To explore the long-term influence of particulate air pollution on cardio-respiratory morbidity in the UK, a cross-sectional postal survey was conducted. Women were randomly selected from the electoral rolls of 11 wards in which Black Smoke measurements had been collected over at least 30 years. Our analyses included 1166 women aged 45 years or older who had lived within 5 miles of their current address for at least 30 years. After adjustment for potential confounders there was no clear increase in prevalence of productive cough or medically diagnosed ischaemic heart disease with long-term residence in places with higher levels of particulate pollution. The prevalence of asthma was lower in wards with the highest Black Smoke measurements (prevalence ratio 0.7, 95% CI 0.5 - 1.0). Our findings provide no indication that prolonged residence in places with relatively high levels of particulate pollution causes an important increase in cardio-respiratory morbidity. This is in contrast to observations in US studies. In view of this discordance, there is a need for further evaluation of the long-term impact of particulate pollution on health in the UK.