1. Black Lung

2. Lung Diseases
Pneumoconiosis
Chronic obstructive pulmonary
Emphysema

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

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

5. Normal

6. Simple CWP

7. PMF

8. Pneumoconiosis is not caused by smoking!…

9. Primary Prevention
Dust control
Alternatives
Ventilation
Respirators

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

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

12. 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

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

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

15. CWP Hot Spots

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

17. Mortality With CWP

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