The 1976 annual report of health activities under the Federal Coal Mine Health and Safety Act of 1969 is presented. Results of medical service programs, X-rays, and autopsies of miners are discussed by the Coal Mine Health Research Advisory Committee. Spirometry, detecting abnormalities, early detection, chemiluminescence, and animal research studies are discussed. Diesel engines, third round coal, coal mine sanitation, and safety research are other topics reviewed. 1976 contracts, agreements, and research grants are described. The authors conclude that new health standards are necessary.