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Black lung is a progressive illness caused by inhaling toxic coal and rock dust in coal mines. There are few treatment options.
"Although coal mining is on the decline, the rates of black lung in Southwest Virginia continue to increase. Coal miners in Central Appalachia face disparities in health related to a range of complex social, economic, occupational and behavioral factors," said Dr. Drew Harris, a pulmonary medicine expert at University of Virginia Health System.
"This study highlights the unrecognized crisis of mental illness in miners that warrants urgent attention, resources and expanded care," added Harris, who is also the medical director of the Black Lung Clinic at Southwest Virginia's Stone Mountain Health Services.
Of more than 1,400 coal miners X-rayed in the last year at Stone Mountain, more than 15% had progressive massive fibrosis, the most severe form of black lung.
Harris and his colleagues analyzed data from more than 2,800 miners, average age 66, assessed for anxiety, depression and post-traumatic stress disorder (PTSD) at the clinic since 2018. Nearly all of the miners were men.
The results showed that about 37% had symptoms consistent with major depression, nearly 39% had clinically significant anxiety, more than 26% had symptoms of PTSD, and just over 11% had considered suicide in the last year, compared with under 3% among Virginia men overall.
"These rates of mental illness far exceeded those documented in coal mining populations internationally," the researchers wrote in the study published recently in the journal JAMA Network Open.
Rates were especially high among sicker miners who required supplemental oxygen to help them breathe: about 48% reported anxiety; 48.5% reported depression, and almost 16% reported considering suicide.
"The rates of mental illness identified in this large population of U.S. coal miners is shocking," Harris said in a University of Virginia news release. "Improved screening and treatment of mental illness in this population is an urgent, unmet need that warrants urgent action."
The authors believe their study is the first to examine mental health issues in a large group of U.S. coal miners.
The American Lung Association has more on black lung disease.
SOURCE: University of Virginia, news release, July 6, 2021
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