Focusing on Coal Workers’ Lung Diseases: A Comparative Analysis of China, Australia, and the United States

Abstract

China has high and increasing annual rates of occupational lung diseases such as pneumoconiosis and silicosis. In contrast, Australia and the United States of America (USA) have greatly lowered their annual rates of lung diseases since the 1970s. This paper systematically compared and analysed the multi-elements of coal dust management and health management in these three countries to provide a reference for China. Regarding coal dust management, this paper found that coal workers in China are more susceptible to lung diseases compared to workers in the USA and Australia, considering fundamental aspects such as mine type, coal rank, and geological conditions. In addition, the controllable aspects such as advanced mitigation, monitoring methods, and the personal protective equipment of coal dust were relatively inadequate in China compared to the USA and Australia. Health management in China was found to have multiple deficiencies in health examination, co-governance, and compensations for coal workers suffering from lung diseases and healthcare for retired coal workers. These deficiencies may be attributed to insufficient medical resources, the Chinese government-dominated governance, ineffective procedures for obtaining compensation, and the lack of effective and preventive healthcare programs for the retired coal workers. Based on the USA and Australia experience, some suggestions for improvement were proposed.

Trends in global, regional and national incidence of pneumoconiosis caused by different aetiologies: an analysis from the Global Burden of Disease Study 2017

“…In contrast, in New Zealand, Taiwan (China) and Montenegro, there has been an increasing trend. Government-based operations and progressive coal mining companies have recently chosen to put more energy and money into production safety with respect to trade-offs between ‘visible and immediate accidents’ and ‘invisible and chronic lung diseases’, which can seriously damage coal miners’ lives and health 27–30…”

The Trends in Global, Regional, and National Incidence of Pneumoconiosis Caused by Different Etiologies: An Analysis from the Global Burden of Disease Study 2017

“…On the contrary, in New Zealand, Taiwan (China), and Montenegro, there has been an increasing trend. Government and coal mines choose to put more energy and money into production safety in the trade-off between "visible and immediate accidents" and "invisible and chronic lung diseases", which seriously damages coal miners' lives and health, and restricts the healthy development of the coal industry [28][29][30][31].…”

Silica dust exposure induces autophagy in alveolar macrophages through switching Beclin1 affinity from Bcl‐2 to PIK3C3

“…A study conducted in 2015 revealed that the prevalence of silicosis in South African gold miners kept a relatively high level between 1984 and 2009, and in India, an estimated 11.5 million workers are still exposing to silica dust . In China, more than half a million silicotic cases were diagnosed between 1991 and 1995, of whom 24 000 silicosis‐related deaths occurred annually . Thus, silicosis is still a severe global health problem, especially in developing or undeveloped countries.…”