Prevalence of Black Lung Disease in Coal Miners Reaches 25-Year High

A new NIOSH report shows that the prevalence of coal workers’ pneumoconiosis, or black lung disease, is continuing to increase among coal miners in the U.S., with the most pronounced increase occurring in central Appalachia. Researchers conducted the study using radiographs collected by NIOSH’s Coal Workers Health Surveillance Program, or CWHSP, during 1970 to 2017. According to the report, the national prevalence of black lung in miners who have worked 25 years or more now exceeds 10 percent. In central Appalachia, which includes Kentucky, Virginia, and West Virginia, 20.6 percent of coal miners have evidence of the disease—the highest level recorded in 25 years.

Progressive massive fibrosis, the most severe form of black lung disease, was previously thought to be nearly eradicated due to improvements in working conditions in coal mines following implementation of the Federal Coal Mine Health and Safety Act of 1969. In the late 1990s, the prevalence of PMF among all miners screened by CWHSP was 0.08 percent. According to NIOSH, the current prevalence of PMF in the central Appalachian region is five percent, the highest prevalence since record-keeping began in the early 1970s.

“Breathing coal mine dust is the sole cause of black lung, and it is entirely preventable,” said epidemiologist David Blackley, DrPH, one of the study’s co-authors. “This study provides further evidence that effective dust control methods and protections to reduce coal mine dust exposure along with early detection of the disease are essential to protect miners’ health.”

The NIOSH report was published online last week in the American Journal of Public Health (subscription or purchase required).

An earlier letter published by NIOSH researchers in the Feb. 6 issue of the Journal of the American Medical Association confirmed 416 cases of PMF from 2013 through 2017 in three clinics in Appalachia. Scott Laney, an epidemiologist with NIOSH, told National Public Radio that the findings represent “the largest cluster of progressive massive fibrosis ever reported.” The cluster was discovered in a region that encompasses parts of Virginia, West Virginia, and Kentucky.