Cigarette smoking and federal black lung benefits in bituminous coal miners

The records of 1000 consecutive coal miners applying for benefits under the Federal Coal Mine Health and Safety Act were examined to determine the contribution of age, dust accumulation, and cigarette smoking to the profile of the miner who satisfies the current pulmonary criteria for disability. Using the presence of pneumoconiosis on chest radiograph as the indication of significant coal dust accumulation, the miners were separated into Group A--those without pneumoconiosis (n = 316) and Group B--those with pneumoconiosis (n = 684). The federal spirometric criteria for disability identified 55/316 miners in Group A (14.5%) and 99/684 miners in Group B (17.4%) potentially eligible for an award (P = .27). The mean ages of miners in both groups did not differ significantly, nor was there difference in the mean ages of groups that did or did not meet the federal criteria. In both groups, those miners potentially eligible for a financial award smoked more cigarettes than did their counterparts (Group A, 31.0 v 18.5 pack-years, P less than .001; Group B, 31.3 v 23.6 pack-years, P less than .001). There was no difference in the smoking histories of the miners from either group who met the federal criteria. Our data indicate that, in the case of bituminous coal miners, the present federal legislation intended to identify and remunerate those who suffer lung impairment from chronic occupational exposure to coal dust is biased in favor of those who sustain additional damage to their ventilatory capacity by smoking cigarettes.