The name black lung says it all. When miners inhale excessive amounts of coal dust, the fine air filtration system of the lungs sieves out the dust, which then remains permanently in the lung. These deposits can even be seen with the naked eye if the lungs are removed from the body, hence the name.
The sinister part is the slow progressing breathing disorder that develops over many years due to excessive lung inflammation and scarring that is triggered by coal mine dust. This disease, coal workers’ pneumoconiosis or black lung, is preventable and was widely considered a thing of the past in Australian miners.
But just before Christmas 2015, people were shocked to hear about newly confirmed cases of black lung in Queensland miners. Governments responded swiftly to investigate the problem, with inquiries established by the Queensland government and the federal senate.
The Department of Natural Resources and Mines has released some interim findingsoutlining poor documentation of confirmed cases, a lack of preventive measures taken where confirmed cases were found and too few screening tests being performed.
There is no cure for black lung. The review has recommended a greater focus on prevention and early detection, and ongoing surveillance.
Preventing black lung
Prevention involves managing exposure by monitoring dust levels and actively taking steps to reduce coal dust exposure in miners. Mining practices have progressively improved over the years, but overseas experience tells us not applying standards can result in cases of black lung.
There are no uniform standards for acceptable levels of dust exposure throughout Australia. Authorities permit Queensland miners to be exposed to coal dust levels higher than those in the United States, where the exposure limit is set at two micrograms per cubic metre.
Prevention also involves regular screening of exposed workers and having the results looked at by experts. The screening procedure requires imaging the lung with X-rays and assessing for possible lung impairment with breathing tests and focused clinical assessment. Each of these steps has to be quality controlled in order to successfully detect the subtle changes of black lung as early as possible.
The very early changes of black lung are an increase in dots and lines on the X-ray. The problem is the blood vessels and airways in the normal lung also show up as dots and lines, and so it takes expert training to tell when things become abnormal.