The relationship between chronic obstructive pulmonary disease (COPD) and occupational exposure to mineral dust is still conflicting because COPD is multifactorial disease, relatively common in the general population. A number of studies have shown that in population exposed to mineral dust there is a greater prevalence of chronic bronchitis, even in the absence of radiographic evidence of pneumoconiosis. There is no agreement, however, that dust alone will induce significant chronic airflow limitation and increase in mortality. It is unlikely that medical evidence could ever provide conclusive "proof" of the work related less of COPD in the singular patient, but it is possible to provide evidence for reasonable statment of probability.