Diatomaceous earth, quarried from the remains of aquatic plants deposited millions of years ago, continues to be a very important raw material with many industrial uses. In its natural state, diatomaceous earth is an amorphous silica with no crystalline pattern. For many uses, however, it is calcinated and calcination converts a portion of the amorphous silica to a crystalline form, cristobalite which is far more fibrogenic. In a factory which produces calcinated diatomaceous earth, seven workers were proved as pneumoconiosis on 1991 and 1992. Authors reviewed medical chart and current status of them. Authors also examined thirty one subjects from the factory with questionnaire, physical examination, spirometry and chest radiography on August 13th 1993. The radiographs were independently interpreted by two radiologists and their findings were classified by International Classification of Radiography of Pneumoconiosis(ILO, 1980). Total and respirable dust of diatomaceous earth were measured on October 1993. The results were as follows; 1. Of 31 workers, 6 (19.4%) were diagnosed as diatomaceous earth pneumoconiosis. There was an increasing tendency in prevalence of pneumoconiosis as the duration of dust exposure gets longer. 2. There were no significant differences in age, smoking rate, alcohol drinking rate, and pulmonary function test results between cases and non-cases. 3. The means of total dust exposures at flour manufacturing, fire brick grinding and packaging, ceramic raws packaging processes exceeded Korean and ACGIH standards, $10mg/m^3$. Above results suggest that engineering controls, periodic environmental and medical surveillance are important for preventing pneumoconiosis in the diatomite factory.