In a routine survey of 623 miners in one colliery, 21 men, an unusually high number, showed radiological progression of simple pneumoconiosis in spite of generally low exposures to mixed coalmine dust. Comparison of the dust exposures of the 21 men with those of matched controls without pneumoconiosis showed highly significant differences in the proportion of quartz in the mixed dust to which they had been exposed. Quartz exposure may be an important factor in the development and rapid progression of coalworkers' pneumoconiosis. Some indication of the levels of quartz exposure which are likely to be hazardous is given.