Occupational Respiratory Disease Surveillance

OCCUPATIONAL RESPIRATORY DISEASE SURVEILLANCE

Coal Workers' Health Surveillance Program (CWHSP)

New information on respiratory diseases in coal miners

NIOSH is currently working to include the submission and evaluation of digital chest x-ray images as part of the CWHSP. The process is complex and requires that multiple activities be completed. To enhance information dissemination we are now providing an Digital Imaging Activities to enable stakeholders and interested parties to obtain the latest information on this transition.

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-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 three components:

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.
National Coal Workers' Autopsy Program
When a coal miner dies, the family may arrange for a free autopsy. The results may help support a 'black lung' benefit claim, and also help scientists and medical doctors learn more about coal workers' pneumoconiosis (CWP) or 'black lung' disease.
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 [PDF - 103 KB]
(OMB 0920-0020) (CDC/NIOSH 2.10) (December 2009)
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 [PDF - 80 KB]
(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 [PDF - 119 KB]
(OMB 0920-0020) (CDC/NIOSH 2.12) (December 2009)
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 [PDF - 207 KB]
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.

Roentgenographic Interpretation Form [PDF - 449 KB] (For official government use only)
En español
(OMB 0920-0020) (CDC/NIOSH 2.8) (December 2009)
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 Roentgenographic Interpretation Form [PDF - 416 KB]
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' Health Surveillance Program (CWHSP) Resource List [PDF - 302 KB]
Contact information for MSHA District Offices, Black Lung Clinics, Black Lung Benefits Offices, and State Offices of Workers' Compensation. (January 2010)

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.

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