Black lung disease is a collection of different lung diseases that can occur due to exposure to coal mine dust. Coal mine dust is made up of many different things, including coal, silica, rock dust, diesel exhaust, and other substances. These substances can accumulate in the lung and cause damage and scarring over the course of years, even after you are no longer exposed to them on a daily basis.

Shortness of breath, cough, mucus production, and wheezing are all symptoms of black lung disease. Early on, a miner may have no symptoms, but with time and continued exposure to coal mine dust, symptoms will appear and get more severe. Usually, it takes years for symptoms to become severe enough to cause disability.

Typically, healthcare providers will complete a physical examination and assess a coal miner’s respiratory symptoms. Special attention is paid to medical problems, smoking history, and work history and exposures. 

The following diagnostic tests are usually performed:

• A breathing test known as a pulmonary function test, which allows the healthcare provider to determine whether a lung disease has affected a person’s breathing capacity
• A chest x-ray to identify any abnormalities related to coal mine dust exposure
• Exercise testing to determine whether lung problems have affected a person’s exercise capacity or ability to transport oxygen from the air into the body

Depending on the situation, other tests may be recommended and performed.

If you develop significant shortness of breath, you should seriously consider being evaluated by a healthcare provider. Consider seeing someone with experience evaluating current and former coal miners. It is important for all the potential contributing factors to your lung problems to be considered.

Yes, black lung disease can become more apparent or get worse even after a person has stopped working in coal mines. This also means that even if you were told you did not have black disease in the past, you could still be diagnosed with it in the future.

Yes, you can have both black lung disease and lung disease related to smoking. In fact, this may be true for many current and former miners.

Yes, you may have black lung disease despite a normal-appearing chest x-ray. Your doctor may have been looking for small spots or scars that are suggestive of one type of black lung disease, but black lung disease can exist even when the chest x-ray is normal.

Unfortunately, once black lung disease develops, there is no specific cure. The main priority is to keep it from developing in the first place. If it does develop, the goal is to keep it from getting worse. Treatments for black lung are focused on the symptoms you experience. For example, inhalers are often prescribed. With more severe disease, treatments like oxygen and pulmonary rehabilitation are used. If you smoke tobacco, you should stop, because smoking can worsen whatever lung damage already exists.

The Federal Coal Mine Health and Safety Act was implemented to limit the amount of coal mine dust that miners are exposed to. Technologies do exist to control the amount of dust a miner breathes in, but these aren’t followed consistently. Personal protective equipment like face masks and respirators are options, but less practical because they make breathing difficult.

The US Department of Labor’s Division of Coal Mine Workers’ Compensation operates the federal black lung benefits program. This program is focused on providing benefits to current and former coal miners who have developed a total disability due to lung disease. Individual states may also have their own Worker’s Compensation programs for black lung disease.