This review discussed the surveillance, epidemiology, exposure settings, disease descriptions, clinical presentation, treatment, associated disorders, and prevention of asbestosis and silicosis. The continued occurrence of new cases of silicosis and asbestosis is partly due to the diversity of settings in which hazardous exposures continue to occur. Exposure to crystalline silica (14808607) has been noted in both surface and underground mining, as well as tunneling and quarrying. Often the risk in the construction industry was unnoticed. Asbestosis (1332214) has been used in more than 3,000 commercial products. Silicosis was described as chronic, accelerated, or acute. There were no symptoms or physical signs uniquely associated with the pneumoconioses. Physical examination may be unremarkable with mild disease. There was no effective treatment to reverse the course of asbestosis or silicosis. The prevention of these diseases through elimination of hazardous exposure conditions has been of primary importance. Even if exposure stops, asbestosis and all forms of silicosis can progress. The most ominous diseases associated with asbestos exposure were cancers of the mesothelium or lung, which occur even in the absence of fibrosis on chest radiography. The author concludes that physicians can contribute to disease prevention through accurate diagnosis and reporting the conditions, and through effective health communications.