Black Lung Disease Every year, nearly 1,500 people who worked in the country's coal mines die from black lung disease. This is equivalent to the Titanic sinking every year, without any ships coming to the rescue. While that long-ago disaster continues to fascinate the nation, black lung victims die agonizing deaths in isolated rural communities, far from the spotlight of publicity. Black lung is the legal term for a human-caused occupational lung disease that is contracted from prolonged breathing of coal mine dust. Some call it miner's asthma, silicosis, pneumonoultramicroscopicsilicovolcanoconiosis, coal workers' pneumoconiosis, or black lung. However, they are all dust diseases with the same symptoms. Only the smallest particles of coal dust make it through the nose, mouth and throat into the alveoli that lie deep in the lungs. The alveoli, or air sacs, are responsible for exchanging gases with the blood and are located at the end of each bronchiole. Microphages, a type of blood cell, collect foreign particles and carry them where they can be swallowed or coughed up. If too much dust is inhaled over a long period of time, some dust-laden microphages and particles permanently collect in the lungs causing black lung disease. The main symptom of the disease is shortness of breath, which worsens as the disease progresses. In severe cases, the patient may develop cor pulmonale, which is an enlargement and tightness on the right side of the heart caused by chronic lung disease. Ultimately, this can cause right heart failure. Some patients develop emphysema as a complication of black lung disease. Others develop a severe type of black lung disease in which damage continues to the upper part of the lungs even after dust exposure has ended, called progressive massive fibrosis. Black lung disease can be diagnosed by checking the patient's history for exposure to coal dust. , followed by a chest x-ray to see if the characteristic spots on the lungs are present. A pulmonary function test can help in the diagnosis. However, all coal miners should have chest x-rays every four years so that the disease can be detected early. Congress has placed strict limits on airborne dust and ordered operators to periodically test the air inside coal mines in 1969.