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OCCUPATIONAL RESPIRATORY DISEASE SURVEILLANCE

Coal Workers' Health Surveillance Program (CWHSP)

IMPORTANT INFORMATION FOR COAL MINE OPERATORS AND INDEPENDENT CONTRACTORS PROVIDING SERVICES AT COAL MINES ABOUT NEW REQUIREMENTS FOR COAL MINER HEALTH TESTING

The National Institute for Occupational Safety and Health (NIOSH) is preparing to expand its national program of health surveillance for coal miners. The health surveillance program is a longstanding NIOSH responsibility under the Federal Mine Safety and Health Act. The action to expand the program is in response to new requirements for health surveillance in the Mine Safety and Health Administration’s (MHSA’s) recently-published final rule on controlling coal mine dust exposure. Under the existing program, periodic chest radiographs and occupational history questionnaires are provided to underground coal miners. The expanded surveillance program will provide periodic lung function testing (called spirometry) and respiratory health assessment questionnaires. It will also extend health surveillance to workers at surface coal mines.

Operators of underground coal mines are currently required to post a NIOSH-approved health examination plan providing health surveillance to their underground miners every five years. The Coal Mine Operator’s Plan Form is already available for submitting these Mine Plans.

During this interim period, as NIOSH prepares to establish the expanded national surveillance program, operators of new underground mines and operators of surface mines must use the existing form to file their Mine Plans. Contractors that employ workers at coal mines who are eligible for health surveillance should also use the existing form to file their Mine Plans. Contractors do not need to indicate at which mines they are operating, and should indicate the number of miles by road from the location of the contractor to the X-Ray Facility(ies).

Surface operators and contractors should leave the x-ray begin-and-end dates blank. NIOSH will assign these dates for all new plans as part of the Mine Plan approval process.

The currently posted mine plan form only provides for x-rays and occupational history questionnaires. MSHA will be notifying operators and contractors that filed plans using the current mine plan form when they need to add periodic spirometry and respiratory health assessment questionnaires to their plans.

MSHA posted questions and answers on June 12, 2014, providing important guidance for coal operators, both underground and surface. These can be found at http://www.msha.gov/endblacklung/faq.asp. NIOSH anticipates that regulations specifying details for operation of its newly expanded health surveillance program will be published in the Federal Register in the near future. At that time, NIOSH will provide additional guidance materials. In the meantime, if you have any questions about the interim actions described above for coal worker health surveillance, contact the NIOSH Coal Workers’ Health Surveillance Program - Tel (toll free): 888-480-4042; E-mail: CWHSP@cdc.gov.

Photo of a coal miner.

"The first priority and concern of all in the coal or other mining industry must be the health and safety of its most precious resource – the miner." (Federal Coal Mine Health and Safety Act of 1969, amended 1977.)

The Federal Coal Mine Health and Safety Act of 1969 (as amended by the Federal Mine Safety and Health Act of 1977) is intended to protect the health and safety of underground coal miners. This Act directs NIOSH to study the causes and consequences of coal mining-related respiratory disease and, in cooperation with the Mine Safety and Health Administration (MSHA), to carry out a program for early detection and prevention of coal workers' pneumoconiosis. These activities are administered through the Coal Workers' Health Surveillance Program (CWHSP), as specified in the Federal Regulations, 42 CFR 37, “Specifications for Medical Examinations of Underground Coal Miners.” The CWHSP consists of two active components:

  1. Coal Workers' X-ray Surveillance Program (CWXSP)
    Information about free chest x-rays provided for underground coal miners. Who pays? What is Coal Workers' Pneumoconiosis? Black Lung? When? Where? Frequently Asked Questions and Answers.
  2. NIOSH B Reader Program
    The B Reader Program aims to ensure competency in radiographic reading by evaluating the ability of readers to classify a test set of radiographs, thereby creating and maintaining a pool of qualified readers having the skills and ability to provide accurate and precise International Labour Office (ILO) classifications.

Coal Workers' Health Surveillance Program (CWHSP) Data Query System

CWHSP Data Query System generates tables by Disease Severity Level and Disease Severity Prevalence, by demographic and geographical criteria for the total number of underground miners who participated in the CWHSP program.

Coal Workers' Health Surveillance Program (CWHSP) Public Data

As part of its ongoing respiratory disease surveillance program, NIOSH publishes periodic updates on patterns, trends, distributions, and clusters of medical outcomes of concern. CWHSP Public Data serves to provide the underlying data from several publications.

Enhanced Coal Workers' Health Surveillance Program (ECWHSP)

In light of the observed onset of advanced pneumoconiosis among younger coal miners, and the apparent regional clustering of rapidly progressive cases, NIOSH, in collaboration with MSHA, has developed, staffed, and implemented the Enhanced Coal Workers' Health Surveillance Program (ECWHSP). This page contains more information about the program and survey summaries.

Coal Workers' Health Surveillance Program (CWHSP) Forms

Coal Mine Operator's Plan
(OMB 0920-0020) (CDC/NIOSH 2.10) (June 2014)
The form and instructions should be used by underground coal mine operators' when submitting a plan for their miner's to receive chest x-rays at designated x-ray facilities. Coal mine operators must submit a plan and mine roster no later than 60 days after opening a new mine or 30 days when mine ownership is transferred. Mail to the address on the form or it may be emailed to CWHSP@cdc.gov.

Facility Certification Document
(OMB 0920-0020) (CDC/NIOSH 2.11) (December 2009)
X-ray facilities should use this form to apply for certification and approval to take x-rays as part of the NIOSH program. Mail to the address on the form or it may be emailed to CWHSP@cdc.gov.

Interpreting Physician Certification Document
(OMB 0920-0020) (CDC/NIOSH 2.12) (December 2013)
Physicians should complete this form to apply to take the NIOSH B Reader examination. Mail to the address on the form. Do NOT send this form electronically to NIOSH.

Miner Identification Form
En español
(OMB 0920-0020) (CDC/NIOSH 2.9) (December 2009)
This form must be completed by the miner and accompany all x-rays sent to NIOSH for interpretation as part of the Coal Workers' X-ray Surveillance Program. Mail to the address on the form. Do NOT send this form electronically to NIOSH. Print/Copy as a double-sided form.

Chest Radiograph Classification Form (For official government use only)
(OMB 0920-0020) (CDC/NIOSH 2.8) (December 2013)
This form must be completed by the A or B Reader that interprets a chest radiograph for NIOSH as part of the Coal Workers' X-ray Surveillance Program. Mail to the address on the form. Do NOT send this form electronically to NIOSH. Print/Copy as a double-sided form.

General Purpose Chest Radiograph Classification Form (July 2014)
The general purpose form is provided as a convenience to certified B Readers and is not an official government form.

Related NIOSH Resources

Black Lung, Don't Become a Victim [PDF - 130 KB]
DHHS (NIOSH) Publication No. 2003-123 (2003)
A NIOSH poster promoting participation in the Coal Workers' Health Surveillance Program.

Coal Workers' Pneumoconiosis-Related Years of Potential Life Lost Before Age 65 Years — United States, 1968–2006
Morbidity and Mortality Weekly Report, December 2009;58(50);1412-1416.

Current Intelligence Bulletin 64: Coal Mine Dust Exposures and Associated Health Outcomes - A Review of Information Published Since 1995
DHHS (NIOSH) Publication Number 2011-172
NIOSH has published this current intelligence bulletin that reviews information on occupational lung diseases of coal miners. This Current Intelligence Bulletin updates the information on coal mine dust exposures and associated health effects from 1995 to the present. The Bulletin refers extensively to the 1995 NIOSH publication - Criteria for a Recommended Standard – Occupational Exposure to Respirable Coal Mine Dust.

Faces of Black Lung (Video)
DHHS (NIOSH) Publication No. 2008-131
Slide Show: Lung sections from victims of pneumoconiosis [PDF - 4,670 KB]

Mine X-Ray Plans Due for Renewal
A list of the underground coal mining operations, recently notified by NIOSH of the requirement to provide chest x-rays to their employees. This information is being made available for NIOSH-approved x-ray providers interested in increasing participation in the NIOSH Coal Workers' X-ray Surveillance Program (CWXSP).

NIOSH Approved X-ray Facility Search and Map
Searchable maps of NIOSH approved x-ray facilities.

NIOSH B Reader Examination
NIOSH B Reader certification is granted to physicians who demonstrate proficiency in the classification of chest x-rays for the pneumoconioses using the International Labour Office (ILO) Classification System.

NIOSH Digital Chest Radiography
NIOSH is currently researching the use of digital chest images for the evaluation of the pneumoconioses.

NIOSH/DRDS/CWHSP Celebrates the 35th Anniversary of the Federal Coal Mine Health and Safety Act

Pneumoconiosis Prevalence Among Working Coal Miners Examined in Federal Chest Radiograph Surveillance Programs — United States, 1996–2002
Morbidity and Mortality Weekly Report, April 2003;52(15):336-340.

Work-Related Lung Disease Surveillance System (eWoRLD), Coal Workers' Pneumoconiosis and Related Exposures

X-Ray Facilities Database Search
Search the X-Ray Facilities Database to view a listing of all currently approved NIOSH x-ray facilities.

Other Related Resources

American College of Radiology (ACR)

Black Lung Benefits Act (BLBA)

U.S. Department of Health and Human Services, Health Resources and Services Administration, Black Lung Clinics Program

Campaign to End Black Lung Now and Forever

Federal Mine Safety & Health Act of 1977

Government Accountability Office,  Reports and Key Studies Support the Scientific Conclusions Underlying the Proposed Exposure Limit for Respirable Coal Mine Dust, GAO-12-832R, Aug 17, 2012

Mine Safety and Health Administration

42CFR37 Specifications of Medical Examinations of Underground Coal Miners (10/15/2012)


 
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