Resurgence of Black Lung in U.S. Coal Miners

Details

• Personal Author:
  Halldin, Cara N. ; Laney AS
• Description:
  Advances in technology over the last century, as well as the exportation of many high exposure jobs, nearly eliminated lung diseases caused by occupational exposure to respirable dust (the pneumoconioses) in the United States. One such example of this near elimination is black lung, or coal workers' pneumoconiosis (CWP), following the 1969 Federal Coal Mine Health and Safety Act. The Act established permissible exposure limits to respirable dust, designed to prevent the most severe forms of CWP from occurring, and a national respiratory health screening program for underground coal miners. Between 1970 and the mid-1990s, disease prevalence plummeted from nearly 35% to less than 5% prevalence among longer tenured miners, and from 3% to less than 1% in miners with less than 10 years of mining tenure (Hall NB, et al. Curr Environ Health Rep. 2019;6[3]:137). Many assumed that this was the last we'd hear of black lung - that the cases of disease existing in the 1990s were likely caused by exposures that occurred prior to the 1969 Act, and within a few years, no further cases would be detected. This appeared to be an entirely reasonable assumption in the 1990s given the 30 years of declining prevalence and the continuous technological advances designed to continue reductions in dust exposures. In fact, the precipitous decline in black lung was briefly viewed as a public health triumph, as the most severe forms appeared to be near eradication in the United States just 2 decades ago (Attfield MD, et al. Am J Public Health. 1992;82[7]:971; Attfield MD, et al. Am J Public Health. 1992;82[7]:964). However, what has since been observed is a strong and ongoing resurgence of the potentially deadly fibrotic interstitial disease starting in the early 2000s (Figure 1), with the most striking increase observed in the Central Appalachian states of Kentucky, Virginia, and West Virginia (Blackley DJ, et al. Am J Respir Crit Care Med. 2014;190[6]:708; Blackley DJ, et al. Am J Public Health. 2018;108[9]:1220). Of great concern is the resurgence of complicated Black Lung (progressive massive fibrosis [PMF]), which is completely disabling and leads to premature mortality. The prevalence of PMF is higher today than when NIOSH started formally tracking the disease in the 1970s, especially among specific populations. [Description provided by NIOSH]
• Subjects:
  Coal Coal Mining Dust Lung Lung Diseases Mining Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Black Lung Disease Coal Dust Coal Miners Coal Mines Coal Mining Coal Workers Coal Workers Pneumoconiosis Pneumoconiosis Pulmonary System Disorders Respirable Dust Respiratory Diseases Respiratory System Disorders Surveillance Underground Miners Underground Mines Underground Mining

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• ISSN:
  1558-6200
• Document Type:
  Text
• Genre:
  Journal Article ; Lay Publication
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  24-27
• Volume:
  15
• Issue:
  2
• NIOSHTIC Number:
  nn:20058622
• Citation:
  Chest Physician 2020 Feb; 15(2):24-27
• Federal Fiscal Year:
  2020
• NORA Priority Area:
  Mining
• Peer Reviewed:
  False
• Source Full Name:
  Chest Phys
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2610adc860d2ace653ff361107a7db5ffa510db4a3ee9bdb37e959e2392a9230e7572b9071538538b81b64e6c790b901d29bda7974f5bf097b99a0b39fef7654
• Download URL:
  https://stacks.cdc.gov/view/cdc/221665/cdc_221665_DS1.pdf
• File Type:
  [PDF - 1.40 MB ]