Black Lung

(Coal Workers' Pneumoconiosis)

Reviewed/Revised Mar 2023 | Modified Dec 2023
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What is black lung?

Black lung is an environmental lung disease caused by breathing in a lot of coal dust over many years.

  • Black lung happens mainly in coal miners and others who work with coal

  • Your lungs look black inside because of the coal dust

  • You may have no symptoms at first but develop a cough and severe breathing problems if the disease gets worse

  • Doctors use chest x-rays and CT (computed tomography) scans to diagnose black lung

  • Doctors treat black lung with oxygen and medicines to make breathing easier

There are two types of black lung disease:

  • Simple black lung

  • Complicated black lung, also called progressive massive fibrosis

Simple black lung disease is caused by coal dust collecting in the small airways in your lungs. Most people with simple black lung disease do not have any symptoms.

Some people with simple black lung get worse and develop complicated black lung. This causes large scars in your lungs and makes it very hard to breathe.

What causes black lung?

Black lung is caused by breathing in coal dust over a long period of time (usually more than 10 years).

What are the symptoms of black lung?

Simple black lung usually has no symptoms. However, many people with this disease often have another lung disease, such as bronchitis or emphysema (especially people who smoke). Those lung diseases cause people to cough and be short of breath.

Complicated black lung causes severe symptoms such as:

  • Coughing and coughing up black mucus

  • Very severe shortness of breath

  • Heart failure (when your heart doesn’t pump blood as well as it should)

How can doctors tell if I have black lung?

If you've been exposed to coal dust, doctors will diagnose black lung using:

How can I prevent black lung?

Prevention is important because there's no cure for black lung. Workplaces can help prevent black lung by preventing too much coal dust at the work site. They can use:

  • Ventilation systems

  • Face masks for workers

If you're a coal worker, you can do these things to help slow down and monitor the disease:

  • Have a chest x-ray each year

  • Move to a job that has less coal dust

  • Stop smoking

  • Get a pneumonia and flu vaccine

How do doctors treat black lung?

There's no treatment for the disease, but doctors can help lessen symptoms. To treat shortness of breath, doctors may prescribe:

  • Oxygen to make breathing easier

  • Pulmonary rehabilitation (a program to help you learn how to breathe with long-term lung disease)

  • Medicines to keep your airways open and free of mucus

Patients with complicated black lung may need a lung transplant. With a transplant, your failing lung is removed and replaced with a healthy one from a donor.

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