Appalachia sees highest rate of Black Lung Disease in 50 years from silica dust

Appalachia is facing its highest rates of Black Lung Disease since 1978, reports Howard Burkes for The
Daily Yonder (republished from Public Health Watch). The statistics come from the National Institute for Occupational Safety and Health, or NIOSH, just as courts stall protections for coal miners.

“If you imagine one out of every three school teachers were getting an incurable lung disease because of something they were exposed to at work, the whole country would put their hands up screaming and stop whatever this exposure was immediately,” said Dr. Drew Harris, a medical director at Virginia’s Stone Mountain black lung clinics, which sees the most patients for black lung care and legal help in the country. “[But] this is largely impacting rural Appalachian folks that don’t have a voice, that don’t have a country to unite behind them.”

A troubling reality is that younger coal miners are falling ill because as Appalachia’s thickest coal seams were mined out, companies looked to smaller seams, which require digging through more rock that tends to be rich in silica. Mining through silica produces highly toxic dust that poses health risks to miners.

“Excessive inhalation of coal mine dust is the sole cause of [black lung] in coal miners,” the new NIOSH research letter said. “Substantial evidence shows that exposure to the respirable crystalline silica component of coal mine dust plays an important role in contemporary disease patterns.”

Even as mining companies comply with silica overexposure regulations 90-97% of the time, any exposure can lead to an influx of cases and lives affected. Stricter regulations for exposure have been suggested by NIOSH since 1974, but no bipartisan action had taken place. 

The Biden administration made exposure limits twice as restrictive and incorporated noncompliance fines in 2024. In response, mining companies sued and federal courts responded. “The Trump administration did not oppose the delay, announcing it too would put enforcement on hold.”