About the Study
In 2022, the Chief Evaluation Office (CEO) partnered with the Mine Safety and Health Administration (MSHA) and commissioned contractor Summit Consulting, LLC (Summit) to conduct the Black Lung Incidence Study under the Administrative Data Research and Analysis portfolio of studies. This study uses secondary data to examine the rate of black lung disease across the United States, how black lung incidence compares between populations of interest (Appalachia and the Navajo Nation) and coal mining or non-coal mining communities, and how residential coal burning correlates with black lung incidence.
This Department of Labor-funded study was a result of the learning agenda process. It contributes to the labor evidence-base to inform data, methods, and tools and worker protection, labor standards, and workplace-related benefits programs and policies and addresses Departmental strategic goals and priorities.
- Black Lung Incidence Study Navajo Nation Research Brief (Research Brief, January 2024)
- Black Lung Incidence Literature Review (Literature Review, December 2023)
- Black Lung Incidence Study Final Report (Final Report, December 2023)
- What is the rate of black lung disease across the United States?
- What is the total number and rate per 1,000 residents of black lung cases?
- What is the total number and rate per 1,000 residents of black lung deaths?
- How does black lung incidence compare between current, former, and non-coal mining communities?
- Are black lung cases and deaths more prevalent in the Navajo Nation or Appalachia than other parts of the United States?
- How does residential coal burning correlate with black lung cases and deaths?
- There is a public health burden in the Navajo Nation related to residential coal use and coal mining, both of which have historically been important to the Navajo economy.
- According to statistical models designed to estimate black lung prevalence in the Navajo Nation by considering factors associated with black lung disease, estimated black lung prevalence is higher than reported in publicly available data from Centers for Disease Control and Prevention (CDC) The National Institute for Occupational Safety and Health’s (NIOSH) Enhanced Coal Workers’ Health Surveillance Program (ECWHSP) and CDC Wide-ranging ONline Data for Epidemiologic Research.
- Underreporting of black lung cases and deaths in the Navajo Nation may result from lack of trust in and access to healthcare and lack of trust in both researchers and the federal government.
- The prevalence of coal workers’ pneumoconiosis (CWP) has been increasing in the United States since the 1990s.
- The results of analyses in the Final Report show that black lung disease continues to be associated with unsafe practices in coal mining, residential coal burning, and air pollution through coal processing and transportation in the United States (based on data from the MSHA, CDC, Census, and the U.S. Energy Information Administration).
- Black lung disease is exponentially higher in counties where coal mining activity has been more predominant, especially those counties that have maintained coal mining practices since the 1970s and 1980s.
- The prevalence of black lung disease is highly concentrated in specific areas of the country, such as Appalachia. In the Navajo Nation where coal mining has historically been important to the economy and available studies show high levels of residential coal use, results regarding black lung disease prevalence were inconclusive, possibly due to underreporting in the Navajo Nation.
Research Brief
Summit Consulting. (2024). Black Lung Incidence Study Navajo Nation Research Brief. Chief Evaluation Office, U.S. Department of Labor.
Literature Review
Summit Consulting. (2023). Black Lung Incidence Study Literature Review. Chief Evaluation Office, U.S. Department of Labor.
Final Report
Summit Consulting. (2023). Black Lung Incidence Study Final Report. Chief Evaluation Office, U.S. Department of Labor.
The Department of Labor’s (DOL) Chief Evaluation Office (CEO) sponsors independent evaluations and research, primarily conducted by external, third-party contractors in accordance with the Department of Labor Evaluation Policy. CEO’s research development process includes extensive technical review at the design, data collection and analysis stage, including: external contractor review and OMB review and approval of data collection methods and instruments per the Paperwork Reduction Act (PRA), Institutional Review Board (IRB) review to ensure studies adhere to the highest ethical standards, review by academic peers (e.g., Technical Working Groups), and inputs from relevant DOL agency and program officials and CEO technical staff. Final reports undergo an additional independent expert technical review and a review for Section 508 compliance prior to publication. The resulting reports represent findings from this independent research and do not represent DOL positions or policies.