A discussion of NIOSH strategy for preventing occupational lung disease was reported. The strategy was directed toward the goal of preventing any new cases of asbestosis, byssinosis, silicosis, and coalworkers' pneumoconiosis by 1990 in workers newly exposed after 1985. The strategy consisted of surveillance, regulatory enforcement, research, control technology and respirator use, education and training, health promotion and smoking cessation, and worker compensation components. Four health studies of mining populations recently completed by the NIOSH Division of Respiratory Disease Studies were summarized. The first study was a mortality and morbidity study of miners exposed to vermiculite (1318009) contaminated with tremolite-asbestos (14567738). The second was a morbidity study of workers exposed to attapulgite, a clay containing agglomeratic fibrous particles. The third and fourth studies were concerned with mortality and morbidity in the Portland cement industry. The vermiculite study found that the increase in lung cancer risk over that expected in United States white males with at least 20 years of exposure was 0.6 percent for each fiber/year of exposure. At 5 fiber/years, the increase was 2.9 percent. The relative risk for small X-ray opacities was 1.3 percent at 5 fiber/years. In the attapulgite workers, there was a slight increase in chest X-ray opacities that was associated with exposure. In the Portland cement workers, there was no convincing evidence that occupational exposure was associated with risk of mortality from all cancers, lung cancer, stomach cancer, nonmalignant respiratory disease, or heart disease. There was no consistent pattern in respiratory symptomatology and ventilatory function and exposure to cement dusts.