Historically well-recognized occupational threats such as coal workers pneumoconiosis, silicosis, and asbestosis remain important and are very likely underestimated in measures of global disease burden. Studies of occupational exposure related to idiopathic pulmonary fibrosis, the most common interstitial lung disease, are limited but there is moderate evidence for metal, wood, and stone dust being significant contributors. Vigilance is required to identify causes, such as hypersensitivity pneumonitis due to microbial contamination of metalworking fluid (now responsible for greater than 50% of occupational hypersensitivity pneumonitis cases in the United Kingdom) in an everchanging workplace environment.