Are health regulations enough? Lung disease on the rise in mine workers

May 7, 2018, Society for Risk Analysis

While on-the-job fatalities due to injuries and accidents have steadily decreased in nearly every industry in the U.S., the burden of debilitating lung disease in the coal mining industry has sharply increased within the last decade. A new study published in Risk Analysis: An International Journal examines whether compliance with health regulations at mines across the country was sufficient to decrease instances of lung disease.

Increases in diseases associated with coal mining have been documented by numerous independent data sources including The National Institute for Occupational Safety and Health (NIOSH) administered Coal Workers' Health Surveillance Program, mortality data from deceased miners, federal black lung compensation and state compensation disability claims and the national transplant registry.

One strategy currently employed to prevent lung in mines is compliance with Mine Safety and Health Administration's (MSHA) requirements. MSHA outlines numerous rules and regulations for sampling, emission limits, medical surveillance, dust monitoring, tests for gases and air flow, etc. However, there are limited resources available to help mines determine how much to invest in each potential prevention activity. Given recent increases in dust-induced lung diseases in , research is needed to help inform resource allocation.

The study, "Interstitial lung diseases in the U.S. mining industry: Using MSHA data to examine trends and the prevention effects of compliance with health regulations, 1996-2015," was conducted by Patrick L. Yorio, Ph.D., A. Scott Laney, Ph.D., Cara N. Halldin, Ph.D., David J. Blackley, Dr.P.H., Susan M. Moore, Ph.D., Kerri Wizner, MPH, Lewis J. Radonovich, M.D., and Lee A. Greenawald, Ph.D., from NIOSH. The researchers analyzed data from MSHA's databases to determine the effectiveness of the MSHA standards and regulations.

Current MSHA requirements outline numerous rules for both eliminating or reducing airborne contamination and the risk of exposure through management practices. For example, maintaining a working environment with noted airborne contaminants below a certain level, effectively communicating levels of airborne contaminants and providing NIOSH-approved personal respiratory protection when appropriate. The researchers analyzed the MSHA standards in their entirety, parts 1-104, and found 17 total instances in which a standard mandates that mines continuously maintain airborne contaminants below a specified level and 51 instances in which a standard mandates that mines accurately assess the airborne hazards, communicate the assessment results and provide protection when appropriate.

The researchers used data from 8,165 mines across the country that were active during 1996-2015. The data revealed 730 cases of lung disease reported from 2006-2015. Coal mines reported a majority of the cases (662), all of which were cases of pneumoconiosis. Additionally, the majority of lung disease cases (640) originated in the Appalachian region, compared to a total of 22 cases in the Western, Southern, and North Central regions combined.

Statistical analysis of the data revealed that for each unit increase in an inspector observed instance of non-compliance with regulations related to reducing the risk of exposure through management practices there was a 12-14 percent increase in the probability of that mine reporting lung disease. For each unit increase in an inspector observed instance of non-compliance with regulations related to reducing airborne contamination, there was a 10-22 percent increase in the probability of that mine reporting a lung disease. Mines located in the Appalachian region were also 2.73-3.40 times more likely to report a case of pneumoconiosis compared to other regions. Underground mines were also 8-9.78 times more likely to report a case than surface coal mines.

"Our study found that mines that comply with relevant MSHA health standards experience a substantially lower number of lung diseases over time," said lead author Yorio, Ph.D., of CDC's NIOSH. "This suggests a disciplined effort to comply with relevant MSHA requirements can be an effective method to prevent mining-related occupational lung disease."

Cases of lung disease reported to the MSHA occurred mostly in underground coal mines concentrated in the Appalachian region of the U.S. In general, coal mines were 16-17.8 times more likely to report a lung disease diagnosis to MSHA than a non-coal mine. The findings of this study empirically demonstrates the efficacy of actionable organizational strategies designed to prevent occupational .

Explore further: Majority of mining-related injuries and illness in Illinois go unreported

More information: Patrick L. Yorio et al, Interstitial Lung Diseases in the U.S. Mining Industry: Using MSHA Data to Examine Trends and the Prevention Effects of Compliance with Health Regulations, 1996-2015, Risk Analysis (2018). DOI: 10.1111/risa.13000

Related Stories

Majority of mining-related injuries and illness in Illinois go unreported

March 9, 2018
Illnesses and injuries associated with working in Illinois mines are substantially underreported to the federal agency tasked with tracking these events, according to a new study published in the American Journal of Industrial ...

Why is mining-related lung disease on the rise?

February 23, 2018
The passage of critical mine health and safety legislation in the late 1960s, along with advances in technology and safety practices, helped to decrease the prevalence of lung diseases for miners. But starting in the mid-1990s, ...

Call for improved monitoring for coal workers

March 31, 2017
Researchers and clinicians are calling on the mining industry and governments to create better regulations in the interest of the health of coal miners.

Black lung disease on the rise

February 16, 2018
An article published Feb. 6, 2018 in the Journal of the American Medical Association reported that researchers from the National Institute for Occupational Safety and Health had identified 416 cases of advanced black lung ...

'Black lung is back' researcher says

May 17, 2013
The dangers of coal mining enter the spotlight periodically when disasters strike, but one West Virginia University researcher argues that coal mine dust exposure, which has caused an increase in the prevalence and severity ...

Recommended for you

India launches 'Modicare', world's biggest health scheme

September 23, 2018
India on Sunday launched the world's biggest health insurance scheme which Prime Minister Narendra Modi said would cover some 500 million poor people.

It's not just for kids—even adults appear to benefit from a regular bedtime

September 21, 2018
Sufficient sleep has been proven to help keep the body healthy and the mind sharp. But it's not just an issue of logging at least seven hours of Z's.

Patient-centered visual aid helps physicians discuss risks, treatments with parents

September 21, 2018
A series of illustrations and charts designed as decision aids for parents of children with minor head injuries helped them communicate with emergency medicine physicians and make informed decisions about their child's care, ...

Alcohol responsible for one in 20 deaths worldwide: WHO

September 21, 2018
Alcohol kills three million people worldwide each year—more than AIDS, violence and road accidents combined, the World Health Organization said Friday, adding that men are particularly at risk.

Smart pills dumb down medical care, experts warn

September 21, 2018
Enthusiasm for an emerging digital health tool, the smart pill, is on the rise but researchers at the University of Illinois at Chicago have published a paper in the American Journal of Bioethics that cautions health care ...

China's doctor shortage prompts rush for AI health care

September 20, 2018
Qu Jianguo, 64, had a futuristic medical visit in Shanghai as he put his wrist through an automated pulse-taking machine and received the result within two minutes on a mobile phone—without a doctor present.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.