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Original research
Prevalence and severity of abnormal lung function among US former coal miners with and without radiographic coal workers’ pneumoconiosis
  1. Leonard H T Go1,2,
  2. Kirsten S Almberg1,
  3. Cecile S Rose3,
  4. Lauren M Zell-Baran3,
  5. Drew A Harris4,5,
  6. Margaret Tomann4,
  7. Lee S Friedman1,
  8. Dolores J Weems1,
  9. Wendy Vonhof3,
  10. Krista M Mastel6,
  11. Robert A Cohen1,2
  1. 1 Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
  2. 2 Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  3. 3 Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA
  4. 4 Stone Mountain Health Services, St. Charles, Virginia, USA
  5. 5 Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
  6. 6 US Department of Health and Human Services, Health Resources and Services Administration, Rockville, Maryland, USA
  1. Correspondence to Dr Leonard H T Go, School of Public Health, Environmental and Occupational Health Sciences Division, University of Illinois at Chicago, Chicago, Illinois 60612, USA; lgo2{at}


Objectives Examination of lung function abnormalities among coal miners has historically focused on actively working miners. This likely underestimates the true burden of chronic respiratory disease. The objective of this study was to characterise patterns and severity of lung function impairment among a population of former coal miners.

Methods Cross-sectional data from 2568 former coal miners evaluated at eight US Black Lung clinics in a 12-month period were retrospectively analysed for patterns of prebronchodilator spirometric abnormality and severity of lung function impairment. Spirometry data from a subset of former miners with chest radiographs were analysed based on the presence and severity of coal workers’ pneumoconiosis (CWP).

Results Abnormal spirometry was identified in 56.6% of subjects. The age-standardised prevalence of airflow obstruction among miners aged ≥45 years was 18.9% overall and 12.2% among never smokers. Among 1624 subjects who underwent chest radiography, the prevalence and severity of abnormal spirometry increased with worsening radiographic category for pneumoconiosis. Of never-smoking former miners without radiographic CWP, 39.0% had abnormal spirometry; 25.1% had abnormally low forced expiratory volume in 1 s (FEV1), and 17.1% had moderate to severe FEV1 impairment.

Conclusions Abnormal spirometry is common among former coal miners. While ever-smoking former miners had higher rates of airflow obstruction, never-smoking former miners also demonstrated clinically significant airflow obstruction, including those without radiographic pneumoconiosis. These findings demonstrate the importance of recognising physiological as well as imaging manifestations of coal mine dust lung diseases in former miners.

  • coal mining
  • public health surveillance
  • physiology
  • lung diseases
  • interstitial
  • respiratory system

Data availability statement

No data are available. Data used in the study are patient data.

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Data availability statement

No data are available. Data used in the study are patient data.

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  • LHTG and KSA are joint first authors.

  • LHTG and KSA contributed equally.

  • Presented at Part of the data in this article was previously presented in the form of an abstract at the American Thoracic Society International Conference in May 2021.

  • Contributors LHTG and KSA designed the study, interpreted the data and wrote the first draft of the manuscript. LHTG is the guarantor of the manuscript. LHTG and KSA were responsible for the analysis. All authors interpreted the data, assisted in drafting the manuscript. All authors approved the final version of the manuscript.

  • Funding The activities described in this abstract were partially funded by the US Department of Health and Human Services, Health Resources and Services Administration (HRSA) under cooperative agreement number U3ARH27243. The views expressed in this publication are solely the opinions of the authors and do not necessarily reflect the official policies of the US Department of Health and Human Services or the HRSA, nor does mention of the department or agency names imply endorsement by the US government.

  • Competing interests LHTG, CSR, DH and RAC provided expert testimony in medicolegal cases relating to occupational lung disease. RAC provided consultation to Boehringer Ingelheim Pharmaceuticals.

  • Provenance and peer review Not commissioned; externally peer reviewed.