To evaluate the alterations of biomarkers in the development and progression of coal workerspneumoconiosis (CWP). Methods The type and number of cells, and the levels of tumor necrosis factor-alpha (TNF-α),pulmonary surfactant protein, phospholipids and fibronectin in bronchoalveolar lavage fluid were assayed in 14 health active coal miners, 21 coal miners without CWP and 13 miners with CWP of 0/1 to 1/1. Results Compared to active coal miners without CWP (8.23 μg/mL), TNF-α concentration was gradually decreased when dust exposure was stopped (5.90 μg/mL).Elevated surfactant protein A (SP-A) level and phosphatidylglycerol (PG) to phosphatidylinositol (PI) ratio were found in miners actively exposed to coal dust (6528 ng/mL for SP-A and 10. for PG/PI), and both parameters decreased when CWP progressed from CWP (0/1) (3419 μg/mL for SP-A and 5.9 for PG/PI) to CWP (1/1) (1654 μg/mL for SP-A and 5.5 for PG/PI).Conclusion Biomarkers in bronchoalveolar lavage fluid can be used to screen coal miners at high risk of developing coal workers pneumoconiosis.