Dr. Alan Ducatman's commentary in the Sunday Gazette-Mail clearly demonstrated his distress over re-emergence of occupational pneumoconiosis in West Virginia. This worsening has also developed in southeastern Virginia and western Kentucky.

Dr. Ducatman's opinion that this issue must be highlighted by public awareness is on the mark. This new information has limited circulation among those in need to know and best able to address this issue.

It has been three years since the National Institute for Occupational Safety and Health published initial findings of a recent increase in the deadly form of "black lung" known as complicated coal workers' pneumoconiosis. This increase has also been noted by the West Virginia Occupational Pneumoconiosis Panel with an increase in complicated pneumoconiosis among those applying for workers' compensation for black lung disease. It is quite noteworthy that this increase has occurred despite regulations designed to reduce generation of coal and silica dust at the workplace.

A study reported in Occupational and Environmental Medicine, 2005, by NIOSH, reported that among 783 miners with black lung, 35.4 percent were of the rapidly progressive complicated coal workers' pneumoconiosis type. This form resulted in disability at an early age and in some instances victims were being considered for lung transplants.

In my opinion, advances in mining mechanization, especially in enclosed underground mines, causes dust levels that are difficult to control by engineering and technological means.

Dust is generated by large continuous miners. Engineering advances in coal production exceed the capacity for dust controls. In addition to coal dust, these machines generate respirable silica particles by grinding rock that sandwiches coal seams.

Coal production is essential for America's economic vitality and energy independence. Dust control remains an important part of mine safety. The importance of addressing dust levels to the extent they can be optimally managed remains an important goal.

However, it appears that we have not directed sufficient attention to personal respiratory protection to those miners who are exposed to higher concentrations of mining dust. It has been proven in other industries, such as sandblasting, tunneling and rock drilling, that silicosis can be essentially eliminated when effective personal respiratory protection is used. Further development of personal respirators would be most cost-effective and of proven effectiveness.

Unless we are aware, we are unable to solve this new problem. As Dr. Ducatman concluded: "The media and public play a big role too. Please keep the heat on unwanted dust and the irreversible disease it causes."

Gaziano is a Charleston lung specialist.

Dr. Alan Ducatman's commentary in the Sunday Gazette-Mail clearly demonstrated his distress over re-emergence of occupational pneumoconiosis in West Virginia. This worsening has also developed in southeastern Virginia and western Kentucky.

Dr. Ducatman's opinion that this issue must be highlighted by public awareness is on the mark. This new information has limited circulation among those in need to know and best able to address this issue.

It has been three years since the National Institute for Occupational Safety and Health published initial findings of a recent increase in the deadly form of "black lung" known as complicated coal workers' pneumoconiosis. This increase has also been noted by the West Virginia Occupational Pneumoconiosis Panel with an increase in complicated pneumoconiosis among those applying for workers' compensation for black lung disease. It is quite noteworthy that this increase has occurred despite regulations designed to reduce generation of coal and silica dust at the workplace.

A study reported in Occupational and Environmental Medicine, 2005, by NIOSH, reported that among 783 miners with black lung, 35.4 percent were of the rapidly progressive complicated coal workers' pneumoconiosis type. This form resulted in disability at an early age and in some instances victims were being considered for lung transplants.

In my opinion, advances in mining mechanization, especially in enclosed underground mines, causes dust levels that are difficult to control by engineering and technological means.

Dust is generated by large continuous miners. Engineering advances in coal production exceed the capacity for dust controls. In addition to coal dust, these machines generate respirable silica particles by grinding rock that sandwiches coal seams.

Coal production is essential for America's economic vitality and energy independence. Dust control remains an important part of mine safety. The importance of addressing dust levels to the extent they can be optimally managed remains an important goal.

However, it appears that we have not directed sufficient attention to personal respiratory protection to those miners who are exposed to higher concentrations of mining dust. It has been proven in other industries, such as sandblasting, tunneling and rock drilling, that silicosis can be essentially eliminated when effective personal respiratory protection is used. Further development of personal respirators would be most cost-effective and of proven effectiveness.

Unless we are aware, we are unable to solve this new problem. As Dr. Ducatman concluded: "The media and public play a big role too. Please keep the heat on unwanted dust and the irreversible disease it causes."

Gaziano is a Charleston lung specialist.