Black Lung

Lung Diseases Pneumoconiosis Chronic obstructive pulmonary Emphysema

Pneumoconiosis Fibrotic disease caused by inhalation of dusts Coal workers’ pneumoconiosis (CWP) from coal dust Severe form is Progressive Massive Fibrosis (PMF)

Pneumoconiosis Silicosis from silica dust Both can lead to disability & premature mortality Very difficult to distinguish between them on the x-ray

Normal

Simple CWP

PMF

Pneumoconiosis is not caused by smoking! …

Primary Prevention Dust control Alternatives Ventilation Respirators

Secondary Prevention Early detection of disease and reduction/elimination of further exposure

NIOSH Programs Regular – clinics used to obtain x-rays Enhanced –NIOSH mobile van

NIOSH Programs Secondary prevention through low dust working environment if pneumoconiosis is seen Population surveillance data to monitor effectiveness of dust control, identify problems & assess trends

Secondary Prevention May slow down or prevent disease development Those with simple pneumoconiosis are at risk of severe disease regardless of future dust exposure

Secondary Prevention Secondary prevention reduces likelihood of future severe disease but does not prevent it Only adequate dust control prevents disease

CWP Hot Spots

A Recent Death Died age 66 27 years mining 17 years underground

Mortality With CWP

Reasons For Increase Longer work hours Greater production Inadequate compliance Increased exposure to silica Dust limits are too high