Mesothelioma vs Black Lung Cancer

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Mesothelioma and black lung disease (pneumoconiosis) are different conditions that sometimes are confused with each other. Both are serious diseases that affect miners and other workers in heavy industry.

Below are the key differences between these two severe health conditions.

Mesothelioma Overview

Mesothelioma is caused by exposure to asbestos in a variety of heavy industry professions, such as mining, power generation, manufacturing, oil refining, and construction. (

As workers inhale or swallow invisible asbestos particles, they stick in delicate body membranes. Over the decades, the particles can cause scarring and DNA changes that eventually lead to cancer in some patients.

Mesothelioma occurs in the thin layer of tissue that covers most of your internal organs. Doctors divide mesothelioma into different varieties depending on the part of the mesothelium is affected.

Pleural Mesothelioma Is Most Common Form

It most often affects the thin membrane surrounding the lungs, which is called pleural mesothelioma. A rarer type of disease affects the abdominal organs and is called peritoneal mesothelioma. The rarest forms of mesothelioma affect the heart and testicles.

Asbestos exposure is the cause of the vast number of mesothelioma cases, of which approximately 3,000 are diagnosed annually.

There are few symptoms of the disease in the early stages. Chest pain and breathlessness tend to occur in stages 3 and 4.

Risk Factors For Mesothelioma

Most people who were exposed to asbestos never get cancer. This suggests there can be other factors involved in determining if a person gets the disease. For example, you could be more genetically disposed to getting mesothelioma. Other factors that can enhance your risk of mesothelioma are:

  • Personal history of exposure to asbestos: If you were directly exposed to asbestos at home or work, you have a much higher chance of getting cancer.
  • Living with a person who works with the carcinogen: People who work with asbestos can carry fibers home on their clothes, skin, and shoes. Exposure to stray asbestos fibers over the years can put people in the home at risk, too. This risk can be mitigated if the person working with asbestos showers and changes clothes before they leave work.
  • History of mesothelioma in the family: If your parent or sibling had mesothelioma, you have a higher risk of getting it.

Black Lung Overview

Black lung disease is a type of pneumoconiosis known as coal worker’s pneumoconiosis (CWP). ( CWP can be caused not just by regularly working with coal dust; it also can form by breathing graphite or man-made carbon for months or years.

While CWP rates have dropped since federal regulations were passed years ago, the number of black lung disease diagnoses have doubled since 1995.

CWP Can Evolve Into Progressive Massive Fibrosis

The problem with coal dust is that it cannot be removed or broken down by your body once it enters the lungs. Bits of coal dust stick on connective tissue in the lungs or pulmonary lymph nodes. In patients with black lung disease, these bits or clumps of dust can lead to lesions in the lungs.

If CWP continues through years of regular exposure, the condition turns into progressive massive fibrosis (PMF). In the final stages of PMF, the lungs are black in color.

No Symptoms in Early Stages of Black Lung Disease

Like mesothelioma, there are no symptoms in the early stages of black lung disease. While a cough and formation of mucus can occur, this does not always mean the patient has CWP; dust-induced bronchitis is common among coal miners.

But as black lung disease gets worse and evolves into PMF, the lungs scar and shortness of breath and a chronic cough develop. The miner also will generate excess mucus and the airway becomes obstructed with fluid.

Black Lung Cases Still Occur

Most people diagnosed with black lung disease are over 50, and spent most of their work years in coal mines, or similarly dangerous environments involving carbon or graphite. Since the 1980s, there have been tougher safety regulations and the number of CWP cases has dropped. Some experts thought black lung disease would be entirely eliminated.

However, new data has puzzled scientists and indicates that black lung disease still can kill workers. It is estimated there are 40,000 coal miners working in the US, but 10,000 or so have died from CWP in the last 10 years.

Reported cases of black lung disease fell 90% from 1970 to 1995 because of the Coal Mine Health and Safety Act of 1969 (CMHSA). But since 1995, the number of CWP cases has at least doubled.

What is especially alarming is that many young coal miners have gotten the disease even though they have worked all their years under the more regulated coal industry created by the CMHSA. (

Why Does Black Lung Disease Still Occur?

The increase in black lung cases has not been fully explained at this time. But the National Institute for Occupational Safety and Health (NIOSH) has five possible explanations:

  1. Inadequacies in coal-mine-dust regulations
  2. Failure to fully comply with or completely enforce the regulations
  3. Inadequate disease prevention measures to accommodate changes in mining practices
  4. Working longer hours in mines in recent years
  5. Miners failing to take advantage of screenings for early disease and take aggressive action to reduce exposure to coal dust

NIOSH has started several programs in the last five years that attempt to improve early detection and prevention. One of the most significant is the Enhanced Coal Workers Health Surveillance Program (ECWHS). (

This is a joint program between NIOSH and the Mine Safety and Health Administration (MSHA). ECWHS provides free health screenings, such as x-rays, to mine workers every 60 months.

They also provide mobile health screening units that travel to black lung hot spots throughout the US. NIOSH also operates the Coal Workers X-Ray Surveillance Program (CWXSP) and the National Coal Workers’ Autopsy Program that aims to provide families evidence needed to make a CWP benefit claim.

Mesothelioma vs Black Lung Summary

Mesothelioma and black lung disease are very different health conditions, but both diseases have seriously affected the health of miners and other heavy industry workers for decades.

If you have worked in an occupation that exposed you to asbestos or coal dust, it is important to be screened regularly by your healthcare professional for the serious health problems that can result from this type of work.