• coal Workers’ pneumoconiosis
• delphi method

Cui et al report on the application of the Delphi method to identify prevention strategies for coal workers’ pneumoconiosis (CWP) in China.1 The Delphi method is a systematic iterative process that engages a panel of experts in revising and ranking proposed criteria to arrive at a consensus.2 This method has been applied internationally to guide the setting of occupational health and safety research.3 Cui et al applied this approach to ranking and grouping 69 indicators that impact CWP risk, such as ventilation and physical characteristics of the coal seam, in four Chinese state-owned coal mining enterprises. They found that the highest ranked factors for preventing and controlling CWP were ‘geological conditions’ and ‘dust control engineering technology’. Surprisingly, these factors ranked higher than occupational health management. The authors’ findings suggest that setting occupational disease prevention strategies, such as regulating permissible coal mine dust exposure levels, at the national level is inadequate when prevalence and risk vary locally by modifiable and non-modifiable factors, such as geography.

Although preventable, disability and mortality from CWP remains a significant burden in China and globally.4 CWP, and its most severe form, progressive massive fibrosis, belong to a family of respiratory conditions known as coal mine dust lung disease (CMDLD). Other diseases in …