The National Institute for Occupational Safety and Health (NIOSH), Coal Workers' Health Surveillance Program 

(CWHSP) studies the causes and effects of respiratory diseases related to coal mine dust exposure and provides 

vital health information to coal miners through health screenings and surveillance.

The NIOSH CWHSP was established by the Federal 

Coal Mine Safety and Health Act of 1969 to provide 

early detection of coal workers' pneumoconiosis, 

also known as black lung, and to prevent 

progression to severe lung disease. The program 

offers health screenings for coal miners and allows 

researchers to identify trends in disease across the 

nation.

Program Background

The CWHSP provides research and health services for 

coal miners, and includes the following components:

• Respiratory health surveillance for coal miners 

throughout the United States provided by 

 NIOSH-approved facilities and NIOSH-operated 

 mobile units.

• B Reader certification program that certifies 

physicians as able to identify and describe black 

lung using chest x-rays. Training and certifications 

are based on the International Labour Office 

(ILO) Classification System of Radiographs of 

Pneumoconioses.

National Institute for Occupational Safety and Health

Coal Workers' Health Surveillance Program

"The first priority and concern of all in the coal or mining industry must be the health and safety 

of our most precious resource, the miner."

~Federal Coal Mine Health and Safety Act of 1969, amended 1977

CWHSP Today

Photo by NIOSH

Photos by NIOSH
Questions and Answers

What is coal workers pneumoconiosis (black lung)? 

Coal workers pneumoconiosis, or black lung, is scarring in the lungs caused by breathing in coal mine dust. It can 

take years for this disease to develop, and the scarring is permanent. Severity of the disease can range from mild, 

where you may not notice any effect on your breathing, to advanced disease. 

The most severe form of black lung is called progressive massive fibrosis, where a large part of your lungs could 

be scarred. Progressive massive fibrosis can lead to respiratory failure and death. 

There is no cure for black lung.

How do coal miners get black lung?

Coal miners can get black lung if they breathe in too much coal mine dust. However, engineering controls can be 

used to control and reduce coal mine dust created during the mining process. Engineering controls include water 

sprays and various ventilation techniques.

What are symptoms of black lung?

Symptoms can include:

• coughing

• excessive phlegm 

• shortness of breath

• labored breathing

• chest tightness

Can young coal miners get black lung?

Yes, miners of all ages can get black lung. It depends on the length and intensity of 

coal mine dust exposures.

How can miners get screened for black lung?

Coal mines file screening plans with NIOSH that identify local health facilities where miners who are currently 

employed can be screened. The plan also lists 6 month periods every 4 to 5 years when screenings occur at the 

mine's expense. The screening plan should be posted on the mine's bulletin board. Alternatively, you can go to a 

NIOSH-approved health facility and obtain a screening at your own expense, or participate in NIOSH's free mobile 

screenings when we are in your community. 

Screenings include:

• work history questionnaire

• chest radiograph

• respiratory assessment questionnaire

• breathing test (spirometry)

• blood pressure screening

How can I learn more about the CWHSP?

You can find more information about the CWHSP on our 

website at cdc.gov/niosh/topics/cwhsp, by emailing CWHSP@cdc.gov, or by calling 1-888-480-4042.

Photos by NIOSH Photos by NIOSH

NIOSH Publication No. 2019-130 (revised 3/2023)

Revised DOI: 10.26616/NIOSHPUB2019130revised032023

March 2023