Abstract: Objective To observe the adverse effects of occupational exposure to dust on workers' pulmonary ventilation function and to discuss the role of pulmonary ventilation function and chest X-ray examinations in the health surveillance among dust-exposed workers. Methods The pulmonary ventilation function and chest X-ray examinations were done among 700 dust-exposed workers with exposure time more than 4 years and 700 workers without any records of dust exposure. Results The indicators of the pulmonary function, the standardized FEV₁ and FEV₁/FVC were lower in the exposed workers(P<0.05). Kappa test showed that change of FVC and FEV₁ were not consistent with the results of chest X-ray examination (the matching coefficient, 0.036 and-0.042, P>0.05). By McNemar test, it was noted that change of the pulmonary ventilation function was more obvious than the change of the chest radiograph; while FVC and FEV₁ had good correlation (the matching coefficient, 0.623,P<0.01). Conclusion The dust exposure caused the damage of pulmonary function. The pulmonary ventilation function and chest X-ray examination should be included in the regular health surveillance, since change of pulmonary ventilation function occurred very early if there was damage.