Two medical journal recently published articles that both provide reviews of the scientific literature on Coal Mine Dust Lung Disease (CMDLD): the umbrella term for lung diseases that coal miners suffer from as a result of their dust exposure.
Go, et al. – “Lung Disease and Coal Mining: What Pulmonologists Need to Know” 22 Current Opinion in Pulmonary Medicine 170 (2016)
Current Opinion in Pulmonary Medicine (Vol. 22, Issue 2, Mar. 2016) published “Lung Disease and Coal Mining: What Pulmonologists Need to Know” by Drs. Leonard H.T. Go, Silpa D. Krefft, Robert A. Cohen, and Cecile S. Rose.
In this article—which is available to download for free from the publisher—the authors provide a highly accessible and readable overview of the group of lung diseases caused by coal-mine employment that is termed Coal Mine Dust Lung Disease. This inclusive term encompasses not only the widely recognized disease Coal Workers’ Pneumoconiosis (CWP), but also other diseases such as silicosis, rapidly progressive pneumoconiosis (RPP), diffuse dust-related fibrosis (DDF), emphysema, chronic bronchitis, asthma, and even cancer.
Two things about the article stand out in addition to its thorough overview of the literature showing the risks of respiratory diseases that coal miners face.
First, the article does a nice job of explaining the conditions that coal miners work in and the questions that an evaluating physician should inquire into. Using diagrams and photographs, the article gives an easy-to-understand introduction to coal mining methods to help pulmonologists and others understand working conditions, and then provides a series of questions to collect the key elements of a coal miner’s occupational history so that the pulmonologist can form an informed opinion about the etiology of a miner’s respiratory impairments. The questions that Go, et al. suggest are useful not only to pulmonologists but also to attorneys and benefits counselors who would like to document a coal miner’s exposure history.
Second, the article directly addresses many of the issues that come up in black lung benefits litigation in which the two opposing sides regularly disagree about whether a miner’s respiratory impairment is related to his coal-mine employment. For example, the article says the following:
- Regarding diagnosis of CWP on x-ray, “Niether opacity shape nor the zonal distribution of opacities may be used to rule out the diagnosis of CWP.”
- Regarding diagnosis of Idiopathic Pulmonary Fibrosis (IPF) instead of diffuse dust-related fibrosis (DDF), “Great care should be taken in attributing these findings to IPF in an exposed coal miner, as pulmonary fibrosis is a recognized lesion following exposure to various mineral dusts, including silica and coal.”
- Regarding diagnosis of asthma, “Occupational asthma has been reported in relation to Rhizopus species found in coal mine aerosals. Mines may contain multiple exposures that may cause, potentiate, or exacerbate asthma, including isocyanates, ureaformol and formophenolic compounds, and diesel particulates.”
- Regarding patterns of pulmonary function abnormalities (e.g., obstructive vs. restrictive vs. mixed), “there is no pattern of abnormalities that rules out the presence of CMDLD.”
And finally, in a useful addition to the bibliography section, the authors note a half dozen articles as “special interest” or “outstanding interest” to help point a beginner to the most important articles related to CMDLD.
Schroedl, et al. – “Coal Mine Dust Lung Disease: The Silent Coal Mining Disaster” 12 Current Respiratory Medicine Review 65 (2016)
Current Respiratory Medicine Review (Vol. 12, No. 1) published “Coal Mine Dust Lung Disease: The Silent Coal Mining Disaster” by Drs. Clara J. Schroedl, Leonard H.T. Go. and Robert A. Cohen.
Similar to the previously discussed article, the Schroedl, et al. article—which is also currently available to download for free from the publisher—provides a review of the literature on CMDLD. The main distinguishing characteristic is that the Schroedl, et al. piece provides a broad, international context for CMDLD. The article discusses epidemiological studies of coal miners not just from America, but also from China, Turkey, India, Ukraine, the United Kingdom, and Australia. (The article was authored before the more recent data about Australia’s resurgence of black lung emerged.)
The article also provides an excellent overview of the literature around CMDLD. I won’t repeat those points, but the brevity of this summary shouldn’t detract from the excellent review put together by Schroedel, et al.
Both articles are helpful additions to the literature related to black lung and provide strong support for the current consensus medical consensus that a coal-mine employment causes a variety of breathing problems for miners and thus an inclusive understanding of disease must be used.