Respiratory Health Program

What are our priorities?

The National Institute for Occupational Safety and Health (NIOSH) Respiratory Health Program works with a diverse range of partners in industry, labor, trade associations, professional organizations, academia, and other governmental agencies. The program focuses on:

  • Protecting workers from respiratory diseases that are caused or made worse by work exposures
  • Improving workers’ respiratory health
What do we do?

The program works with partners to conduct research, share information, provide services, and transfer research findings into practice. Listed below are key program activities.

  • Providing summaries of national data tracking the burden of work-related respiratory disease and the types and amounts of hazardous workplace respiratory exposures.
  • Providing health screening and surveillance services to U.S. coal miners under a program mandated by Federal law called the Coal Workers’ Health Surveillance Program (CWHSP). We help individual miners by detecting disease early and provide group data to guide broader prevention activities.
  • Conducting multidisciplinary research needed to identify respiratory hazards; characterize
  • their risks; and design, validate, and disseminate effective interventions.
  • Contributing to the NIOSH Health Hazard Evaluation (HHE) Program by responding to U.S. workplace requests for evaluations of potential respiratory hazards and providing recommendations for solutions.
  • Certifying courses that train technicians to perform spirometry (a type of lung function testing).
  • Providing training and certification testing to physicians who classify chest x-rays for findings of pneumoconiosis (a chronic lung disease caused by inhaling dust) using the International Labour Organization’s classification system.
What have we accomplished?
  • Collaborated with state public health departments and academic investigators to report an outbreak of silicosis among engineered stone countertop workers in four states and further disseminated information for prevention in an infographic available in Englishpdf icon, Spanishpdf icon, and Chinesepdf icon.
  • Reported a cluster of five young nonsmoking workers at an industrial equipment manufacturing facility with an unusual lung disease causing bronchiolitis and emphysema.
  • Developed a model for work information in electronic health records (EHRs) called Occupational Data for Health and achieved publication by Health Level Seven International (HL7®), an important standard-setting organization.
What’s next?
  • Evaluate potentially hazardous exposures and workers’ respiratory health in a variety of settings, including workers installing trenchless cured-in-place pipes using water and steam technologies, workers in coffee roasting and packaging facilities, and coal miners.
  • Engage clinical organizations to pilot the collection and use of work information in EHRs.
  • Respond to the Coronavirus Disease 2019 pandemic, helping to ensure safe U.S. work-places and prevent SARS-CoV-2 infections among workers.
  • Implement updates to training and certification testing using the International Labour Organization’s system to classify chest x-rays for changes of pneumoconiosis.
  • Update training materials for technicians performing spirometry to reflect recent changes to recommendations from several professional organizations.

Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention.


The Respiratory Health Program mission is to provide national and international leadership to prevent work-related respiratory diseases and improve workers’ respiratory health. This snapshot shows recent accomplishments and upcoming projects.

Percentage of examined underground miners with coal workers' pneumoconiosis (ILO category 1/0+) by tenure in mining, 1974-2018*
Percentage of examined underground miners with coal workers' pneumoconiosis (ILO  category 1/0+) by tenure in mining, 1974-2018*

Source: Coal Workers’ Health Surveillance Program * Percentages are 5-year moving averages.

Number of spirometry training course attendees, 2015-2019
Number of spirometry training course  attendees, 2015-2019

Source: NIOSH Spirometry Training Program

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November 2020

Page last reviewed: November 16, 2020