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Current intelligence bulletin 64: coal mine dust exposures and associated health outcomes - a review of information published since 1995.
Attfield M; Hale J; Suarthana E; Wang ML; Castranova V; Clough Thomas K
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2011-172, (CIB 64), 2011 Apr; :1-38
Information relating to occupational pulmonary disease morbidity and mortality of coal miners available up to 1995 was reviewed in the NIOSH publication: Criteria for a Recommended Standard - Occupational Exposure to Respirable Coal Mine Dust, or Coal Criteria Document (CCD). This led to the following principal conclusions concerning health effects associated with coal mining: 1. Exposure to coal mine dust causes various pulmonary diseases, including coal workers' pneumoconiosis (CWP) and chronic obstructive pulmonary disease (COPD). 2. Coal miners are also exposed to crystalline silica dust, which causes silicosis, COPD, and other diseases. 3. These lung diseases can bring about impairment, disability and premature death. This Current Intelligence Bulletin updates the previously published review with respect to findings relevant to the health of U.S. coal miners published since 1995. The main conclusions are: 1. After a long period of declining CWP prevalence, recent surveillance data indicate that the prevalence is rising. 2. Coal miners are developing severe CWP at relatively young ages (less than 50 years). 3. There is some indication that early development of CWP is being manifested as premature mortality. 4. The above individuals would have been employed all of their working lives in environmental conditions mandated by the 1969 Coal Mine Health and Safety Act. 5. The increase in CWP occurrence appears to be concentrated in hot spots of disease mostly concentrated in the central Appalachian region of southern West Virginia, eastern Kentucky, and western Virginia. 6. The cause of this resurgence in disease is likely multifactorial. Possible explanations include excessive exposure due to increases in coal mine dust levels and duration of exposure (longer working hours), and increases in crystalline silica exposure. As indicated by data on disease prevalence and severity, workers in smaller mines may be at special risk. 7. Given that the more productive seams of coal are being mined out, a transition by the industry to mining thinner coal seams and those with more rock v intrusions is taking place and will likely accelerate in the future. Concomitant with this is the likelihood of increased potential for exposure to crystalline silica, and associated increased risk of silicosis, in coal mining. The main conclusions drawn from review of the new information are: 1. While findings published since 1995 refine or add further to the understanding of the respiratory health effects of coal mine dust described in the NIOSH CCD, they do not contradict or critically modify the primary conclusions and associated recommendations given there. Rather, the new findings strengthen those conclusions and recommendations. 2. Overall, the evidence and logical basis for recommendations concerning prevention of occupational respiratory disease among coal miners remains essentially unaffected by the newer findings that have emerged since publication of the CCD. In summary, as recommended by the CCD, every effort needs to be made to reduce exposure to both coal mine dust and to crystalline silica dust. As also recommended in the CCD, the latter task requires establishing a separate compliance standard in order to provide an effective limit to exposure to crystalline silica dust.
Coal-mining; Coal-miners; Coal-dust; Dust-exposure; Dusts; Morbidity-rates; Mortality-rates; Respirable-dust; Coal-workers-pneumoconiosis; Respiratory-system-disorders; Pulmonary-system-disorders; Silica-dusts; Silicosis; Pneumoconiosis; Lung-disease; Lung-disorders; Lung-fibrosis; Age-factors; Surveillance
Numbered Publication; Current Intelligence Bulletin
NTIS Accession No.
DHHS (NIOSH) Publication No. 2011-172; CIB 64
Manufacturing; Healthcare and Social Assistance
National Institute for Occupational Safety and Health
WV; KY; VA