NIOSH Coal Workers’ Health Surveillance Program

CWHSP banner of testing and van

National Institute for Occupational Safety and Health

Coal Workers’ Health Surveillance Program

“The first priority and concern of all in the coal or mining industry must be the health and safety of our most precious resource, the miner.”

~Federal Coal Mine Health and Safety Act of 1969, amended 1977

The National Institute for Occupational Safety and Health (NIOSH), Coal Workers’ Health Surveillance Program (CWHSP) studies the causes and effects of respiratory diseases related to coal mine dust exposure and provides vital health information to coal miners through health screenings and surveillance

Program Background

The NIOSH CWHSP was established by the Federal Coal Mine Safety and Health Act of 1969 to provide early detection of coal workers’ pneumoconiosis, also known as black lung, and to prevent progression to severe lung disease. The program offers health screenings for coal miners and allows researchers to identify trends in disease across the nation.

Coal workers walking into the CWHSP van


The CWHSP provides research and health services for coal miners, and includes the following components:

  • Respiratory health surveillance for coal miners throughout the United States provided by NIOSH-approved facilities and NIOSH-operated mobile units.
  • B Reader certification program that certifies physicians as able to identify and describe black lung using chest x-rays. Training and certifications are based on the International Labour Office (ILO) Classification System of Radiographs of Pneumoconioses.

Questions and Answers

What is coal workers pneumoconiosis (black lung)?
Coal workers pneumoconiosis, or black lung, is scarring in the lungs caused by breathing in coal mine dust. It can take years for this disease to develop, and the scarring is permanent. Severity of the disease can range from mild, where you may not notice any effect on your breathing, to advanced disease.

The most severe form of black lung is called progressive massive fibrosis, where a large part of your lungs could be scarred. Progressive massive fibrosis can lead to respiratory failure and death.

There is no cure for black lung.

Man coughing

How do coal miners get black lung?
Coal miners can get black lung if they breathe in too much coal mine dust. However, engineering controls can be used to control and reduce coal mine dust created during the mining process. Engineering controls include water sprays and various ventilation techniques.

What are symptoms of black lung?
Symptoms can include:

  • coughing
  • excessive phlegm
  • shortness of breath
  • labored breathing
  • chest tightness

Can young coal miners get black lung?
Yes, miners of all ages can get black lung. It depends on the length and intensity of coal mine dust exposures.

How can miners get screened for black lung?
Coal mines file screening plans with NIOSH that identify local health facilities where miners who are currently employed can be screened. The plan also lists 6 month periods every 4 to 5 years when screenings occur at the mine’s expense. The screening plan should be posted on the mine’s bulletin board. Alternatively, you can go to a NIOSH-approved health facility and obtain a screening at your own expense, or participate in NIOSH’s free mobile screenings when we are in your community.

Coal workers walking into the van

Screenings include:

  • work history questionnaire
  • chest radiograph
  • respiratory assessment questionnaire
  • breathing test (spirometry)
  • blood pressure screening

How can I learn more about the CWHSP?
You can find more information about the CWHSP on our website at, on the CWHSP Facebook page, or by calling 1-800-480-4042.
DHHS (NIOSH) Publication No. 2019-130
April 2019