Killer dust: Pingxiang’s pneumoconiosis story

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This article was contributed to CDB by Explorer. 


After China’s economic opening in the late 1970s, people from all over the country started businesses to seize new opportunities and prosper. In the city of Pingxiang, Jiangxi Province, people took advantage of the region’s rich coal resources to open private coal mines and profit from coal mining. As a result, many migrant workers went deep into the mines to earn money.

However, working long hours underground without protective gear led these workers to inhale large amounts of harmful coal dust. Many worked for up to 30 years, only realizing the problem when they began to feel unwell. By then, it was too late; they were plagued by an incurable disease: pneumoconiosis.

Pneumoconiosis is a disease caused by prolonged inhalation of dust, leading to irreversible lung damage. Dust settles in the lungs, reducing their elasticity and causing them to harden. Then, the lungs can’t expand and contract effectively, making breathing increasingly difficult for the patient. With impaired lung function, oxygen can’t easily enter the bloodstream, and waste carbon dioxide produced by the body’s metabolism can’t be effectively expelled. Thus, patients often experience chronic shortness of breath and fatigue due to insufficient oxygen in the blood.

Moreover, dust particles stimulate an immune response in the lungs. Over time, this immune response can lead to chronic inflammation and eventually the formation of fibrous scar tissue, a condition known as pulmonary fibrosis. This fibrosis further hinders lung function, destroying the delicate structure of the alveoli where gas exchange occurs.

Pneumoconiosis and pneumoconiosis patients

“The condition worsens year by year,” says He Guoqing, a 51-year-old pneumoconiosis worker. In 1999, having reached his twenties and in need of money, He started working in the mines. Unbeknownst to him, from the moment he picked up his axe, countless dust particles began to enter his airways. In 2016, a decade after leaving the mines, he suddenly felt chest pain accompanied by a strong cough, a persistent high fever, and severe throat pain. The unbearable physical discomfort forced him to seek medical attention, only to be diagnosed with pneumoconiosis. This diagnosis marked a turning point in his life.

In Pingxiang there are countless pneumoconiosis workers like He Guoqing. Most of them entered the mines for the same reason: money. In that era, a monthly salary of a few hundred yuan seemed particularly attractive. One by one, young men from villages and towns, some as young as 12 or 13, entered the dust-filled tunnels.

For these workers, instead of enjoying their later years, fate delivered a cruel blow— the sudden onset of pneumoconiosis, robbing them of a peaceful old age. Initial symptoms might just involve a cough, an unexplained fever, or a persistent cold. But by the time they realized something was wrong and sought medical attention, many were already in the most severe stage of pneumoconiosis.

The pain of the disease is the primary torment for patients. Their physical condition gradually deteriorates. Since fibrosis of the lungs is irreversible, doctors are unable to stop the progression of the condition. Initially thinking their condition isn’t so severe, some patients lose hope as they see their health decline and choose to give up. After several flare-ups and hospitalizations, their mental state also begins to deteriorate.

Some patients even say, “I don’t want treatment anymore, and the exercises are useless.”

Additionally, financial difficulties are a common challenge for patients and their families. Pneumoconiosis workers lose their ability to work due to their illness, leaving their families without income. Many families struggle, living a life where they can only buy medicine if they are rich.” With the cost of food, electricity, and rent, it is a struggle to afford medication.

Because of this, pneumoconiosis doesn’t just affect the patients but also impacts their families.

The Pingxiang City Xingjian Charity Volunteer Association primarily carries out relief work for local pneumoconiosis workers. The president of Xingjian Volunteer Association said,  “More than half of the families of pneumoconiosis patients have already broken up. Wives have disappeared, perhaps forming new families, leaving children torn in the middle.” In such situations, patients who lose their ability to work and have no income can’t maintain their families. Once the family breaks apart, there’s no one to care for the patient, leading to a more rapid decline.

Treatment of pneumoconiosis

Since the damage from pneumoconiosis is irreversible, patients can only rely on limited drug treatments to alleviate their symptoms. These treatments mainly include anti-fibrosis medicines, cough relief, and anti-inflammatory agents.

Firstly, anti-fibrosis drugs mainly include glycyrrhizic acid preparations and ursodeoxycholic acid. These drugs can delay and improve the degree of lung fibrosis, extending the patient’s life expectancy and quality of life. Most patients can tolerate anti-fibrosis treatment, but long-term use causes gastrointestinal side effects.

Cough relief drugs mainly include bronchodilators, which relax the airways in the lungs, widening the bronchi and airways to make it easier for air to enter and exit, helping alleviate uneven breathing.

Anti-inflammatory drugs mainly include corticosteroids. These steroids can reduce the body’s immune response, thereby alleviating inflammation. This can reduce symptoms like coughing and chest tightness.

Another treatment method for pneumoconiosis patients is to rely on equipment.

Air is composed of oxygen and a large amount of nitrogen. Oxygen generators can remove the nitrogen from the air, providing oxygen with a concentration of up to 95 percent. Healthy individuals might be able to inhale all the oxygen in the air (about 20 percent), but due to the reduced elasticity of the lungs of pneumoconiosis patients, they might only be able to inhale 5-10 percent of the oxygen. Therefore, they need oxygen generators to provide sufficient supplies of oxygen.

Charitable organizations have launched many public welfare projects to support the daily treatment of pneumoconiosis patients.

Love Save Pneumoconiosis is a national public welfare organization dedicated to assisting pneumoconiosis workers. They have initiated a medical treatment project for pneumoconiosis patients nationwide. Each pneumoconiosis patient can apply for 10,000 yuan ($1373) for hospital medical expenses in this project. Each time they are hospitalized in their designated cooperative hospital, the self-paid part after medical insurance reimbursement is deducted from this amount.

In 2018, Love Save Pneumoconiosis began medical assistance in Pingxiang, cooperating with the Third People’s Hospital of Pingxiang City, to start this relief work for local patients.

In addition, the organization also donates oxygen generators to pneumoconiosis patients with few employment prospects.

For some patients with serious conditions, using an oxygen generator at home can alleviate their symptoms. However, many patients’ families can’t afford them due to financial difficulties. Therefore, the donations from Love Save Pneumoconiosis allow patients who need long-term oxygen therapy to have an oxygen generator.

At the same time, the local public welfare organization, Pingxiang City Xingjian Charity Volunteer Association, also supports local patients.

Traditional Chinese medicine is also used to alleviate the symptoms of pneumoconiosis. Sanfu Patch is a typical traditional Chinese medical treatment that can effectively alleviate the problem of pneumoconiosis patients being more susceptible to illness in winter. People believe that during the three hottest days of summer, when people’s yang energy is at its peak, the Sanfu Patch can increase this yang energy to its highest point, preventing cold energy from entering the body in winter. “Anyone with lung disease will use the Sanfu Patch in spring and summer, so their condition won’t easily flare up in winter. This is very important for pneumoconiosis patients,” said Dr. Li Zhifeng, head of the Pulmonary Department of Pingxiang City Traditional Chinese Medicine Hospital.

NGOs also regularly provide flu vaccines for patients. Pneumoconiosis patients are often anxious about catching a cold because colds can easily lead to respiratory diseases, which might increase the chances of pneumoconiosis symptoms and cause lung infections. If they get the flu, many severely symptomatic patients might even face life-threatening situations. Therefore, charitable organizations also provide free flu vaccines for patients every winter. “Getting vaccinated in winter is very important for us because even a slight cold can make us feel very uncomfortable,” said Liu, a pneumoconiosis patient in Pingxiang.


For pneumoconiosis sufferers, rehabilitation is a process which differs from treatment. It focuses more on improving the quality of life, maintaining and enhancing the patient’s lung function, rather than just treating the symptoms. The rehabilitation of pneumoconiosis patients mainly includes respiratory and exercise rehabilitation and psychological rehabilitation. This is a critical process, helping control the disease and improving the patient’s quality of life.

Firstly, respiratory rehabilitation is a way to reduce the respiratory burden on pneumoconiosis patients through correct breathing techniques. The lung function of pneumoconiosis patients will gradually decline, and the lungs will harden, causing difficulties in contraction and expansion. Scientific breathing training, such as abdominal breathing and pursed-lip breathing, can effectively preserve the function of the non-fibrotic parts of the lungs and slow down their fibrosis rate. Moreover, appropriate physical exercise can also enhance lung capacity through respiratory function training and improve blood circulation, helping alleviate the impact of pneumoconiosis on cardiovascular health.

Lastly, psychological rehabilitation is crucial in helping patients deal with the psychological stress related to the disease and to improve their quality of life. Patients need to learn how to cope with anxiety and depression related to the disease, and rehabilitation centers provide such assistance. This sense of community connection can have a positive transformative effect on patients’ perceptions and emotions.

The local public welfare organization, Pingxiang City Xingjian Charity Volunteer Association, has also launched many projects to assist in the rehabilitation of pneumoconiosis patients.

Firstly, the Xingjian Volunteer Association designed a respiratory rehabilitation exercise specifically for pneumoconiosis patients. Through inhalation, breath-holding, and exhalation training, patients can drive their limbs to rise, pause, and fall, further enhancing lung function and alleviating symptoms of breathing difficulty.

At the same time, in cooperation with Love Save Pneumoconiosis, Xingjian Charity Volunteer Association, and the local health clinic, a rehabilitation center was established in Pingxiang to provide free services to local pneumoconiosis patients.

The rehabilitation center provides free services to patients, monitors their physical condition, leads them in rehabilitation exercises, and provides health education. Professionals impart knowledge about pneumoconiosis, its triggers, symptom management strategies and offer health advice.

After coming to the rehabilitation center, pneumoconiosis patient Liu voluntarily chose to serve as a volunteer, assisting the staff of the charitable organization in carrying out rescue and rehabilitation activities. His positive character provides a sense of purpose and belief for others, helping them maintain a good mindset and to stabilize their condition.

Over time, as people’s levels of education rise, irregular coal mines will gradually disappear. With society’s increasing awareness of pneumoconiosis, governments at all levels have also increased investment in protecting worker health, implementing stricter occupational safety regulations to reduce workers’ exposure to harmful dust. At the same time, the emergence of charitable organizations provides better treatment and rehabilitation pathways, significantly improving the quality of life for pneumoconiosis patients. Therefore, although the challenges of pneumoconiosis still exist, we have reason to believe that through education, regulation, medical advancements, and societal support, we can reduce the harm of pneumoconiosis and protect more people from this occupational threat.

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