This article analyses why Australia's first epidemic of silicosis developed, notwithstanding the accumulating medical and lay knowledge that the disease was caused by dust from rock drills and poorly ventilated mines. Previously unexamined sources show that at key points, where the potential existed to minimise its progress and impact, public policy failed. Instead of containing or mediating the disease, legislative choices fostered its unconstrained spread. Legal, regulatory, political, financial and social aspects of silicosis were subordinated to, and shaped by, the economic interests of industry and the state. Paradoxically, this was couched in terms of protecting workers through saving jobs. At the same time, blame for the epidemic was shifted from factors outside workers control, such as mine design and the machinery purchased by mine owners, to workers' reckless disregard of purported protective equipment. Response to the epidemic established a pattern that was repeated in other states over the following decades wherever workers were exposed to silica dust.