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American new coal-mining methods seen driving black lung increase - Research

Coal News - Published on Wed, 22 May 2019

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According to research presented here at the American Thoracic Society's annual meeting, rising prevalence of the most deadly form of black lung disease among US miners appears largely due to shifting mining methods resulting in increased inhalation of crystalline silica. A review of mortality data from 1991 through 1996 from NIOSH's National Coal Workers' Autopsy Study showed little evidence of a transition to silica predominant disease. Apparently, more recent shifts in exposures are driving the resurgence in the rapidly progressing form of black lung known as progressive massive fibrosis (PMF).

Another analysis of PMF cases recorded in the NCWAS data before and after 1990 suggested a historical shift in the disease, with silicotic PMF accounting for a greater percentage of cases in the latter period. And a third analysis showed a proportional increase in mortality from non-malignant respiratory diseases among younger miners (<65 years) in more recent birth cohorts compared to miners born earlier.

The three studies examining the changing pathology and demographics of black lung disease were all led by Mr Robert Cohen, MD, of the University of Illinois at Chicago's Black Lung Center of Excellence. Mr Cohen told MedPage Today that the increase in the silicotic form of black lung underscores the need for tougher federal standards regulating respiratory exposures associated with modern mining practices.

Mr Cohen said that "Existing regulations don't address this very well." He added that animal and toxicology studies show that dust from modern mining which contains very small particle silica from rock is up to 20 times more toxic than the dust derived from coal alone. Silica is also a recognized carcinogen, whereas the evidence linking coal dust to lung cancer remains weak.

Radiographic and pathologic evidence suggests a strong link between the increase in pulmonary massive fibrosis and increased exposure to respirable crystalline silica.

In an effort to further explore this link, occupational pathologists reviewed lung tissue under light microscopy from 325 miners who had been classified as having PMF with sufficient lung material available for review.

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Posted By : Rabi Wangkhem on Wed, 22 May 2019
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