Keith Stoddart is used to confined spaces — he worked as a coal miner for 31 years — but 2020 has brought him a new kind of confinement.

Key points: Pneumoconiosis, or black lung, is a potentially fatal disease caused by long exposure to coal dust

Pneumoconiosis, or black lung, is a potentially fatal disease caused by long exposure to coal dust Experts say those with black lung, or any underlying lung disease, are vulnerable to COVID-19

Experts say those with black lung, or any underlying lung disease, are vulnerable to COVID-19 Coal mines employed 30,000 Queenslanders in 2019, according to the State Government

The 70-year-old has kept his stepson home from school and stays in the car when his wife does the grocery shopping.

He has coal worker's pneumoconiosis, also known as black lung, a potentially fatal respiratory disease caused by prolonged exposure to mine dust.

Keith Stoddart contracted black lung from 31 years working in coal mines in Queensland and NSW. ( ABC 7.30, file photo )

Experts say those with lung diseases like Mr Stoddart are vulnerable to COVID-19 and, alarmingly, expect there are many more miners out there yet to realise their heightened risk.

Mr Stoddart said it was hard not to get angry with those responsible for putting him at risk.

More mine dust cases in the pipeline

In the 30 years before 2015, just nine cases of mine dust lung diseases like silicosis, asbestosis, and pneumoconiosis were diagnosed in Queensland.

But since 2015, when the State Government introduced a suite of dust control and diagnostic improvements, there has been 134 cases discovered.

Black lung accounts for 41 of those cases, yet it was thought to have been eradicated from the state in the 1980s.

Experts say there are many more cases on the way over the next 20 years.

Mine safety expert Professor David Cliff said since 2015, the air quality in the state's mines and quarries had drastically improved.

"Things like water sprays, extraction systems, kicking people out of dust clouds, automation, a whole pile of controls available to do that … have been applied more rigorously," Professor Cliff said.

But he says the improvements will likely not be evident for a number of years, given the latency of the disease and the number of miners working before 2015.

"It will take between 10 and 20 years for it to work its way through the system before we'll really see the effects of the current control processes being totally effective," Professor Cliff said.

Professor Cliff's research shows Respirable Coal Dust (RCD) levels in underground mines has decreased since reporting measures were introduced in 2015. ( Supplied: David Cliff )

Cases will continue to emerge

United States black lung expert Dr Robert Cohen said it was very likely that cases would continue to appear in Queensland miners for the next decade, despite improvements in dust monitoring and diagnostic procedures.

"The disease usually takes a minimum of five years to 10 years in very heavy exposure to develop, and a bit longer if the exposures are not so heavy," Dr Cohen said.

"So we're not likely going to see that for a little bit of time yet in terms of the effect of new dust controls.

"While we are getting a number of new cases, I think that in some ways we are gathering up these cases that were probably undiagnosed and hadn't been paid attention to before."

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

Coal mines employed 30,000 Queenslanders in 2019, according to the State Government.

Professor Cliff said the number of miners with the condition would depend on the amount of time they spent in dusty conditions.

"Typically, 10 to 20 years of dust exposure has been the underlying factor which determines whether people get the dust disease or not," he said.

"So it is not appropriate to just consider what the dust exposure is now. We need to look at what's happened over the previous 20 years.

Vulnerable to coronavirus complications

Dr Cohen, the medical director of the Black Lung Centre of Excellence at the University of Illinois, has been closely involved with improving the Queensland pneumoconiosis diagnosis process.

He said people with black lung would be exposed to complications if they contracted COVID-19.

"Coronavirus is definitely worse in people who have underlying lung disease," he said.

"If you've inhaled these mineral dusts for a long time and you have a coal mine dust lung disease then you're going to be at greater risk from complications of coronavirus."

Dr Cohen was working from home when we spoke.

"We actually closed all our black lung clinics and we're asking miners not to come in for exams at the moment," he said.

"We don't think it's worth the risk them being in hospitals and clinics where sick people are at this time."

'I won't survive it'

Enhanced dust reporting has come all too late for Mr Stoddart who worked as a miner for decades prior to the mine dust reforms.

He said his diagnosis in 2015 was devastating.

"I was an old bloke, 66 at the time, but I was working like a 40-year-old and I was really enjoying the company of the young men. And they were enjoying my company," Mr Stoddart said.

"Then, all of a sudden, just nothing.

"I loved work, I always have, especially coal mining."

He said the condition had stopped him from doing the things he loved.

"When I was first diagnosed I was still mowing the lawn, but it took me about two hours," Mr Stoddart said said.

"I keep getting all these chest infections, start coughing up blood. I've just finished a bout of it.

He said he tried not to dwell on the anger he felt for those responsible for his illness.

"I get very angry because I think they knew," Mr Stoddart said.

"The government, the mines department, the mines themselves — I'm sure they knew that they hadn't eradicated black lung.

"And I should have had more sense myself, an old bloke."

Black lung is irreparable, and Mr Stoddart has accepted his prognosis, but he said he worried about the threat of contracting novel coronavirus.

"I know what will happen if I contract it, I won't survive it. That's the end of the story," he said.

"I'd be one of them ones that's a statistic."