The South African goldmining industry employs a large labour force exposed to several health hazards, of which one of the most important is underground dust, containing a high level of free crystalline silica (30%). Inhalation of silica dust can cause chronic obstructive pulmonary disease (COPD). The present paper reviews the epidemiological evidence on COPD in white South African goldminers. COPD emerges as a major cause of disability and increased mortality. The associated risk factors are smoking and combined exposure to dust and smoking. In conclusion, decreased tobacco consumption in white goldminers would in most cases prevent serious lung function impairment and the premature deaths associated with it.