Highlights in the history of efforts to prevent occupational lung disease among 
coal miners in the United States are reviewed. The Federal Coal Mine Health and 
Safety Act of 1969 is summarized, and the sources and effects of its provisions 
to prevent coal workers' pneumoconiosis are examined. Descriptions follow of the 
identification of coal workers' pneumoconiosis as a disease, identification of 
respirable coal mine dust as its cause, and establishment and enforcement of an 
exposure limit. The development of prevention efforts focusing on surveillance 
of both exposure and outcome and of enforcement of dust control methods is 
examined.