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Black Lung Disease

In the last decade, over 10,000 miners have died of coal workers' pneumoconiosis, or what is commonly called black lung disease.

Black lung disease, which is caused by inhaling coal mine dust, results in scarring of the lungs and emphysema, shortness of breath, disability, and premature death. While the prevalence of black lung disease had decreased by about 90% from 1969 to 1995 following the enactment of the Coal Mine Health and Safety Act, the downward trend of this disease in coal miners has stopped. Since 1995, the prevalence of black lung cases has more than doubled.

Many current underground miners (some as young as in their 30s) are developing severe and advanced cases. Identification of advanced cases among miners under age 50 is of particular concern, as they were exposed to coal-mine dust in the years after implementation of the disease prevention measures mandated by the 1969 federal legislation. An increased risk of pneumoconiosis has also been associated with work in certain mining jobs, in smaller mines, in several geographic areas, and among contract miners.

While the exact causes for the continued occurrence of black lung disease are not fully understood, possible explanations include:

  1. inadequacies in the mandated coal-mine-dust regulations
  2. failure to comply with or adequately enforce those regulations
  3. lack of disease prevention measures to accommodate changes in mining practices (e.g., thin-seam mining with cutting of adjacent silica-containing rock) brought about by depletion of richer coal reserves
  4. the effect of working longer hours in recent years, and
  5. missed opportunities by miners to be screened for early disease and take action to reduce dust exposure

To help recognize early disease in miners and to enable those with black lung to take action to reduce their dust exposures, NIOSH operates the Coal Workers' Health Surveillance Program. Miners who participate in the program receive no cost health evaluations (including a chest x-ray) once every five years. Chest x-rays can detect the early signs of coal workers' pneumoconiosis and can detect lung changes often before the miner is aware of any breathing problems.

These programs are meant to protect the health of the miners, but they can only do so if the miners participate. Interviews with miners have indicated that reasons for non-participation are manifold, including concerns that a positive finding might be disclosed to their employers and lead to job loss or affect future receipt of compensation for disability. However, under federal law a mine operator can not legally dismiss a miner due to presence of black lung disease (or any other type of disease).

Coal operators are required under the law to adhere to the dust standards. Today's mining industry has the necessary tools to control each miner's exposure to respirable dust and silica. The industry and the miners must both ensure that control measures are conscientiously applied and dust levels accurately monitored. In addition, miners need to reduce their exposure to coal-mine dust when early disease is seen and, when necessary, to exercise their legal right for transfer to a job with reduced exposure, if available. When all of this is achieved we will be one step closer to a time when miners and their families will no longer have to suffer the devastating effects of black lung disease.