A new NIOSH report published in the shows that the prevalence of coal workers’ pneumoconiosis, or black lung disease, is continuing to increase among coal miners in the U.S., with the most pronounced increase occurring in central Appalachia. Researchers conducted the study using radiographs collected by NIOSH’s Coal Workers Health Surveillance Program, or CWHSP, from 1970 through 2017. According to the report, the national prevalence of black lung in miners who have worked 25 years or more now exceeds 10 percent. In central Appalachia, which includes Kentucky, Virginia, and West Virginia, 20.6 percent of coal miners have evidence of the disease—the highest level recorded in 25 years. Progressive massive fibrosis, the most severe form of black lung disease, was previously thought to be nearly eradicated due to improvements in working conditions in coal mines following implementation of the Federal Coal Mine Health and Safety Act of 1969. In the late 1990s, the prevalence of PMF among all miners screened by CWHSP was 0.08 percent. According to NIOSH, the current prevalence of PMF in the central Appalachian region is five percent, the highest prevalence since record-keeping began in the early 1970s. “Breathing coal mine dust is the sole cause of black lung, and it is entirely preventable,” said epidemiologist David Blackley, DrPH, one of the study’s co-authors. “This study provides further evidence that effective dust control methods and protections to reduce coal mine dust exposure along with early detection of the disease are essential to protect miners’ health.”