The experience of the Michigan Department of Public Health (MDPH) silicosis surveillance program between 1987 and 1995 was described. Cases which met NIOSH criteria for silicosis were reported to the program by hospitals, physicians, the state workers' compensation board, or were identified from death certificates. There were 577 persons with silicosis reported to the MDPH system between 1987 and 1995. Hospitals were the primary source of the reports, accounting for 61% of the total. Only ten of the silicosis patients were female. By race, 44.9% were black, 52.3% were white, 0.2% were Asian, and 2.6% were listed as 'other'. The average year of birth of the patients was 1918. They had worked in silica (14808607) exposed jobs an average of 28.7 years (yr). The overall average incidence rates of silicosis among black and white males 40yr or older were 14.3 and 2.1 cases per 100,000, respectively. Simple silicosis had been diagnosed in 65.3% of the subjects and 28.4% had progressive massive fibrosis. The primary work setting in which the patient's had silicosis was iron foundries, 79.8% of the cases occurring in this industry. Inspections had been conducted in only 56 (25.3%) of the 221 facilities in which patients had worked. Twenty of the 39 facilities which had performed air testing had silica concentrations above the NIOSH recommended exposure level of 0.05mg/m3. Only four of 54 facilities (7.4%) which reported having a medical surveillance program provided silicosis medical screening for its workers. Only 228 (39.5%) of the silicotics or their next of kin ever applied for workers' compensation benefits. The authors conclude that the MDPH surveillance program has proved useful in characterizing workers with silicosis, estimating its prevalence, and targeting sites for public health interventions.