Coal workers' pneumoconiosis, in its most severe state, develops after the initial, milder form of the disease known as anthracosis (anthrac - coal, carbon). This is often asymptomatic and is found to at least some extent in all urban dwellers due to air pollution. Prolonged exposure to large amounts of carbon dust can result in more serious forms of the disease, simple coal workers' pneumoconiosis and complicated coal workers' pneumoconiosis.
In the 25 years since the Federal Coal Mine Health and Safety Act of 1969 became law, the proportion of miners with black lung disease has gone down by about 90%. But the downward trend of this disease in coal miners has stopped. Rates of black lung are on the rise and have almost doubled in the last 10 years. From 2000 to 2004, over 4,000 miners died from black lung disease in the United States.
The National Institute for Occupational Safety and Health (NIOSH), with support of the Mine Safety and Health Administration (MSHA), has started a Mobile Health Screening Program. This Mobile Unit travels to mining regions around the United States. Miners who participate in the Program receive health evaluations once every five years, at no cost to themselves. Chest x-rays can detect the early signs of and changes in CWP, often before the miner is aware of any lung problems. The screening program is only available to current miners.
Continued exposure to coal dust following the development of simple CWP may result in its progression to complicated CWP, which generally requires a number of years to develop. Large, black, fibrotic scars 2-10cm in diameter are present, with accompanying decreased lung function. The lung itself appears blackened. A minority of these cases progresses to progressive massive fibrosis (PMF), the most serious form of CWP.
NIOSH Coal Workers' Health Surveillance Program http://www.cdc.gov/niosh/topics/surveillance/ORDS/CoalWorkersHealthSurvProgram.html
American College of Radiology (ACR) http://www.acr.org
Black Lung Benefits Act (BLBA) http://www.dol.gov/dol/compliance/comp-blba.htm
Black Lung Clinics Program http://bphc.hrsa.gov/blacklung/default.htm
Campaign to End Black Lung Now and Forever http://www.msha.gov/S&HINFO/BLUNG/HOMEPAGE.HTM
Federal Mine Safety & Health Act of 1977 http://www.msha.gov/Regs/Act/Acttc.htm
Mine Safety and Health Administration http://www.msha.gov
42CFR27 Specifications of Medical Examinations of Underground Coal Miners http://www.access.gpo.gov/nara/cfr/waisidx_02/42cfr37_02.html
The Courier-Journal (Louisville, Ky): Black Lung Chronicles http://www.courier-journal.com/cjextra/blacklung/index.html