Background. Although crystalline silica exposure is associated with silicosis, lung cancer, pulmonary tuberculosis and COPD, there is less support for an association with autoimmune disease, and renal disease. Methods. Using data from the U.S. National Occupational Mortality Surveillance (NOMS) system, a matched case-control design was employed to examine each of several diseases. These diseases included silicosis, lung cancer, stomach cancer, esophageal cancer, chronic obstructive pulmonary disease (COPD), respiratory tuberculosis, sarcoidosis, systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and various types of renal disease. Cases were subjects whose death certificate mentioned the disease of interest. A separate control group for each of the diseases of interest was selected from among subjects whose death certificate did not mention the disease of interest nor any of several diseases reported to be associated with crystalline silica exposure. Subjects were assigned into a qualitative crystalline silica exposure category based on the industry/occupation pairing found on their death certificate. Results. Those predicted to have had detectable crystalline silica exposure had a significantly increased risk for silicosis, lung cancer, COPD, respiratory tuberculosis, and rheumatoid arthritis. Although monotonic increases in disease risk with increasing crystalline silica exposure were observed for silicosis, esophageal cancer, COPD, respiratory tuberculosis, systemic sclerosis, and systemic lupus erythematosis, those postulated to have had the greatest crystalline silica exposure had a significantly elevated risk for silicosis, lung cancer, COPD, and respiratory tuberculosis only. Conclusions. This study corroborates the association between crystalline silica exposure and silicosis, lung cancer, respiratory tuberculosis, and COPD. Finally, limited support is provided for an association between crystalline silica exposure and rheumatoid arthritis, systemic sclerosis, and systemic lupus erythematosis.