Federal agencies, NPR report surge in black-lung disease among coal miners in Central Appalachia

Progressive massive fibrosis in underground miners
with more than 25 years experience (Coal Workers’
Health Surveillance Program, Ky.,Va.,W.Va,1974–2015)

Black-lung disease is surging among Appalachian coal miners, according to a report by the federal Centers for Disease Control and Prevention and an investigation by Howard Berkes of NPR.

In June, Eastern Kentucky radiologist Brandon Crum contacted the National Institute for Occupational Safety and Health to report a surge in black-lung disease in the coal-mining area. The radiologist, who was not named, said 60 active or former coal mining patients examined in Pike County from Jan. 1, 2015 to Aug. 17, 2016 had radiographic findings consistent with progressive massive fibrosis, the most progressive form of black lung.

"I think the percentage of black lung that we're seeing now here in Central Appalachia is unprecedented in any recorded data that I can find anywhere," Crum told NPR. NIOSH epidemiologist Scott Laney told the network, "We had not seen cases of this magnitude ever before in history in Central Appalachia."

PMF cases in the region are "more than 10 times what federal regulators report," NPR reports, based on "data from 11 black lung clinics in Virginia, West Virginia, Pennsylvania and Ohio. "The true number is probably even higher, because some clinics had incomplete records and others declined to provide data." The CDC report says, "The actual extent of PMF in U.S. coal miners remains unclear." Under the law, NIOSH can only test working miners, and many of them are reluctant to be examined for fear that a black-lung diagnosis would disqualify them from jobs with other coal operators; the last employer of a miner with black lung pays the benefits, Berkes notes.

The CDC did not identify the mining practices that led to the increase in cases, but slope mining and the economy were suggested as possible reasons, Bill Estep reports for the Lexington Herald-Leader. Slope mining "involves using a continuous mining machine to cut through hundreds of feet of sandstone to reach coal seams, the report said," Estep notes. "Sandstone in Eastern Kentucky contains a high level of quartz, so slope mining could expose miners to hazardous dust with a high concentration of breathable crystalline silica, the report said."

It also was suggested that "many miners didn’t seek examinations for the disease early in their careers for fear of losing a job or not being able to get a job, but have come forward more recently because the region has lost thousands of coal jobs and the miners are getting tested in order to seek benefits," Estep writes.

Berkes reports, "New and tougher federal limits on mine dust exposure fully took effect in August, and they get even tougher when there's excessive silica. Simple black lung and PMF can take a decade or longer to develop." The coal industry's decline may put the benefits in doubt. "The fund is nearly $6 billion in debt. It has taken on 1,000 claims that were covered by self-insured mining companies until they went bankrupt. And the coal excise tax that supports the fund is set for a 50 percent cut in two years."

Map by Alexandra Kanik, Ohio Valley ReSource