Pneumoconiosis: Support for Former Miners

Lee Rowley Excerpts

Tuesday 13th March 2018 Westminster Hall

[Ben Bradley (Mansfield) (Con)]

I beg to move,

That this House has considered support for former miners with pneumoconiosis.

It is a great pleasure to serve under your chairmanship, Mr Bailey. I thank the Minister for being here to respond to the debate and colleagues for their attendance.

It is a privilege to have secured my first Westminster Hall debate on a subject of interest to many of my constituents and many in former coalmining communities across the UK. Mansfield has a proud coalmining history, which ended very recently—just a few years ago—when the nearby Thoresby colliery closed. For decades, the community was built around the industry, and we still feel many of its effects.

I applied for this debate because, although coalminers’ pneumoconiosis is not a terribly widely known illness, it is prevalent within mining communities and should receive greater attention. I have been contacted by a number of constituents and unions about this issue, which I am keen to raise directly with Ministers. I am asking the Department for Work and Pensions to work with the Department of Health and Social Care to review the diagnostic tools that are used to assess miners for signs for pneumoconiosis.

Coalminers’ pneumoconiosis is an occupational lung disease caused by the inhalation of dust from coalmines. It is often known as “black lung” and it causes thousands of death each year worldwide. Inhaled coal dust progressively builds up in the lungs over long periods, leading to inflammation of the lungs, fibrosis and even necrosis. The most common symptoms of pneumoconiosis are coughing and shortness of breath. The risk is generally higher when people have been exposed to mineral dust in high concentrations and if they have been exposed to coal dust for long periods.

Coughing and shortness of breath can, of course, be symptoms of a wide range of illnesses, which is partly why pneumoconiosis is often overlooked by health professionals and others. Even when a former miner presents to their GP with those symptoms, it is not always picked up straightaway. Most miners would recognise that a cough is inherent—part of the territory of working in those conditions—and many would not consider it a symptom of anything more than their career underground. Many therefore do not come forward early enough, and this is where the problem lies. We need to do more to encourage this conversation.

Many former miners who present with such symptoms are simply referred as out-patients to their local hospitals for standard chest X-rays. They will have had these X-rays regularly throughout their time in the industry and most will have been told that they have a clean bill of health on that basis. The trouble is that traditional two-dimensional X-ray films often do not show enough detail to diagnose pneumoconiosis, especially when the patient is in the early stages of the disease. The tell-tale sign of the disease is nodules in the lungs, which can be as small as l mm or 2 mm in diameter. When using X-rays for diagnosis, it is usually possible to pick up on pneumoconiosis only at a later stage, when large masses of dense fibrosis have developed in the lungs. By that stage, there is usually a notable decrease in lung function—in effect, it is too late.

A successful diagnosis is also less likely because of the time that has passed since the pits closed. The doctor they see now, who examines the X-ray, is less likely to have specialist knowledge of the industry and related illnesses. They are also less likely to have seen this disease before, so are perhaps less likely to spot it.

For the best results and the quickest analysis, a CT scan is the most effective diagnostic tool. CT scans show the lungs in three dimensions, which provides far greater detail and allows for a more accurate diagnosis. For many of us, it is surprising to learn that there is not a regular screening programme in place for former coalminers to pick up cases of pneumoconiosis and other lung conditions. Many former miners received their last X-ray at work. When miners retire or are made redundant, their access to regular X-rays simply stops. Former miners then tend not to receive another until they present to their GP with symptoms such as breathing difficulties or a persistent cough. Many fear that they have cancer, and are given a CT scan only to find that it is in fact pneumoconiosis.

It is important to note that the latency period for pneumoconiosis is about 10 years, but can be as long as 15 to 20 years. The lack of regular screening once a miner leaves that environment and retires is clearly a problem. I am aware of several cases in my constituency of miners who received the all-clear for pneumoconiosis after getting old-fashioned X-rays at work, but were subsequently diagnosed with pneumoconiosis after CT scans revealed evidence of the disease.

[Lee Rowley (North East Derbyshire) (Con)]

My hon. Friend is making an excellent point. I have personal experience of lung disease in the family. Both of my grandfathers were miners, and some of their lung issues did not come to the fore until at least a decade after they left the pit. I want to emphasise the importance of what he says: we need to ensure that there is support throughout the process and throughout people’s lives.

[Ben Bradley]

My hon. Friend is absolutely right. That is a prime example of why it is important that assessment is ongoing and people who used to work down the mines have access to diagnosis and treatment throughout the rest of their lives.

A few years ago, the Union of Democratic Mineworkers decided to run a test case. The UDM paid for five former miners who had recently been made redundant to have CT scans. The men had all received recent occupational X-rays at the colliery, and each had received the all-clear from those scans, but when the five men went for CT scans, two were diagnosed with pneumoconiosis. Interestingly, two of the other three men were diagnosed with other health issues, which had previously been unseen in the X-rays. Four out of five had conditions that required a CT scan to get a diagnosis. Surely it is clear that former mineworkers are at high risk of many different respiratory health problems, and that a CT scan is the most effective tool for diagnosis.

At present, the reality is that without post-retirement screening for pneumoconiosis, and with standard guidance from the DWP and the Department of Health promoting X-rays for testing, many cases are not picked up until it is too late. It is a sad truth that pneumoconiosis is often noted in a patient’s file for the first time when they receive a diagnosis of lung cancer or other advanced respiratory illness. That is clearly unacceptable.