Does silicosis still occur?

A state-based surveillance system has identified 401 individuals with the diagnosis of silicosis for the years 1979 through 1987. The individuals identified were generally older men who began work before 1960 and had worked for 15 years or more in potteries, construction, foundries, or sand mines. Follow-up inspections at the identified companies indicated ongoing poorly controlled exposure to silica. Difficulties in distinguishing coal worker's pneumoconiosis from silicosis and inadequate attention to tuberculosis by the treating physicians were noted. Few workers applied for workers' compensation. Extrapolation of our results to the whole country suggests that the current national surveillance system for occupational illnesses markedly underestimates the true occurrence of silicosis.