NSW has recorded its first case of black lung disease in almost half a century.
The state's mining industry regulator on Friday confirmed it had been alerted to a case of coal worker's pneumoconiosis - the first since the 1970s.
The coal miner affected worked at a number of mines before leaving the industry in 2014.
He'd been suffering from respiratory symptoms for 18 months.
The NSW Department of Industry Resources Regulator was notified in December before further testing confirmed the diagnosis.
Investigators are now looking into how it occurred and any potential breaches of health and safety laws.
"Even though this insidious disease has not been confirmed in NSW for decades, one case of pneumoconiosis is one case too many," said resources regulator chief compliance officer Lee Shearer said in a statement.
Black lung is caused by prolonged and close exposure to respirable coal dust and the gradual build up of coal dust particles in lung tissue.
NSW Mining said the case was a reminder of the need to protect workers' health and safety.
The state had the strictest protocols for dust exposure and health screening arrangements, the organisation said in a statement.
While the potential for an isolated case has always been possible, operators and unions were working on any required improvements.
"As far as the industry is concerned, one case is one too many," a spokesman said.
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