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Pneumoconiosis, “Black Lung” in Coal Workers

Friday, 04 Mar 2016
Pneumoconiosis, “Black Lung” in Coal Workers

The relationship between dust exposure in mining and the development of lung disease has been recognised for centuries. In the 16th century, the Joachimstal Town physician, Agricola (1494-1555) recorded:

"In the mines of the Carpathian Mountains, women are found who have married seven husbands, all of whom this terrible consumption has carried off to a premature death"

Such historical accounts serve to remind us of the toll on human health where preventive measures are neglected.

Coal workers' pneumoconiosis (CWP), commonly called “Black Lung” is a chronic lung disease caused by inhalation of coalmine dust. Pneumoconiosis is a fibrotic (scarring) disease of the lung tissue; coal workers' pneumoconiosis generally takes many years to develop and manifest.

The primary cause of the pneumoconioses is work-place exposure. It is rare for environmental exposures to cause these diseases. It may therefore be fairly said that these diseases are entirely man-made, and can be avoided through appropriate dust control. With appropriate dust control, these diseases have become rare.

However, towards the end of 2015, several cases of coal workers pneumoconiosis were diagnosed in Queensland underground coal miners. There are also anecdotal reports in the press of dust monitoring levels in some mines exceeding the allowable standard. This coincided with changes within the industry such as; 12 hour shifts, increased production, and fragmentation of the industry through increased use of contractors may all have contributed to an increased risk, and/or a reduction in effectiveness of the existing health monitoring programs.

Health monitoring is used to detect ill health due to the effects of exposure to hazardous materials and substances at an early stage, so employers can introduce better controls to prevent the issue from getting worse. Black Lung is typically detected in living individuals through the use of radiological imaging and health monitoring including regular spirometry readings. Experienced Occupational and Environmental Physicians are able to assist organisations to develop protocols for health monitoring and evaluation and evaluate work place health risks.

In response to the recently identified cases of Coal Workers' Pneumoconiosis in Queensland, the Minister for Natural Resources and Mines invited Professor Malcolm Sim, Director of the Centre for Occupational Health and Safety at Monash University, and Professor Robert Cohen, from the Division of Environmental Occupational Health Sciences at the University of Illinois to undertake a review of the existing Coal Mine Workers Health Scheme.

The Department also convened a Reference Group to oversee the review process, and to act as a link between the Review Team and industry representatives. Dr Adam was invited to be a member of that Group because of his experience and long involvement in the coal industry.

While the outcome of the review is still several months away, Dr Adam believes that a likely outcome will be the requirement to ensure high quality standards for the performance of both x-rays and spirometry to screen for Coal workers' pneumoconiosis.

For more information on how Sonic HealthPlus' Occupational and Environmental Physicians can assist you please visit our Specialised Services Page.


Dr Adam can be contacted directly through the contact details listed in his biography.

Dr Keith Adam

Dr Keith Adam is a Senior Specialist Occupational Physician with Sonic HealthPlus and an Associate Professor of Occupational Medicine with the University of Queensland. Treating and rehabilitating injured workers since 1984, Dr Adam has extensive experience in determining what duties injured workers may be able to perform, and managing return to work programmes.

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