Queensland underground coal mine operators have been warned by the mining union to reduce their dust levels below the state's safety standard or they will be shut down.

The Queensland Resources Council has condemned the warning as an "ill-conceived threat" based on questionable legality.

Three weeks ago 7.30 revealed that Percy Verrall and three other former and current coalminers have the potentially life-threatening disease "black lung", or coal miners' pneumoconiosis, thought to have been eradicated from Australian coalfields.

The mining union, CFMEU, now says it is likely more cases will emerge.

"At this stage, there are four confirmed cases of black lung," CFMEU Queensland mining president, Stephen Smyth said.

"And we have another four unconfirmed cases which will be verified in the forthcoming weeks."

The CFMEU's national president Andrew Vickers said he was "gutted" by the development.

"That in 2015 we are seeing a re-occurrence of the disease, and a terrible debilitating disease and a murderous disease that we thought we had eradicated from the industry. It is just not good enough," he said.

The Queensland Mines Department and mine operators like BHP asserted that local radiologists have the skills to correctly identify the disease in regular checkups, a claim the union disputes.

"I have no faith in the current scheme with these nominated medical authorities (company doctors) and some of the radiologists because they have failed," Mr Smyth said.

"And the system shows us that they are failing, because we have all these cases of black lung which had to be confirmed either by a biopsy in Australia ,or read by an expert in the US," he said.

"So the system is not working."

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Queensland Government requests urgent review

The Queensland Government has announced an urgent review of the coal miners' health scheme, to be conducted by Monash University's Professor Malcolm Sim.

What is black lung? Pneumoconiosis is a potentially fatal disease caused by long exposure to coal dust, more commonly known as "black lung" because those with the disease have lungs that look black instead of a healthy pink. Black lung most often stems from working in the coal industry or in the manufacturing of graphite or man-made carbon products and has no known cure. The risk of getting black lung depends on how much time has been spent around coal dust. There are two types of black lung: simple and complicated. There are relatively few symptoms associated with simple black lung, also known as coal worker's pneumoconiosis (CWP), and the prognosis is usually good. But CWP can progress into the more complicated progressive massive fibrosis (PMF), the symptoms of which may include a long-term cough and shortness of breath. There is no cure for black lung, but doctors may be able to treat complications caused by the disease. In 2013, coal worker's pneumoconiosis killed 25,000 people, according to UK medical journal The Lancet. Source: University of Kentucky, US National Library of Medicine and The Lancet

It will begin in a few weeks time.

"I think they've lost confidence in the program, the medical monitoring, and we need to review that and make sure that every time they go and have their medical done they feel confident about the results to come back to them," Professor Sim said.

"What's important here is to be doing enough of these X-rays to keep the skills up for the particular signs that are found in this disease."

He said his review will examine whether a smaller group of people reviewing the X-rays regularly is a better method than the current system.

The president-elect of the Royal Australian and New Zealand College of Radiologists, Dr Greg Slater, believes the new Queensland cases have been an important wake-up call over a serious issue.

He said the College was establishing a register of radiologists in Australia willing to report using the ILO (International Labour Organisation) classification which is "the most important international classification of the dust disease black lung".

"These people will have experience, they'll have an ongoing caseload, they will use the ILO criteria for their reports and that way they will guarantee quality," he said.

Underground miners facing 'breathless' Christmas

Meanwhile, underground miners like Keith Stoddart are nervously facing a bleak Christmas. A heavy smoker until last year, he is still not sure if he has the disease.

Underground miner Keith Stoddart believes he may have the disease. ( 7.30 )

"I am concerned about what I've got," he said.

"Hopefully I won't get any worse than what I am."

Mr Stoddart works underground at Anglo-American's Grasstree mine near Middlemount, where another miner is also suspected of having black lung.

He is hoping his symptoms are not from the carbon already identified in his lungs

"Just breathlessness. Got a tightness of the chest, as the day goes on I puff and pant more," he said.

"If I don't get any worse than this, I'll be happy."

According to Mr Smyth many of his members are worried.

"On a daily basis I get calls by people wanting their X-rays to be read," he said.

"They are concerned and I don't blame them, them and their families.

"At the end of the day there is a process in place and should have been in place which has failed these workers."

1984 black lung review

7.30 has now obtained a copy of a 1984 review by Dr Mannie Rathus of nearly 8,000 Queensland underground coal miners.

Space to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume. Watch Duration: 8 minutes 58 seconds 8 m The diagnosis of four Queensland coal miners with black lung has prompted a review

It identified 75 confirmed or suspected cases of black lung.

The Mines Department said these findings were made public in the Coal Board's 1984 annual report, which concluded that although there was no room for complacency, "the problem of dust in mines is well in hand".

But Mr Vickers, who was a Queensland union official at the time, said the information was hidden from the union.

"They didn't tell us. They didn't make it public," he said.

"This is a major health crisis in the Queensland coal mining industry, an industry that is critical to the economy of Queensland.

"There is no indication of what the follow-up was for 75 people — none whatsoever.

"It's a scandal. It's a disgrace."

The Rathus report recommended regular supervision and follow-up of the identified miners.

A Health Department spokesperson said a follow-up consisted of referring them to their GP or local hospital.

Alarming rates of black lung in US prompts caution in Qld

The re-emergence of black lung in Queensland follows heightened concern about the disease in the US, where it has claimed tens of thousands of lives.

In West Virginia five years ago, an explosion at the Upper Big Branch mine killed 29 miners, sparking national outrage and a criminal conviction of the mine's chief executive.

Alarmingly, when US pneumoconiosis specialist Dr Robert Cohen reviewed autopsies of the dead men able to be examined, he found black lung.

"Seventy-one per cent of those had signs of coal workers pneumoconiosis, even those who have been working for less than five years, which was very striking to us," he said.

The US has now reduced its recommended level of coal dust exposure to 1.5 milligrams per cubic metre per eight hour shift, which is half the Queensland standard of three milligrams per cubic metre.

"We've actually coined a new term here, called rapidly progressive pneumoconiosis, for those miners who have the disease moving very quickly, much more quickly than we had seen in past," Dr Cohen said.

Yet this year underground mines in Queensland have consistently exceeded the already high legal dust limit of three milligrams.

This week, the union warned all underground mines that were not in compliance would be closed down under health and safety laws, an action the Queensland Resources Council described as ill-conceived and legally questionable.

But Mr Smyth warned his union, which has launched a 'Make Black Lung History' campaign, will do whatever it takes.

"To us it's game on," he said.

"Whether it's government or coal companies, we are going to go hard and ensure that they start to do what they should be doing, by providing safe places of work for our members and coal miners generally."

And that is all coal miner Mr Stoddart wants.

"I've got a lot of mates, I've got a son working in a coal mine. I love coalmining. I want it safe," he said.