Federal bill promotes x-ray screening for black lung

2016 12 21 15 11 05 414 Lung Cancer 400

Legislation has been introduced into the U.S. Congress that would shore up the federal program that provides x-ray screening to detect black lung in coal miners. The legislation is intended to head off a looming health crisis as the number of black lung diagnoses climbs in the Appalachian region.

The legislation would promote ways to increase the participation of coal miners in the Coal Workers' Health Surveillance Program (CWHSP), which the U.S. government set up in 1969 to screen miners for signs of black lung. The program is run by the U.S. National Institute for Occupational Safety and Health (NIOSH) and offers chest x-rays, lung function testing, respiratory health assessment questionnaires, and extended health surveillance to miners.

The problem is that participation in the CWHSP program has fallen to 35% of eligible active coal miners, and it is even lower among retired mine workers, according to a press release by Sen. Mark Warner (D-VA), a co-sponsor of the legislation. At the same time, recent studies have found that rates of black lung disease are rising again and are almost triple what they were in 2000 among miners in central Appalachia.

Warner's bill would take a number of steps to improve participation in black lung screening. It would require NIOSH to submit a report to Congress on ways to boost outreach efforts and increase participation in the black lung screening program. It would also require NIOSH to identify the barriers that prevent miners from undergoing screening.

Warner introduced the bill as an amendment to HR 6157, an appropriations bill for the U.S. Department of Defense that also includes funding for the Labor, Health and Human Services, and Education departments. The legislation is currently under debate in the U.S. Senate. The amendment is co-sponsored by senators from both the Republican and Democratic parties.

A political tug of war has erupted over the black lung screening program, as coal mining firms and their political allies seek to reduce the number of claims for compensation, while unions representing mine workers push back by trying to promote screening. For example, the Kentucky Legislature recently passed a law that stripped the ability of radiologists to read x-rays as part of the CWHSP program, instead giving pulmonologists exclusive rights to the interpretations.

Many miners are thought to shun screening because they fear losing their jobs if they file a claim for compensation.

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