Preventing silicosis in construction workers was discussed. The problem of silica (14808607) exposure in the construction industry was summarized. A NIOSH study of mortality in 61,682 construction workers in 19 states conducted between 1984 and 1986 found a significant increase in silicosis mortality, proportionate mortality ratio 327. About 700,000 construction workers were estimated to be exposed to silica dust, primarily as a result of exposure to concrete and rock dusts. It was noted that since surface coal mining operations resemble those of construction, actions taken to reduce silica exposures in surface coal mines may be applicable to construction operations. Cases of silicosis that have occurred in surface coal miners in West Virginia were summarized. Concerns related to controlling dust exposures during surface coal mining applicable to the construction industry were considered. These include identifying and tracking small employer contract drillers, the inability of semiannual silica sampling to identify excess silica exposures particularly in highly variable environments, and the need to control excessive exposures during the period between the date of sampling and the date sampling results are received. Costs associated with installing dust control equipment in surface coal mines were discussed. Poorly controlled drills represented the major source of dust exposure. Sampling, respirator use, medical screening, and surveillance programs for preventing silicosis in construction workers were discussed. It was noted that sampling alone may not be a reliable indicator of risk since at construction sites dust exposures are highly variable and depend strongly on work practices, equipment controls, site settings, and meteorological conditions. Medical screening and surveillance are under used. Many construction workers wear inappropriate respirators, such as disposable paper masks, when performing abrasive blasting work.