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Coal Workers' X-ray Surveillance Program (CWXSP)

	Technician assiting miner with x-ray

Frequently Asked Questions

Under the expanded CWHSP program, a coal miner or contractors working for either underground or surface mines receive a free chest x-ray, lung function test (spirometry), symptom assessment, and a health assessment questionnaire. The following types of examinations are in accordance with the Mine Safety and Health Administration’s (MSHA’s) final rule on respirable coal mine dust exposure.

Voluntary examinations must be provided at least every 5 years with a 6-month window if the miner was employed at a coal mine on or before August 1, 2014.

Mandatory examinations must be provided for each miner who begins work as a coal miner or contractor for the first time (is new to the coal mining industry) in these three instances:

  1. Pre-employment screening or within 30 days of starting employment
  2. The operator must provide medical examinations to the miner within 3 years after the initial examinations.

If, from the follow-up exams, the chest x-ray shows evidence of pneumoconiosis or the spirometry results indicate decreased lung function, another follow-up exam must be provided within 2 years if that miner is still engaged in coal mining.

All facilities that perform the periodic chest x-rays required for the CWHSP must be approved by NIOSH. Current NIOSH-approved facilities are not required to submit a new application and should continue to submit x-rays and supporting documents in their usual manner. Facilities applying for approval to provide chest x-rays to the CWHSP (underground and surface coal miners) should consult the regulations outlined in 42 CFR, Part 37 [42CFR37 Specifications of Medical Examinations of Underground Coal Miners]. Facilities interested in NIOSH approval should contact the CWHSP for an approval packet which details the requirements. Facilities may be approved for x-ray only, spirometry only, or both x-ray and spirometry.

Information on the Mine Safety and Health Administration’s (MSHA’s) final rule on respirable coal mine dust exposure:

For Coal Miners

The new MSHA Regulation 42 C.F.R. Part 37 provides all U.S. coal miners with the opportunity to have respiratory health testing. The testing is provided under the NIOSH Coal Workers’ Health Surveillance Program (CWHSP). The primary purpose of this testing is to prevent severe coal mining-related respiratory disease by detecting it early so miners can take steps to keep it from getting worse. This information also know if miners are being adequately protected from respiratory diseases including to coal workers’ pneumoconiosis (black lung), silicosis, COPD and other mining-related respiratory diseases.

Under the new rule, coal miners have the right to receive periodic chest x-rays and lung function tests at no cost to themselves. Operators must inform the miners when they are eligible and where they can go to receive these screening tests. All new miners must be provided this testing within the first 30 days of work once a Mine Plan is approved by NIOSH. Miners receive the results of their tests from NIOSH with clear interpretations of the findings and additional instructions if follow up is recommended. Miners with evidence of black lung on their chest x-rays are informed as to how to pursue their right to work with reduced dust exposure through the Mine Safety and Health Administration (MSHA). NIOSH will not share a miner’s individually identifiable test results without the permission of the miner or their legal representative.

To participate in the testing, coal miners should watch for the required notices about when and where the checkups will be available.

For Coal Mine Operators Including Contractors

Operators and contractors of underground and surface coal mines are required to post a NIOSH-approved health examination plan providing health surveillance to their miners every five years. Coal mine operators must use the Coal Mine Operator’s Plan for submitting these Mine Plans. Coal mine contractors must use the Coal Contractor Plan to file their Mine Plans. For contractor personnel, eligible employees are those who require MSHA Part 48 training.

All coal mine operators must promptly display in a visible location on the bulletin board at the mine its proposed Plan when it is submitted to NIOSH.  The proposed Plan or change in Plan must remain posted in a visible location on the bulletin board until NIOSH either grants or denies approval of it at which time the approved Plan or denial of approval must be permanently posted.  In the case of an operator who does not have a bulletin board, such as an operator that is a contractor, they must otherwise notify their employees of the examination arrangements.  Upon request, the contractor must show NIOSH written evidence that its employees have been notified.  Contractors do not need to indicate at which mines they are operating, but should indicate the number of miles by road from the location of the contractor to the radiograph facility(ies).

Currently, the posted mine plan form only provides for radiographs and occupational history questionnaires. MSHA will be notifying operators and contractors when they need to add periodic spirometry and respiratory health assessment questionnaires to their plans.

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