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Few studies estimated life years lost and lifetime costs resulted from pneumoconiosis. We aimed to assess the expected life years lost (EYLL) and lifetime healthcare expenditures (LTHE) in patients with pneumoconiosis in Taiwan.A cohort of patients with pneumoconiosis was established by recruiting new cases aged 25 or older from the National Health Insurance (NHI) reimbursement dataset. The case was defined by at least 3 times of outpatient clinic visits or hospitalisation with disease diagnosis using ICD-9-CM codes 500–505 for the period 1998–2012. The cohort was linked with National Mortality Registry to verify survival status. Using a semi-parametric method, we extrapolated lifetime survival function under the assumption of constant excess hazard. For each patient, we simulated gender-, and age-matched referents based on the life table from national statistics to estimate the EYLL for the cohort. The LTHE were estimated by multiplying the survival probability with mean monthly costs paid by the NHI for diagnosis and treatment and summing this for the expected lifetime.A total of 34 749 pneumoconiosis patients during the 15 years period, approximating an average of 2482 cases per year, were identified through NHI scheme in Taiwan. We estimated that the EYLL due to overall pneumoconiosis was 2.45±0.1 years. The average EYLL resulted from asbestosis, silicosis, and coal workers’ pneumoconiosis were 3.32±0.7 years, 4.29±0.41 years, 2.66±0.2 years, respectively. The LTHE for pneumoconiosis was NT$708,114±10,859, higher in females than males (749,200 vs 694,518). Asbestosis ranked top among different types of pneumoconiosis.The accumulated disease burden in terms of total EYLL for pneumoconiosis was estimated more than 90 000 life years. The disease burden for pneumoconiosis is substantial. We recommend appropriate measures should be taken for prevention of pneumoconiosis.