In the nineteen-seventies a cross-sectional survey was conducted in the Dutch fine-ceramic industry. Workers employed in the ceramic industry (n = 3258) were examined for the presence of silicosis. In this article the results are reported for the area of Gouda and Maastricht. In Gouda the fine-ceramic industry consists of small workshops. The Maastricht working population comprises workers of two large, mechanized companies. The survey indicated that silicosis is still commonly present in Gouda (total prevalence of 13.3%), but is relatively rare in Maastricht (total prevalence of 1.7%). A clear dose-response relationship was found in both areas between duration of exposure to quartz-containing dust and the prevalence of silicosis. Furthermore it was noted that smoking was a risk factor for silicosis. However, this was restricted to workers who were heavy smokers and had had an occupational history of 20 years or more of exposure to quartz-containing dust. In this exposure category the prevalence of silicosis among heavy smokers was 50% higher than in light smokers and non-smokers.