Coal workers' pneumoconiosis, also known as "
black lung disease," is an occupational
lung disease caused by overexposure to respirable
coal mine dust. Inhaled dust leads to
inflammation and
fibrosis in the lungs, and
coal workers' pneumoconiosis can be a debilitating disease. The Federal
Coal Mine Health and Safety Act of 1969 (
Coal Act),* amended in 1977, established dust limits for U.S.
coal mines and created the National Institute for Occupational Safety and Health (NIOSH)-administered
Coal Workers' Health Surveillance Program with the goal of reducing the incidence of
coal workers' pneumoconiosis and eliminating its most severe form, progressive massive
fibrosis (PMF),† which can be lethal. The prevalence of PMF fell sharply after implementation of the
Coal Act and reached historic lows in the 1990s, with 31 unique cases identified by the
Coal Workers' Health Surveillance Program during 1990-1999. Since then, a resurgence of the disease has occurred, notably in central Appalachia (Figure 1) (1,2). This report describes a cluster of 60 cases of PMF identified in current and former
coal miners at a single eastern Kentucky radiology practice during January 2015-August 2016. This cluster was not discovered through the national surveillance program. This ongoing outbreak highlights an urgent need for effective dust control in
coal mines to prevent
coal workers' pneumoconiosis, and for improved surveillance to promptly identify the early stages of the disease and stop its progression to PMF.