Black lung is a type of lung disease that’s caused by long-term inhalation of coal mine dust. The condition is also known as coal workers’ pneumoconiosis (CWP) or miner’s lung.

The disease has a long history as a work-related illness. That’s because inhaling coal mine dust commonly happens in those who work in mines. It rarely occurs in the general environment.

Black lung is still prevalent in coal workers today. Additionally, without treatment, black lung can cause serious complications such as heart failure, tuberculosis, and lung cancer.

Read on to learn more about the causes, symptoms, and treatment options for black lung, plus how to reduce your risk.

The type and severity of black lung symptoms depend on the level of coal mine dust exposure.

The symptoms can develop over many years. As a result, most people don’t start showing signs of black lung disease until they’re closer to retirement age.

Common symptoms of black lung include:

In some cases, black lung might not cause obvious symptoms.

The main cause of black lung is inhaling coal dust over time. It primarily affects people who work in coal mines. Black lung rarely occurs in people not regularly exposed to coal dust.

Coal dust consists of carbon-containing particles that are harmful to the lungs. In some cases, coal workers might also inhale silica-containing particles.

When you inhale coal dust, the particles settle into the alveoli in your lungs. Alveoli are small air sacs that help your lungs take in oxygen. If coal dust gets into your alveoli, your lung tissue attempts to fight and remove the particles. This results in chronic lung inflammation, which can cause scarring over time.

Black lung is classified as:

  • Simple: This type involves small amounts of scarring in lung tissue. It appears as small circular bumps on a chest X-ray or CT scan.
  • Complicated: Also known as progressive massive fibrosis, this type involves severe scarring. It also affects a more widespread area of the lung.

People who work in coal mines of all sizes can develop black lung. Specifically, the following jobs present a higher risk:

  • continuous miner operators
  • shuttle car operators
  • surface drillers and blasters
  • high wall and thin seam miners

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Normal lung vs black lung disease
Photo credit: National Institute for Occupational Safety and Health – NIOSH

A healthy lung looks pink. A black lung, which has been exposed to coal mine dust, has black nodules due to scarring. The black area will get bigger as the scarring becomes more severe.

There’s no test for diagnosing black lung. Your doctor will use different methods to determine if you have the disease. This will likely include the following:

  • Medical history: Since black lung is associated with certain careers, your doctor will want to learn more about your job history. They’ll also ask questions about your symptoms.
  • Physical exam: A physical exam allows your doctor to examine your chest area and listen to your breathing.
  • Breathing tests: These tests will measure how well your lungs can inhale oxygen.
  • Imaging tests: A chest X-ray or CT scan will allow your doctor to see inside your lungs. They’ll look for scarring and inflammation.

Black lung affects about 16 percent of coal workers, both old and young miners alike.

There’s no cure for this disease. As such, the goal of treatment is to ease symptoms and reduce the risk of complications.

This can be done by using:

  • Medication: Your doctor will likely prescribe medication that reduces inflammation in your lungs and supports breathing.
  • Pulmonary rehabilitation: During pulmonary rehabilitation, you’ll learn exercises to improve your lung strength and breathing abilities This can help you stay active and breathe more effectively.
  • Supplemental oxygen: Also called oxygen therapy, this treatment uses a device that delivers extra oxygen into your lungs. It’s used for severe cases of black lung disease.
  • Lung transplant: In this procedure, one or both of your lungs is replaced by lungs from a donor. It’s only used in very severe cases.

Without symptom management, black lung can lead to complications like:

In 2016, the Centers for Disease Control and Prevention (CDC) reported that black lung decreases life expectancy by 12.6 years.

Not all coal workers develop black lung. However, it’s a preventable disease, and certain methods may help reduce the risk.

For coal miners, prevention strategies include:

  • wearing an appropriate respirator while working
  • washing skin that’s exposed to coal dust
  • safely removing coal mine dust from clothing
  • washing your hands and face before eating or drinking

If you work in or near a coal mine, it’s also a good idea to get regular physical checkups. This will allow your doctor to monitor your lung function and breathing and to notice any warning signs in the early stages.

Black lung, or coal workers’ pneumoconiosis, is caused by inhaling coal dust over a long period of time. The condition is most common in coal workers.

Symptoms include coughing, difficulty breathing, and producing black mucus. Over time, the condition can lead to complications like tuberculosis, COPD, and lung cancer. It can also reduce life expectancy and cause premature death.

There’s no cure for black lung, but treatment can help relieve symptoms and reduce the risk of complications. Treatment usually includes medication, oxygen therapy, and pulmonary rehabilitation.