Learn About Coal Workers’ Pneumoconiosis

Key Facts

• Coal workers’ pneumoconiosis, or black lung disease, is one of over 200 types of pulmonary fibrosis and is classified as an interstitial lung disease. Your healthcare provider may refer to your disease by any of these terms.
  • Fibrosis - a process in which the tissue in the lungs becomes thicker and stiffer than normal.
  • Interstitial Lung Disease (ILD) - an umbrella term used for a large group of diseases that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs which makes it difficult to breathe and get oxygen to the bloodstream. Lung damage from ILDs is often irreversible and can get worse over time. 
• After decades of improvement, the number of cases of black lung disease is rising again.
• There is no cure for coal workers’ pneumoconiosis, but treatment can help manage symptoms and improve quality of life.
• The Mine Safety and Health Administration (MSHA) has safety standards to help employers and workers take steps to prevent black lung disease.

What Causes Coal Workers’ Pneumoconiosis?

Black lung disease can develop when coal dust is inhaled over a long period of time. Coal dust is made of dangerous carbon-containing particles that coal miners are at risk of inhaling, which is why it is mostly considered an occupational (workplace) disease. Coal miners may also be exposed to silica-containing dust because coal mining may involve drilling into silica-containing rock. People who live with coal workers, or launder their work wardrobe, are also at risk of inhaling coal dust and developing black lung disease.

Not all workers will develop the disease. The prevalence has been increasing in recent years, with central Appalachian and Indigenous coal miners being disproportionately impacted. This increase may be linked to changes in mining technology that allow for higher volumes of coal to be extracted at a time, production of finer mineral particulates during the extraction process and changes in the mineral content of the coal, making modern mining practices potentially more hazardous.

How It Affects Your Body

When coal dust is inhaled, the particles can travel through your airways into the alveoli (air sacs) that are deep in your lungs. When dust particles settle in your lungs, it can cause swelling as your body tries to fight the foreign particles. In some cases, the body’s reaction to the particles is severe enough to cause scar tissue to form. The damaging effects of the inhaled coal dust may not show up for many years, and you may not develop symptoms until long after your initial exposure.

For coal workers’ pneumoconiosis, the scarring can be separated into two types: simple or complicated. With simple pneumoconiosis, a chest X-ray or CT scan will reveal small amounts of scar tissue, seen as tiny, circular nodules on the lungs. Complicated pneumoconiosis, also called progressive massive fibrosis, involves more severe scarring over a larger area of the lung tissue. With both types, your breathing will be negatively affected.