Black lung disease
Occupational lung disease from coal dust inhalation.
Black lung disease (BLD), also known as coal workers' pneumoconiosis, coal miner's lung, or simply black lung, is an occupational type of pneumoconiosis caused by long-term inhalation and deposition of coal dust in the lungs and the lung tissue's consequent reaction to its presence. It is common in coal miners and others who work with coal, and is similar to both silicosis and asbestosis. Inhaled coal dust progressively builds up in the lungs, leading to inflammation, fibrosis, and in worse cases, necrosis.
- field
- Occupational lung disease
- known_for
- Caused by inhalation of coal dust, leading to pneumoconiosis
- global_deaths_2013
- 25,000
- global_deaths_1990
- 29,000
- prevalence_in_US_miners_over_25_years_19
- 32%
- prevalence_in_US_miners_over_25_years_20
- 9%
Lore & Background
Black lung disease develops after the initial, milder form known as anthracosis, which is often asymptomatic and found in all urban dwellers due to air pollution. Prolonged exposure to large amounts of coal dust can result in simple coal workers' pneumoconiosis and complicated coal workers' pneumoconiosis (progressive massive fibrosis, PMF). More commonly, workers exposed to coal dust develop industrial bronchitis, a chronic bronchitis associated with workplace dust exposure. In non-smokers, studies of coal miners have shown a 16% to 17% incidence of industrial bronchitis.
Reader's Guide
Black lung disease has significant historical and public health importance as a preventable occupational illness that has caused substantial morbidity and mortality among coal miners. The disease was not well-understood until the 1950s, and union priorities initially avoided raising the issue to maintain mechanization and higher wages. The Federal Coal Mine Health and Safety Act of 1969 set dust standards and created the Black Lung Disability Trust, which by 2009 had distributed over $44 billion in benefits. After the act, rates decreased by about 90%, but resurged in the 21st century, with close to 9% of miners with 25+ years testing positive in 2005–2006. New findings show BLD can also affect surface coal miners, who are 48% of the workforce. There is no cure; treatments only relieve symptoms, and prevention focuses on avoiding inhalation of coal dust through respirators and regular exams.
Did You Know?
- In 2013, BLD resulted in 25,000 deaths globally, down from 29,000 in 1990.
- Coal dust that enters the lungs can neither be destroyed nor removed by the body.
- Simple BLD is marked by 1–2 mm nodular aggregations of anthracotic macrophages known as coal macules.
- In Australia, BLD was considered eliminated in the 1970s but resurged, with first new cases detected in May 2015.
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