About the Literature Review

Download Literature Review

One component of the Mine Safety and Health Administration’s (MSHA’s) mission to “prevent death, illness, and injury from mining and promote safe and healthful workplaces for U.S. miners” is protecting coal miners and coal mining communities from black lung disease (“Mission”). In support of that mission, the literature review expands the U.S. Department of Labor’s knowledge base by synthesizing the available evidence related to black lung disease; coal mining and black lung disease; black lung incidence related to residential coal use; black lung incidence in Appalachia; and black lung incidence among Navajo Nation residents.

Download this Summary (PDF)

Key Takeaways

• Black Lung Disease Overview 
  • The narrowest definition of black lung disease describes diagnoses of coal workers' pneumoconiosis (CWP), but a broader set of illnesses and health impacts are associated with coal mining and use.
  • Because the symptoms and respiratory illnesses associated with coal dust can often resemble other illnesses, a well-documented history of exposure or an autopsy is the only conclusive way to determine the cause.
  • Undercounts in the caseload of black lung disease in the United States are attributed to factors including low uptake of screenings from the Coal Workers’ Health Surveillance Program (CWHSP) and low compensation approval rates.
• Link Between Coal Mining and Black Lung Disease
  • The link between coal dust and CWP is well established and accepted by the medical community, though no definitive scientific explanation for this connection has been identified.
  • CWP prevalence has been increasing in the United States since the 1990s.
• Black Lung Incidence Related to Residential Coal Use
  • Residential coal burning poses a significant risk to public health.
  • Indoor air pollution from residential coal use has been shown to increase the risk of lung cancer and respiratory illness, particularly among women and children.
• Black Lung Incidence in Appalachia
  • Central Appalachia is experiencing a sharp rise in CWP cases after the late 1990s, as shown in a prevalence study of radiographs collected from 1970 to 2017; one in five long-tenured central Appalachian coal miners has evidence of CWP. 
  • Appalachian communities in close proximity to coal mines experience higher rates of mortality and morbidity from a range of respiratory and other illnesses.
• Black Lung Incidence Among Navajo Nation Residents
  • Coal mining has historically been important to the Navajo economy.
  • Available studies show high levels of residential coal use in the Navajo Nation.
  • There is a high public health burden in the Navajo Nation related to coal use and coal mining.

Citation

Summit Consulting. (2023). Black Lung Incidence Study Literature Review. Chief Evaluation Office, U.S. Department of Labor.

Download Literature Review   View Study Profile

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 and CEO’s research development process.