Focusing on coal workers' lung diseases: A comparative analysis of China, Australia, and the United States

China has high and increasing annual rates of occupational lung diseases such as pneumoconiosis and silicosis. In contrast, Australia and the United States of America (USA) have greatly lowered their annual rates of lung diseases since the 1970s. This paper systematically compared and analysed the multi-elements of coal dust management and health management in these three countries to provide a reference for China. Regarding coal dust management, this paper found that coal workers in China are more susceptible to lung diseases compared to workers in the USA and Australia, considering fundamental aspects such as mine type, coal rank, and geological conditions. In addition, the controllable aspects such as advanced mitigation, monitoring methods, and the personal protective equipment of coal dust were relatively inadequate in China compared to the USA and Australia. Health management in China was found to have multiple deficiencies in health examination, co-governance, and compensations for coal workers suffering from lung diseases and healthcare for retired coal workers. These deficiencies may be attributed to insufficient medical resources, the Chinese government-dominated governance, ineffective procedures for obtaining compensation, and the lack of effective and preventive healthcare programs for the retired coal workers. Based on the USA and Australia experience, some suggestions for improvement were proposed