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Coal workers’ pneumoconiosis: an Australian perspective

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“Pneumoconiosis” refers to a group of fibrotic lung diseases caused by the retention of dust in the lung. Coal workers’ pneumoconiosis (CWP), also known as “black lung”, is an irreversible interstitial lung disease resulting from chronic inhalation of coal dust.1 CWP has a long history, with the first case being reported in 1831.2 Workers exposed to coal dust are at risk of a range of chronic lung diseases including CWP,1 silicosis,1 mixed dust pneumoconiosis,3 chronic obstructive pulmonary disease4 and chronic bronchitis.4 In cases of heavy dust exposure, CWP may develop into progressive massive fibrosis (PMF),5 which can be fatal. In 2013, CWP resulted in 25 000 deaths globally.6 Most cases of CWP occur in the setting of poor occupational hygiene and dust control.7

Recent reports of CWP in Australia — six confirmed cases were reported by nominated medical advisers in the Queensland coal industry between May 2015 and February 20168 — are highly concerning and point to a potential decline in exposure control in Australian mines or a failure of the screening…