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Silicosis is caused by inhaling free crystalline silica. Few case reports have addressed the risk of silicosis in the jewelry trade where chalk molds containing a high percentage of silica are used in casting. We conducted a cross‐sectional study involving 100 goldsmiths exposed to silica.All workers replied to a questionnaire and underwent a clinical examination, pulmonary function tests, a chest X‐ray and a high‐resolution CT scan.High‐resolution CT visualized signs of silicosis in 23 cases, confirmed by standard chest X‐rays in 10. In the 23 workers with CT evidence of silicosis Total Lung Capacity, FEV1 and the Lung Diffusing Capacity did not differ from the workers without the disease. Pulmonary function tests did not correlate with silica exposure.In this study we demonstrate that use of chalk molds in casting in jewelry causes silicosis. The composition of the dust could be responsible of the high prevalence observed. Am. J. Ind. Med. 50:577–583, 2007. © 2007 Wiley‐Liss, Inc. [ABSTRACT FROM AUTHOR]