NIOSH Expands Coal Workers’ Health Evaluation Program

The National Institute for Occupational Safety and Health (NIOSH) is expanding its national program of health surveillance for coal miners. In accordance with the Mine Safety and Health Administration’s (MHSA’s) recently-published rule on respirable coal mine dust exposure, NIOSH’s Coal Workers’ Health Surveillance Program (CWHSP) will expand medical surveillance from covering only underground coal miners to also include those working at surface operations. The new regulation will also add lung function testing and a respiratory symptom assessment to the list of services offered.  

The NIOSH Coal Workers’ Health Surveillance Program was established in 1970 by the Federal Coal Mine Health and Safety Act of 1969. In addition to studying black lung disease and working to prevent its progression in individual miners, the CWHSP tracks temporal and geographic trends of the disease. In order to meet these objectives, NIOSH requires that mine operators provide health examinations to miners who begin work at a coal mine for the first time.

These health examinations were limited to chest radiographs and health history questionnaires, and were only required for underground coal miners. These services, along with periodic lung function testing (called spirometry) and respiratory health assessment questionnaires, will now be offered to all miners, including surface miners – a workforce that we now know is also at risk of coal mine dust-related lung disease.

Such new measures are important because they help create more comprehensive pulmonary evaluations of miners in America. For example, x-ray examinations do not track lung function decline, and they may not detect other health conditions linked to dust exposure. Spirometry can therefore help miners and their providers recognize meaningful losses of lung function that may occur as a result of dust exposures in a mine.

Under this new rule, coal miners have the right to receive periodic chest x-rays and lung function tests at no cost to themselves. Individual miner participation in the program is voluntary. Mine operators, as well as contractors that employ workers at coal mines who are eligible for surveillance, are mandated to provide examinations to miners who wish to participate in the program, and must provide testing to new miners within the first 30 days of work once a mine plan is approved by NIOSH. If early dust-induced lung disease is detected, miners are informed as to how to pursue their right to work with reduced dust exposure through the Mine Safety and Health Administration (MSHA).

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