Physical and chemical properties of coal and its relationship with coal workers’ pneumoconiosis (CWP) have been studied previously. However definitive conclusions have not been reached, primarily due to the complex nature of coal mine dust. It remains unclear exactly which properties of coal mine dust related to the grade of coal cause differences in the exposure–response relationship. The aim of the study is to identify the coal mine environmental factors, and personal factors affecting the severity of CWP. This study was a retrospective cross-sectional study and included total of 116 coal mine workers diagnosed as CWP in a tertiary hospital between January 1, 2014, and December 31, 2021. Of the cases, 77 (66.4%) worked in a hard coal mine and 39 (33.6%) worked in a lignite mine, and mean age was 60.2 ± 11.5 years. There was a significantly higher prevalence of concomitant pulmonary disease in hard coal mine workers compared to lignite mine workers (p= 0.005). In addition, the prevalence of progressive massive fibrosis (PMF) was higher in hard coal mine workers compared to lignite mine workers, and a statistically significant difference was found (p= 0.004). The value of FEV1 and FEV1/FVC were significantly lower in hard coal mine workers than in lignite mine workers (p= 0.005, p= 0.002). As a conclusion, concomitant lung disease, presence of PMF and impairment in lung functions, which are important causes of mortality and morbidity for CWP, were found to be more common in hard coal mine workers than in lignite mine workers. Therefore, taking into account the type of coal mine while making protective arrangements to prevent pneumoconiosis in coal mines may contribute to reduce the burden of CWP.