Continued Increase in Coal Workers’ Pneumoconiosis

Continued Increase in Prevalence of Coal Workers’ Pneumoconiosis in the United States, 1970-2017

Objectives. To update prevalence estimates for coal workers’ pneumoconiosis (CWP)
among working underground coal miners in the United States.

Methods. We conducted a prevalence study using radiographs collected from 1970
to 2017.We classified each radiograph using international standards.We defined CWP
as the presence of small opacities, with profusion greater than or equal to subcategory
1/0, or the presence of a large opacity larger than 1 centimeter.

Results. Following a low point in the late 1990s, the national prevalence of CWP in
miners with 25 years or more of tenure now exceeds 10%. In central Appalachia
(Kentucky, Virginia, West Virginia), 20.6% of long-tenured miners have CWP. When we
excluded miners from central Appalachia, the prevalence for the remainder of the United
States was lower, but an increase since 2000 remains evident.

Conclusions. The national prevalence of CWP among working coal miners is increasing.
This increase is most pronounced in central Appalachia. Current CWP prevalence estimates
will likely be reflected in future trends for severe and disabling disease, including
progressive massive fibrosis.

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