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Historiography has revealed a complex combination of scientific, technical, socio-political, economic, and cultural factors affecting the identification of occupational risks and the adoption of corrective measures and compensation schemes. In the case of coal dust, the late recognition of pneumoconiosis as an occupational disease of coal workers in the 1940s was largely because the hazard of silica overshadowed that of coal dust. In the case of Spain, the coal mining industry had a period of expansion in the 1940s and 1950s, when its traditional lack of competitiveness with British coal was overcome by autarchic protectionism under Franco regime. This gave rise to an intensification of workloads and the worsening of working conditions, converting coal workers’ pneumoconiosis into the main industrial disease in Franco’s Spain. The preventive approach to coal dust problem has received scant attention from historians. Thus, the aim of this paper is to explore the politics of preventive approaches against coal dust diseases during the Franco regime.A historiographical analysis of the rich documentation kept in the archives of Spanish coal mining companies has been carried out.Apart from medical monitoring, very little action was taken on dust suppression until the early 1960s. Despite the costs of compensation in this period, employers failed to take voluntary action to address the dust problem. Changing strategies developed after nationalisation of the sector in 1967The growing labour unrest and political concerns about rising pneumoconiosis rates in the late 1950s led to the updating of the Code of Mining Safety Regulations (1960), which for the first time included regular dust control measurements. After nationalisation, the new public corporation (HUNOSA) focused more on prevention than compensation, developing a more technical approach to dust suppression.