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Understanding Black Lung Disease

Black lung is legally defined as the man-made occupational lung disease caused by the prolonged inhalation of silica and carbon found in coal mine dust. The term black lung arose from the black coloring of the lungs due to the heavy deposits of coal dust, as opposed to the pink color of a healthy lung. Other names for this disease include miner’s asthma, silicosis, and coal workers’ pneumoconiosis.

The risk of contracting black lung disease is directly related to the duration and extent of exposure to coal dust. When present, the most common symptoms are shortness of breath, obstruction of airways, and a severe chronic cough. Black lung disease can be diagnosed through a series of tests including checking patients’ history for exposure to coal dust and conducting chest x-rays to discover whether dust deposits are present. Pulmonary function tests are also utilized in the diagnosis of black lung disease. In its most severe state, black lung disease can lead to heart related problems, emphysema, and the risk of premature death for patients. At this time, there is no cure for black lung disease. The treatments undertaken are aimed at the symptoms and complications of the disease. Ultimately, black lung disease can be prevented only by avoiding long-term exposure to coal dust.

Historical Background

Beginning in the 1820s and 1830s, doctors, both in the United States and in the United Kingdom, began to treat coal miners for the early symptoms of black lung disease. In the beginning, doctors called this condition “miner’s asthma”; In 1831, however, the term black lung was introduced to describe the black pigmentation found in coal miner’s lungs. Despite the efforts of British investigators and the United Mine Workers of America (UMWA), black lung was not widely recognized in the United States until the 1950s. In 1952Alabama became the first state to provide compensation for coal workers’ pneumoconiosis. In 1965 Pennsylvania enacted legislation providing for compensation, subsequently, in 1968, Virginia amended its compensation law to include coal workers’ pneumoconiosis. On November 20, 1968, a devastating coal mine explosion at Farmington, West Virginia, killed 78 miners. In late 1968 a number of miners organized the West Virginia Black Lung Association, which successfully led a campaign to introduce a bill in the 1969 session of the West Virginia legislature making coal workers’ pneumoconiosis a compensable disease. When their campaign ran into heavy opposition from the West Virginia legislature, which was heavily influenced by the coal industry, 40,000 miners in West Virginia went on strike, and many marched on the state capital demanding passage of the bill. The strike, lasting three weeks, was one of the largest and longest ever on the single issue of occupational health and played a vital role in the enactment of the Federal Coal Mine Health and Safety Act of 1969 (CMA) and the Occupational Safety and Health Act of 1970.

For the first time in history, through the enactment of the CMA, Congress mandated the elimination of an occupational disease occurring in a major industry. As coal workers’ pneumoconiosis was the only disease indicated throughout all of the state and federal statutes up to that time, Congress legalized the term black lung as a synonym for that disease in Title IV of the CMA. The CMA also stipulated dates on which decreasing levels of respirable dust must become effective and required that working miners must now have periodic chest x-rays to check for symptoms of black lung disease.

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