Coal is the second largest source of energy worldwide. As global energy demands continue
to rise, coal will remain an important fuel source for years to come. Coal mine dust lung disease
(CMDLD) describes the spectrum of respiratory diseases caused by coal mine dust and includes coal
workers’ pneumoconiosis (CWP), mixed-dust pneumoconiosis, chronic obstructive pulmonary disease
(COPD), and diffuse dust-related fibrosis (DDF). Estimates of the worldwide prevalence of CMDLD are unknown due to
the lack of reliable information. It is recognized that the prevalence is greater in developing countries where working
conditions are not well regulated. Strictly enforced dust control limits in the developed world have resulted in a declining
prevalence of CMDLD. However, some countries have seen resurgence in both the prevalence and severity of CMDLD in
the last 15 years. There is no cure for CMDLD, and it can progress even after exposure has ceased. Primary prevention of
CMDLD, mainly through engineering controls to limit the presence of respirable dust, is therefore of critical importance.
These methods include dust suppression techniques and ventilation plans. Unbiased dust sampling programs are needed to
evaluate the effectiveness of these controls. Personal protective equipment provides inadequate protection due to difficulty
with continuous use. Early detection of CMDLD using well-designed medical surveillance screening programs for coal
miners is recommended. These programs should include chest imaging, spirometry, and clinical questionnaires. Detection
of early disease allows for medical workplace removal as well as evaluation and implementation of improved
environmental safety controls that can protect the respiratory health of all miners.