TeleCritical Care: Another Member of the Multidisciplinary Critical Care Team

long after their first abnormal chest radiograph. One of these spoke poignantly about the need to support his family (8). Whatever the historical and current reasons are for the lack of participation in Part 90, most eligible coal miners are not exercising their Part 90 rights. In 2018, NIOSH solicited a request for information from stakeholders, entitled “Barriers to Participation in the NIOSH CoalWorkers Health Surveillance Program,” to inform efforts to improve participation in health surveillance (9). In a June 2022 address to the United MineWorkers of America, MSHA Assistant Secretary ChrisWilliamson commented on the lack of participation in the Part 90 program and committed to making efforts to reduce barriers to participation (10). To that end, MSHA and NIOSH have convened a working group to reduce barriers to participation and improve participation in the CWHSP and the Part 90 program. To date, NIOSH andMSHA have updated their websites, andMSHA has launched theMiner HealthMatters campaign aimed at preventing and addressing health impacts in the mining community, including highlighting Part 90 and streamlining reporting. Black lung remains a major problem in the United States more than 50years after passage of the Coal Act. For working coal miners with early-stage disease, the protections afforded by Part 90 are an opportunity to prevent the most debilitating effects of the disease while keeping their jobs and income. However, these data raise questions about the effectiveness of a voluntary medical mitigation programwith benefits limited to special work accommodations from a current employer in regions of the country where opportunities for goodpaying alternative employment are limited (2). Unless participation in Part 90 improves, there will continue to be hundreds of coal miners each year with newly identified black lung who are not afforded the full protections from additional coal mine dust exposure first offered by the Coal Act. As long as there are coal miners working with black lung, the need for an effective Part 90 programwill remain.