OBJECTIVE To review the possible association between occupational exposure to dust and ischaemic heart disease (IHD). METHODS A literature search was performed of relevant studies regarding IHD in specific exposures to dust. The chosen exposures were arsenic, asbestos, beryllium, lead, polycyclic aromatic hydrocarbons, and quartz. The chosen occupations were farmers, paper and paper pulp workers, sawyers, and welders. CONCLUSIONS A theory was launched in 1995 that urban particulate air pollution may provoke alveolar inflammation, with release of mediators capable of increasing blood coagulability in susceptible people and cause cardiovascular deaths. The present review expands this hypothesis and links occupational exposure to inhaled particles with the occurrence of ischaemic heart disease. CONCLUSIONS This hypothesis should be tested by comparing the concentrations of fibrinogen in workers exposed and nonexposed to particles with control for other possible confounders such as smoking habits.