Introduction Occupational lung diseases are a broad group of diagnoses caused by a wide range of hazards in the workplace such dusts, chemicals or proteins. The International Labour Organisation estimates that 700.000 people in the world die yearly from occupational lung diseases. Teaching the subject at the undergraduate levels in medical schools is important, so that the students consider these diagnoses later on in their careers. However, earlier surveys have shown that the interest in occupational medicine is low in medical students. Teaching occupational lung diseases can be especially challenging since the terminology is confusing.

Methods In order to improve students’ learning, a puzzle game on occupational lung diseases was developed. On a game-board, five columns and ten rows made a grid of fifty squares. The headings of the five columns were different disease groups: Pneumoconiosis, Inhalation Fevers, Allergic Alveolitis, Occupational Asthma, and Toxic Pneumonitis. The rows headings were: Subtypes, Prevalence, Exposure, Symptoms, Clinical Findings, Lab Tests, Chest X-ray, Pulmonary Function Tests, Prognosis, and Treatment. Fifty cards with text descriptions should be placed on the correct square on the board. For example, one card described that more than 350 substances (Exposure) have been associated with occupational asthma. After finding the correct place for all the cards, they are turned upside down showing a poster from a movie related to occupational medicine for example Norma Ray. The students are asked to describe that relation.

Results The game has been tested by 160 medical students who were very interested and worked intensely. The students gave high ratings in the course evaluation and enjoyed the puzzle.

Conclusion This educational game on occupational lung disease probably improved medical students’ learning outcomes compared to passively listening to lectures. The game is also suitable for other groups such as physicians and staff in Occupational Health Services.