Are there comparable models of interstitial lung diseases where therapies have been tried? The answer is complicated by the different pathogenetic mechanisms leading to interstitial lung disease. Sarcoidosis, although granulomatous like silicosis, often has a variable course (unlike silicosis) yet has been shown to respond to steroid therapy. Idiopathic pulmonary fibrosis, a disease with an expected survival time similar to this population of silicotics, has been the subject of 15 trials suitable for analysis.7 Scleroderma, an interstitial lung disease with primary vascular involvement, has benefited from the initiation of the Scleroderma Patient-Centered Intervention Network8 to identify patients and develop clinical trials. All these diseases, like silicosis, are relatively rare, and in none of the therapeutic trials has there been evidence that the inciting reason for the illness was altered.