CDC Documents Increased Black Lung Cases in Kentucky

The report describes a cluster of 60 cases of PMF identified in current and former coal miners at one Eastern Kentucky radiology practice during January 2015–August 2016, a cluster that was not uncovered by the national surveillance program.

CDC's MMWR on Dec. 16 offered online an alarming report about a surge in cases of Appalachian coal workers' black lung disease. An NPR investigation also probed the increase in this occupational lung disease, which is caused by overexposure to respirable coal mine dust. NIOSH administers the Coal Workers' Health Surveillance Program, a voluntary program with the goal of reducing the incidence of black lung -- pneumoconiosis -- and eliminating its most severe form, progressive massive fibrosis (PMF).

The report describes a cluster of 60 cases of PMF identified in current and former coal miners at one Eastern Kentucky radiology practice during January 2015–August 2016, a cluster that was not uncovered by the national surveillance program. "This ongoing outbreak highlights an urgent need for effective dust control in coal mines to prevent coal workers' pneumoconiosis, and for improved surveillance to promptly identify the early stages of the disease and stop its progression to PMF," the authors point out.

NPR's Howard Berkes obtained data from 11 black lung clinics in Virginia, West Virginia, Pennsylvania, and Ohio that reported a total of 962 cases so far this decade, and he wrote, "The true number is probably even higher, because some clinics had incomplete records and others declined to provide data." The number is more than 10 times higher than what federal regulators report, he wrote.

The MMWR report says on June 9, 2016, a radiologist contacted NIOSH to report a sharp increase during the past two years in the number of PMF cases among patients who were coal miners seen at his practice serving eastern Kentucky counties. This triggered the investigation of the undiscovered cluster of cases. The 60 male patients' mean age was 60.3 years, and their mean coal mining tenure was 29.2 years.