title: Coal mine dust lung disease in the modern era.
abstract: Coal workers' pneumoconiosis (CWP), as part of the spectrum of coal mine dust lung disease (CMDLD), is a preventable but incurable lung disease that can be complicated by respiratory failure and death. Recent increases in coal production from the financial incentive of economic growth lead to higher respirable coal and quartz dust levels, often associated with mechanization of longwall coal mining. In Australia, the observed increase in the number of new CWP diagnoses since the year 2000 has necessitated a review of recommended respirable dust exposure limits, where exposure limits and monitoring protocols should ideally be standardized. Evidence that considers the regulation of engineering dust controls in the mines is lacking even in high-income countries, despite this being the primary preventative measure. Also, it is a global public health priority for at-risk miners to be systemically screened to detect early changes of CWP and to include confirmed patients within a central registry; a task limited by financial constraints in less developed countries. Characteristic X-ray changes are usually categorized using the International Labour Office classification, although future evaluation by low-dose HRCT) chest scanning may allow for CWP detection and thus avoidance of further exposure, at an earlier stage. Preclinical animal and human organoid-based models are required to explore potential re-purposing of anti-fibrotic and related agents with potential efficacy. Epidemiological patterns and the assessment of molecular and genetic biomarkers may further enhance our capacity to identify susceptible individuals to the inhalation of coal dust in the modern era.
authors.affiliation: Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.|Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.|Institute for Breathing and Sleep (IBAS), Melbourne, Victoria, Australia.
authors.forename: Jennifer L
authors.identifier: 0000-0001-7034-0615
authors.initials: JL
authors.lastname: Perret
authors.affiliation: PM10 Laboratories Pty Limited, Somersby, New South Wales, Australia.|Faculty of Engineering and Informational Sciences, The University of Wollongong, Wollongong, New South Wales, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Plush
authors.affiliation: Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.|Department of Respiratory Medicine and Sleep Disorders, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Philippe
authors.identifier: 0000-0001-9290-1823
authors.initials: P
authors.lastname: Lachapelle
authors.affiliation: Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.|Department for Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia.|Clinical and Experimental Sciences, University of Southampton, Southampton, UK.|Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton University Hospital, Southampton, UK.
authors.forename: Timothy S C
authors.initials: TS
authors.lastname: Hinks
authors.affiliation: Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.|Department of Respiratory Medicine and Sleep Disorders, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Walter
authors.affiliation: Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Clarke
authors.affiliation: Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.|Department of Respiratory Medicine and Sleep Disorders, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Louis
authors.initials: L
authors.lastname: Irving
authors.affiliation: Pump Investments Pty Limited, Melbourne, Victoria, Australia.
authors.forename: Pat
authors.initials: P
authors.lastname: Brady
authors.affiliation: Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.|Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Shyamali C
authors.initials: SC
authors.lastname: Dharmage
authors.affiliation: Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.|Department of Pharmacology and Therapeutics, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Alastair
authors.initials: A
authors.lastname: Stewart
mesh_terms: D055008:Anthracosis / Q000453:epidemiology* / Q000209:etiology; D003032:Coal Mining; D004391:Dust; D014943:Global Health; D006801:Humans; D009017:Morbidity; D016273:Occupational Exposure / Q000009:adverse effects*
chemical_list: D004391:Dust
keywords: coal mine dust lung disease; coal mining; coal workers’ pneumoconiosis; health surveillance; respirable dust