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Alpha Foundation 2


Alpha Foundation for the Improvement of Mine Safety and Health, Inc. Heading link

Project II – Linkage of Active Miner Surveillance, Former Miner Disability Evaluations, and Mortality Data Sets to Evaluate and Prevent Lifetime Risk of Cardiopulmonary Disease in U.S. Miners

Coal miners are a unique subset of miners for whom several national data sets exist that allow in-depth study of their health. The objective of this study was to link demographic, radiologic, physiologic, and mortality data from the National Institute for Occupational Safety and Health (NIOSH) Coal Workers’ Health Surveillance Program (CWHSP), the U.S. Department of Labor (DOL) Federal Black Lung Program (FBLP), and the National Death Index (NDI).

Main findings:

  • A large percentage (39%) of miners applying for FBLP benefits between 2000 and 2013 had not previously participated in the CWHSP. Geographic differences in participation in either of these programs were evident, although the majority of participants in both were from Central Appalachia.
  • Data on miners with serial chest x-rays (CXRs) and lung function tests indicate that progression of disease to progressive massive fibrosis (PMF) and lung function decline can occur in former miners absent further coal mine dust exposure.
  • We identified 4,679 cases of PMF among miners applying for FBLP benefits between 1970 and 2016. The number of PMF cases has been increasing since the 1990s with nearly half of all PMF cases identified since 2000. We identified 2,474 miners with PMF in the FBLP data from 1996-2016 which is more than ten times greater than the number identified by our national surveillance program in the same time period. The proportion of federal black lung benefits claimants with PMF has been increasing since 1978, and began increasing at a significantly increased rate after 1996.
  • Highest rates of severe disease were observed in the Central Appalachian states of Virginia, West Virginia, and Kentucky.
  • Among miners participating in national surveillance and the FBLP, proportional mortality from nonmalignant respiratory diseases (NMRD), and specifically pneumoconioses, increased across birth cohorts, with the highest proportions observed in miners born after 1940. This increase is pronounced among younger miners and may reflect increased mortality from progressive massive fibrosis, which is occurring more frequently and in younger U.S. coal miners.