Current Review of Pneumoconiosis Among US Coal Miners

Abstract

Purpose of review: This review summarizes recent research on pneumoconiosis in coal workers following the identification of the resurgence of this disease among US coal miners in the early 2000s. We describe the impact of this research and how this has led to increased public attention, benefitting affected miners.

Recent findings: The latest research shows that the prevalence of pneumoconiosis, including progressive massive fibrosis, continues to increase, especially in central Appalachia. Contributing factors may include mining of thin coal seams or cutting rock to access coal, which may expose miners to coal mine dust with a higher content of silica and silicates than in the past. The impact of recently implemented changes, such as the reduced occupational exposure limit for respirable coal mine dust and the introduction of continuous personal dust monitors, will likely take years to appropriately evaluate.

Keywords: Coal miners; Environmental health; Pneumoconiosis.

Fig. 1

Prevalence of pneumoconiosis among working underground coal miners participating in the Coal Workers’ Health Surveillance Program, in central Appalachia and the USA excluding central Appalachia, 1974–2018. Note: Central Appalachia includes Kentucky, Virginia, and West Virginia. Data are presented as the 5-year moving average percentage; surveillance is conducted on a 5-year national cycle

Fig. 2

Prevalence of progressive massive fibrosis among working underground coal miners with 25 or more years of underground mining tenure participating in the Coal Workers’ Health Surveillance Program in Kentucky, Virginia, and West Virginia, 1974–2018. Note: Data are presented as the 5-year moving average percentage; surveillance is conducted on a 5-year national cycle

Fig. 3

Photograph taken by a miner in 2012 at a surface coal mine; it shows three miners enveloped in a dust cloud loading drill holes to blast overburden. Reprinted with permission from “Debilitating Lung Disease Among Surface Coal Miners With No Underground Mining Tenure,” by C.N. Halldin, W.R. Reed, et al., 2015, J Occup Environ Med, 57 (1):62–67

Fig. 4

Explanted lungs of a male Northern West Virginia coal miner with progressive massive fibrosis who underwent bilateral transplant at age 60 years (Panel a is a photograph of the right explanted lung, Panel b the left lung). He was a life-long never smoker who began his mining career in 1973 at the age of 21. He had 35 total years of mining tenure with 28 years as a continuous miner operator. He exercised Part 90 transfer rights 4 years prior to leaving mining in 2008. The upper left lobe is replaced by progressive massive fibrosis (PMF). The pale nodular areas within the PMF, seen most clearly in the right lung, suggest a component of silicosis

Fig. 5

Chest radiograph image taken in 2016 of a 56-year-old male eastern Kentucky resident with 29 years of total mining tenure (including 11 years as a roof bolter). Image classified as category C large opacity, with 3/2 small opacity profusion, and primarily rounded opacities (q-type)