very sick worker but it likely means you have a sick workplace, and it might even mean you have a sick industry which means you should respond with a rapid response team," he said.

"Get out there and survey the entire workforce and see how big your problem is, because that person is usually the tip of the iceberg and you don't know how much of that iceberg is submerged."

'I would be covered in it'

Jack Gray and his daughter Scarlett. ( ABC News: Gus Goswell )

Jack Gray, 34, is coming to terms with his diagnosis of progressive massive fibrosis.

He spent 12 years working in the Melbourne and Gold Coast factories of Willis Bros, one of the largest engineered stone fabricators.

Jack Gray with dust on his face after work. ( Supplied: Jack Gray )

He said the dust was overwhelming.

"I would be covered in it. You could barely see your hand in front of you. It was pretty full on," Mr Gray said.

"Suppliers would come around all the time and drop off their new samples and that, and they'd see the environment. They never said, 'You shouldn't be working in this environment'. No-one ever really said that until now people are getting diagnosed with it."

7.30 has learned Willis Bros is one of the most heavily affected workplaces.

In a statement the company said it had received 19 WorkCover claims from current and former staff in Queensland.

Another five of their former workers have lodged WorkCover claims, but against different employers.

"We deeply regret the news that our former workmate, Jack Gray, has been diagnosed with this condition," Willis Bros said.

"We have undertaken CT scans of our employees who have had three or more years in our industry, as recommended by the Royal Australasian College of Physicians.

"To the best of our knowledge we have complied with relevant regulations as they have applied over the years."

Mr Gray resigned in August but is still installing engineered stone to pay the bills.

"When I first started, I'd lift 100kg pieces of stone up all day, and now I'll get one piece up and I'm exhausted, I need to sit down and have a rest," he said.

Nick Lardieri and Deb Dennison with their children. ( Supplied: Deb Dennison )

Stonemason Nick Lardieri is only 35 but some days feels like an old man.

"Putting my shoes on I struggle, it hurts. It just takes me longer to do things, short of breath. Sometimes I feel like I'm 80 years old," he said.

He's been diagnosed with silicosis and a related auto-immune condition.

Mr Lardieri said he was cutting stone with little safety protection for more than a decade, exposing him to hazardous levels of silica dust.

"You'd be covered in it. You look like Casper the ghost. All white, white hair," he said.

To make matters even worse for the family, his partner Deb Dennison has terminal breast cancer.

"It is the new asbestos, but it's got a quicker turnaround time," Ms Dennison said. "You don't have to be exposed as long and its terminal.

"Nick's only 35 and it's devastating, just devastating."

Mr Gray and Mr Lardieri have now lodged workers compensation claims for silicosis, taking the number of stonemasons in Victoria with claims since 2015 to 18.

'It is a national crisis'

A stone kitchen bench under construction. ( Supplied: Nick Lardieri )

NSW safety inspectors have cracked down on more than 100 unsafe engineered stone businesses.

The NSW Government is offering free respiratory medical examinations to current and former stonemasons through its Dust Diseases Care unit.

But Roger Singh, a dust disease specialist at Shine Lawyers, believes other states are failing to act with enough urgency.

"It begs the question, have we not learned the lessons of what occurred with asbestos?" Mr Singh said.

"And of further alarm is the lack of urgency on the part of many states and territories in dealing with this crisis, and it is a national crisis."

The Victorian Minister responsible for WorkSafe, Robin Scott, was unavailable for interview and did not respond to specific criticisms about his Government's response.

But in a statement, Mr Scott said consultation on the health crisis was continuing.

"WorkSafe is conducting a compliance blitz to ensure safe work practices, and boosting resources, education and awareness of the dangers of silicosis," he said.

"We've also called for the urgent establishment of a national registry and a review of the current standards."

Companies 'know what the product does when you cut it'

There is now immense pressure on the engineered stone industry to show its products are being used safely.

Leading suppliers of Caesarstone, Quantum Quartz and Smart Stone are yet to speak publicly about stonemason health, and all declined interviews with 7.30.

"Caesarstone, Quantum Quartz — they know, they know, they actually know what the product does when you cut it," Mr Lardieri said.

What is silicosis? An incurable and often fatal lung disease caused by breathing dust containing fragments of crystalline silica

An incurable and often fatal lung disease caused by breathing dust containing fragments of crystalline silica Silica in concrete, masonry, sandstone, rock, paint and other abrasives is released by cutting, drilling or blasting

Silica in concrete, masonry, sandstone, rock, paint and other abrasives is released by cutting, drilling or blasting Three types of silicosis: chronic (most common) from at least 10 years of exposure; accelerated, from higher exposure levels and 5-10 years of exposure; acute (fatal) from weeks or months of very high exposure Source: US Centers for Disease Control and Prevention

"They push the product, saying it's durable, it's scratch proof, it doesn't stain. OK, you tell us all the good stuff. Tell the employers if you cut like this your workers are going to get sick."

Israeli multinational Caesarstone is one of the biggest suppliers. The company estimates its revenue this year could reach $830 million.

It has faced legal action over silicosis cases in Israel, Spain and Australia, but the company claims it has never admitted liability.

"They've seen fit to peddle their product in Australia without safeguarding the health and safety of workers," Mr Singh said.

"For confidentiality reasons I can't say too much, but what I can say is we are looking to progress legal action against the suppliers."

In a statement, Caesarstone said it had recently formed an industry advisory group with other suppliers.

"Stonemasons are independent contractors and members of the advisory group provide them with recommended instructions and warnings," the statement said.

"If the correct procedures are followed, the risk of silicosis can be eliminated."

Caesarstone also said it was a member of both the NSW Government taskforce and Queensland Government working group, which are examining solutions.

"Caesarstone continues to engage with government Workcover agencies, unions, occupational physicians and the Thoracic Society, industry associations and state health departments, to ensure there is ongoing awareness of adequate safety standards and the importance of workplace monitoring," the company said.

"We welcome the ongoing audits of stonemason workshops by the Government to ensure full compliance with recommended safety standards."