- The popular name for pneumoconiosis, "black lung", stems from the fact that the lungs of those with the disease appear black instead of pink. In early stages, called anthracosis, little or no symptoms are present, but over time shortness of breath may develop, along with partial obstruction of airways and dark snot. Other exterior symptoms include coughing, labored breathing, and weight loss. Internally, the lungs become stiff and function poorly and may become scarred. Diagnosis is usually based on chest X-rays and an occupational history that includes inhalation of coal dust or other industrial pollutants.
- Coal particles that reach the lung cannot be broken down by the body. The foreign particles are surrounded by macrophages, part of the immune system that usually consumes invading bacteria, but not eliminated. In cases of prolonged exposure to coal dust, such as occurs with miners, coal can collect in the lungs into solid nodules that may hinder airflow in the lungs, a condition called massive fibrosis. The accumulation of coal dust in the lungs increases the risk of emphysema, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Obstruction of the lungs can strain the heart and create other secondary health risks.
- There is no recognized medically effective treatment for black lung. The best prevention is avoiding inhalation of coal dust and other foreign matter. Treatment is usually limited to the symptoms of black lung disease and aim at improving quality of life rather than curing the disease. Prescription strength and over-the-counter expectorants, which encourage the expulsion of phlegm from the lungs can be helpful in preventing accumulation, but do not remedy an existing condition.
- In the nineteenth and early twentieth centuries, coal mining emerged as a crucial industry, providing fuel for trains and ships. Mining was always considered as a dangerous profession, due to the possibility of collapses and other accidents. But eventually another threat emerged. The Federal Coal Mine Health and Safety Act of 1969 has helped reduce incidence of black lung in U.S. miners, but has not eliminated the disease. Today, efforts to compensate miners are limited to those completely disabled and applies only to the costs of treatment. The Black Lung Disability Trust Fund pays these costs for miners last employed in a mine prior to January 1, 1970 or where courts have failed to hold a coal mine operating company responsible for the onset of the disease. As a result of the restrictions, most miners do not qualify for federal support.
- Incidente of black lung is concentrated in areas where coal mining remains a common form of employment. In the U.S., the Appalachian regions of Eastern Kentucky and West Virginia are major sources of domestic coal, and therefore hot spots for black lung disease. Because mining remains one of the highest paid professions in these areas, many accept the risks. Regulations aimed at improving mine ventilation and other safety precautions cannot change the fact that mine workers are exposed to air pollution levels far beyond the general population. Mine safety and the liability of mine operating companies are perennial in these areas.
