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“The first priority and concern of all in the coal or other mining industry must be the health and safety of its most precious resource – the miner.” Federal Coal Mine Health and Safety Act of 1969, amended 1977 The Federal Coal Mine Health and Safety Act of 1969 (as amended by the Federal Mine Safety and Health Act of 1977) is intended to protect the health and safety of underground coal miners. This Act directs NIOSH to study the causes and consequences of coal-related respiratory disease and, in cooperation with the Mine Safety and Health Administration (MSHA), to carry out a program for early detection and prevention of coal workers' pneumoconiosis. These activities are administered through the Coal Workers’ Health Surveillance Program (CWHSP), as specified in the Federal Regulations, 42 CFR 37, “Specifications for Medical Examinations of Underground Coal Miners.” NIOSH staff located at the Division of Respiratory Disease Studies (DRDS) in Morgantown, WV, are responsible for conducting the CWHSP. The CWHSP consists of three components:
- Coal Workers' X-ray Surveillance Program (CWXSP). Information about free chest x-rays provided for underground coal miners. Who pays? What is Coal Workers' Pneumoconiosis? Black Lung? When? Where? Frequently Asked Questions and Answers.
- National Coal Workers' Autopsy Program. When a coal miner dies, the family may arrange for a free autopsy. The results may help support a "black lung" benefit claim, and also help scientists and medical doctors learn more about coal workers' pneumoconiosis (CWP) or "black lung" disease.
- NIOSH B Reader Certification Program. NIOSH B Reader certification is granted to physicians who demonstrate proficiency in the classification of chest x-rays for the pneumoconioses using the International Labour Office (ILO) Classification System.
Enhanced Coal Workers' Health Surveillance Program (ECWHSP)
Enhanced Coal Workers' Health Surveillance Program (ECWHSP)
In light of the observed onset of advanced pneumoconiosis among younger coal miners, and the apparent regional clustering of rapidly progressive cases, NIOSH, in collaboration with MSHA, has developed, staffed, and implemented the ECWHSP. This page contains more information about the program and survey summaries.
NIOSH Resources Related to the CWHSP
Mine X-Ray Plans Due for Renewal. A list of the underground coal mining operations, recently notified by NIOSH of the requirement to provide chest x-rays to their employees. This information is being made available for NIOSH-approved x-ray providers interested in increasing participation in the NIOSH Coal Workers’ X-ray Surveillance Program (CWXSP).
X-Ray Facilities Database Search Form. Search the X-Ray Facilities Database to view a listing of all currently approved NIOSH x-ray facilities.
Miner Identification Form
 PDF only 357 KB (2 pages)  En español
(OMB 0920-0020) (CDC/NIOSH 2.9) (July 2007)
This form must be completed by the miner and accompany all x-rays sent to NIOSH for interpretation as part of the Coal Workers' X-ray Surveillance Program. Print/Copy as a double-sided form.
Roentgenographic Interpretation Form
 PDF only 460 KB (2 pages) En español
(OMB 0920-0020) (CDC/NIOSH 2.8) (July 2007)
This form must be completed by the A or B Reader that interprets a chest radiograph for NIOSH as part of the Coal Workers' X-ray Surveillance Program. Print/Copy as a double-sided form.
NIOSH Products Related to CWHSP
Faces of Black Lung (Video)
DHHS (NIOSH) Publication No. 2008-131
Slide Show: Lung sections from victims of pneumoconiosis
PDF only 4,550 KB (18 page)
Black Lung, Don't Become a Victim
DHHS (NIOSH) Publication No. 2003-123 (2003)
PDF 130 KB (1 page) JPG 2,164 KB
A NIOSH poster promoting participation in the Coal Workers' Health Surveillance Program.
NIOSH/DRDS/CWHSP Celebrates the 35th Anniversary of the Federal Coal Mine Health and Safety Act
PDF 195 KB (5 pages)
Mining Safety and Health Research, a NIOSH workplace safety and health topic (includes information on the NIOSH project that administers the Coal Workers' X-ray Surveillance Program).
Pneumoconiosis, a NIOSH workplace safety and health topic.
Recent statistics on prevalence of coal worker's pneumoconiosis in the U.S.
Morbidity and Mortality Weekly Report, April 2003 / 52(15);336
PDF only 130 KB (1 page)
A NIOSH analysis of recent radiographic information from the U.S. National Coal Workers' X-ray Surveillance Program (CWXSP).
Work-Related Lung Disease (eWoRLD) Surveillance System
The Work-Related Lung Disease (eWoRLD) Surveillance System, produced by the National Institute for Occupational Safety and Health (NIOSH), presents up-to-date summary tables, graphs, and figures of occupationally-related respiratory disease surveillance data on the pneumoconioses, occupational asthma and other airways diseases, and several other respiratory conditions. For many of these diseases, selected data on related exposures are also presented.
Section 2: Coal Workers' Pneumoconiosis and Related Exposures
Other Resources Related to the CWHSP
The links to external web sites included below are provided for informational purposes only. Citation should not be taken as endorsement by NIOSH of the web site content nor of the sponsoring organization.
American College of Radiology (ACR)
External link: http://www.acr.org
Black Lung Benefits Act (BLBA)
External Link: http://www.dol.gov/dol/compliance/comp-blba.htm
Black Lung Clinics Program
External Link: http://ruralhealth.hrsa.gov/funding/BLCP/
Campaign to End Black Lung Now and Forever
External Link: http://www.msha.gov/S&HINFO/BlackLung/homepage.htm
Federal Mine Safety & Health Act of 1977
External link: http://www.msha.gov/Regs/Act/Acttc.htm
Mine Safety and Health Administration
External link: http://www.msha.gov
42CFR27 Specifications of Medical Examinations of Underground Coal Miners
External link: http://www.access.gpo.gov/nara/cfr/waisidx_02/42cfr37_02.html
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Coal Workers' Health Surveillance Program
