[Federal Register Volume 83, Number 219 (Tuesday, November 13, 2018)]
[Notices]
[Pages 56327-56328]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-24700]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Docket No. CDC-2018-0110; NIOSH-224]


Barriers to Participation in the NIOSH Coal Workers Health 
Surveillance Program

AGENCY: Centers for Disease Control and Prevention, HHS.

ACTION: Request for information.

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SUMMARY: The Coal Workers' Health Surveillance Program (CWHSP or 
Program), administered by CDC's National Institute for Occupational 
Safety and Health (NIOSH), is seeking information from coal miners, 
miner advocates, unions, industry stakeholders, and other interested 
parties about barriers to participating in health screening offered by 
the Program to inform efforts to improve participation.

DATES: Comments must be received by January 14, 2019.

ADDRESSES: Written comments: Comments may be submitted electronically, 
through the Federal eRulemaking Portal: http://www.regulations.gov, or 
by sending a hard copy to the NIOSH Docket Office, Robert A. Taft 
Laboratories, MS-C34, 1090 Tusculum Avenue, Cincinnati, OH 45226. All 
written submissions received must include the agency name (Centers for 
Disease Control and Prevention, HHS) and docket number (CDC-2018-0110; 
NIOSH-224) for this action. All relevant comments, including any 
personal information provided, will be posted without change to http://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Cara N. Halldin, NIOSH Coal Workers' 
Health Surveillance Program, Respiratory Health Division, 1095 
Willowdale Road, MS HG900.2, Morgantown, WV 26505-2888; (304) 285-5754 
(this is not a toll-free number); [email protected].

SUPPLEMENTARY INFORMATION: 
    The NIOSH Coal Workers' Health Surveillance Program was authorized 
by the Coal Mine Health and Safety Act of 1969, as amended by the 
Federal Mine Safety and Health Act of 1977 (30 U.S.C. 801 et seq.), to 
detect dust-induced interstitial lung disease (black lung or coal 
workers' pneumoconiosis) and prevent its progression in individual 
miners, and obtain information about temporal and geographic trends 
across the population of coal miners. Through the Program, coal miners 
are offered periodic health screenings, including chest x-rays and 
spirometry examinations, at no cost to them. These screenings can 
potentially detect early signs of black lung. NIOSH has administered 
the Program since 1970. Since that time, the prevalence of radiographic 
evidence of pneumoconiosis among participating coal miners reached its 
lowest level in the late 1990s, but has steadily increased since 2000 
and is now at a 25-year high. In the Appalachian coal mining states of 
Kentucky, Virginia, and West Virginia, as many as one in five 
underground coal miners with more than 25 years' tenure are thought to 
have radiographic evidence of pneumoconiosis.\1\ Participation by coal 
miners in the CWHSP is voluntary, and about 35 percent of active coal 
miners participate in health screenings offered by the Program.\2\
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    \1\ Blackley DJ, Halldin CN, Laney AS [2018]. Continued increase 
in prevalence of coal workers' pneumoconiosis in the United States, 
1970-2017. AJPH 108(9):1220-1222.
    \2\ Id.
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    Greater participation in the Program would provide more 
opportunities for early detection of pneumoconiosis in coal miners, 
providing those with early disease the ability to take action to reduce 
the chance for progression to severe lung disease. In order to identify 
ways to improve participation in the Program, NIOSH is seeking 
information from all interested parties, especially active coal miners, 
as well as miner advocates, unions, industry stakeholders, and 
healthcare providers of screening services for the CWHSP, to learn 
about the factors that keep miners from participating in the health 
screening examinations that are available to them.
    NIOSH is particularly interested in receiving information about the 
following questions:
    1. Are coal miners aware that periodic health screenings are 
available, at no cost to them, through the Coal Workers' Health 
Surveillance Program?
    2. Is lack of convenience of the screening--for example, screening 
locations or hours of availability--a barrier to participation? If yes, 
please describe those factors that may prevent miners from accessing 
CWHSP screenings.
    3. NIOSH's mobile surveillance unit travels to different locations 
to provide free black lung screenings, including chest x-rays and 
spirometry tests.\3\ Does the mobile unit provide a useful supplement 
to services offered by approved healthcare facilities engaged by mine 
operators? If yes, please explain why mobile outreach is a useful 
supplement. If no, or if mobile outreach could be improved, please 
provide recommendations on how it could become more useful to the coal 
mining community.
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    \3\ See https://www.cdc.gov/niosh/topics/cwhsp/free-screening/wv.html.
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    4. Do coal miners receive encouragement to participate (or 
discouragement from participating) in the CWHSP screenings from others 
such as employers, unions, or co-workers? If so, please describe.
    5. Are scheduling issues, such as the need to take unpaid time off 
from work or use vacation hours or non-work hours for health 
screenings, a barrier to miners' participation in health

[[Page 56328]]

screenings? If yes, please explain the scheduling issue that is a 
barrier and provide recommendations for how it could be overcome.
    6. Does concern about the confidentiality of medical information 
pose a barrier to participation? If this is a barrier, then please 
provide recommendations or suggestions for how it can be overcome.
    7. Does concern that the early identification of dust-related lung 
disease might adversely affect a miner's career (e.g., prevent career 
advancement or the ability to get a new coal mining job) pose a barrier 
to participation? If this is a barrier, then please provide 
recommendations or suggestions for how it can be overcome.
    8. Does concern that early identification of dust-related lung 
disease might affect subsequent eligibility for compensation through 
Federal or State programs pose a barrier to participation? If this is a 
barrier, then please describe the specific compensation programs and 
how eligibility for them can be affected by early detection of dust-
related lung disease. Please also provide recommendations or 
suggestions for how this barrier could be overcome.
    9. Does concern that personal finances will require a miner to 
continue working despite early identification of dust-related lung 
disease pose a barrier to participation? If this is a barrier, please 
provide recommendations or suggestions for how it can be overcome.
    10. Are there any other barriers to participation that NIOSH should 
be aware of?
    Interested parties may participate in this activity by submitting 
written views, opinions, recommendations, and data. Comments received, 
including attachments and other supporting materials, are part of the 
public record and subject to public disclosure. Do not include any 
information in your comment or supporting materials that you do not 
wish to be disclosed. Although your name, contact information, or other 
information that identifies you in the body of your comments will be on 
public display, NIOSH will review all submissions and may choose to 
redact or withhold submissions containing private or proprietary 
information such as Social Security numbers, medical information, and/
or inappropriate language. Comments may be submitted on any topic 
related to this action. All public comments will be posted in the 
docket for this action at https://www.regulations.gov.

John J. Howard,
Director, National Institute for Occupational Safety and Health, 
Centers for Disease Control and Prevention.
[FR Doc. 2018-24700 Filed 11-9-18; 8:45 am]
 BILLING CODE 4163-19-P