Historically, coal mining has been a very dangerous activity and the list of historical coal mining disasters is a long one. In the US alone, more than 100,000 coal miners were killed in accidents over the past century, with more than 3,200 dying in 1907 alone. Open cut hazards are principally mine wall failures and vehicle collisions; underground mining hazards include suffocation, gas poisoning, roof collapse and gas explosions.
 
Firedamp explosions can trigger the much more dangerous coal dust explosions, which can engulf an entire pit. Most of these risks can be greatly reduced in modern mines, and multiple fatality incidents are now rare in some parts of the developed world. Modern mining in the US results in approximately 30 deaths per year due to mine accidents.
 
However, in lesser developed countries and some developing countries, many miners continue to die annually, either through direct accidents in coal mines or through adverse health consequences from working under poor conditions. China, in particular, has the highest number of coal mining related deaths in the world, with official statistics claiming that 6,027 deaths occurred in 2004. To compare, 28 deaths were reported in the US in the same year. Coal production in China is twice that in the US, while the number of coal miners is around 50 times that of the US, making deaths in coal mines in China 4 times as common per worker (108 times as common per unit output) as in the US.
 
In 2006, fatal work injuries among miners in the US doubled from the previous year, totaling 47. These figures can in part be attributed to the Sago Mine disaster of January 2006. The 2007 mine accident in Utah's Crandall Canyon Mine, where nine miners were killed and six entombed, speaks to the increase in occupational risks faced by US miners. More recently, the Upper Big Branch Mine disaster in West Virginia killed 29 miners in April 2010.
 
Chronic lung diseases, such as pneumoconiosis (black lung) were once common in miners, leading to reduced life expectancy. In some mining countries black lung is still common, with 4,000 new cases of black lung every year in the US (4 percent of workers annually) and 10,000 new cases every year in China (0.2 percent of workers).[26] Rates may be higher than reported in some regions.