New silica-dust exposure limits aim to protect coal miners from black lung disease; data may not support that promise

The CDC encourages miners to get screened for black-lung
disease; the severest type is on the rise. (CDC graphic)

A proposed federal solution for preventing black-lung disease in coal miners may overlook thousands of deaths, and its regulation would not be enough to push mine operators to change tactics, report Howard Berkes of Public Health Watch and Justin Hicks of Louisville Public Media. "After decades of delay, the federal Mine Safety and Health Administration is finally getting serious about overexposure to silica in the nation’s mines," they write. "The agency is proposing a silica-dust exposure limit twice as tough as it is now. MSHA would also directly regulate excessive silica exposures, something it hasn’t previously done, making citations and fines possible for putting miners at risk."

Black lung "has been a known threat to coal miners for over a century — it’s taken the lives of tens of thousands of Americans since 1968. While black lung became less common through the 1990s, it’s on the rise again. Now, even middle-aged miners have been diagnosed with advanced stages of the disease," reports Allen Siegler of Mountain State Spotlight. "Severe black lung continues to disproportionately affect central Appalachia; from 2019 to mid-2023, nearly 30% of Americans diagnosed with progressive massive fibrosis at federally-funded black lung clinics were West Virginians, according to the Black Lung Data and Resource Center at the University of Illinois. That trend is widely attributed to more frequent exposures to silica dust. . . . Grinding quartz creates silica dust, which is 20 times more toxic than coal dust alone."

How effective MSHA's proposed measures would be is uncertain. "An investigation by Public Health Watch, Louisville Public Media and Mountain State Spotlight shows that the plan’s purported benefits understate the silica risk to coal miners and the urgent need for immediate action," Berkes and Hicks report. 

Siegler reports, "Independent analyses of MSHA’s own coal-mine dust samples show its previous silica-dust exposure limits failed to adequately protect miners for decades. An investigation by NPR and PBS Frontline in 2018 analyzed MSHA’s data and found 21,000 instances of overexposure to silica dust since 1986. . . . While the proposed rule, in its current form, does require regular dust sampling, much of its effectiveness will depend on mining companies sampling their own mines and reporting it accurately and honestly."

At hearing on mine-dust rule, miner advocates and industry find fault; next one is Thursday morning in Beckley, W.Va.

Dr. Drew Harris demonstrates why temporary use of respirators
may not protect miners. (Photo by Justin Hicks, LPM)

The first of three hearings on a regulation proposed to cut in half "the amount of toxic silica dust all miners can legally be exposed to," and extend the first such protections to coal miners, elicited concerns from both sides of the issues, reports Justin Hicks of Louisville Public Media.

"Lung doctors and labor unions representing coal workers profusely thanked the agency for drafting the proposal," but objected to continued reliance on mining companies to record dust exposure, Hicks reports. Dr. Drew Harris, medical director of the Black Lung Program at Stone Mountain Health Services in Virginia, told U.S. Mine Safety and Health Administration officials, “Many of my patients were told by their supervisors to do things that are appalling to me, whether it’s covering their dust monitors in coffee filters or putting them in their lunch boxes or being told to hang them in clean air parts of the mine.”

"Miner unions and black lung advocates also chafed at part of the proposal that lets miners 'temporarily' continue work in known silica-laden environments as long as they use respirators," Hicks reports. "Advocates said no clear definition of the word 'temporary' in the rule could leave a loophole for companies to ignore hazards, and practically, they doubt miners will wear respirators faithfully during hot, strenuous work."

On the other hand, "Industry groups – most representing companies who deal in minerals like limestone, sand and gravel – had their own concerns,' Hicks reports. They wanted more than 45 days to submit comments, and asked that the rule acknowledge "that dust exposure at work varies by task, not by the specific job title. They cited an Occupational Safety and Health Administration table for non-mine jobs that involve silica dust.

"Several industry representatives characterized the proposed rule as 'onerous' and speculated that the costs to implement it would put smaller mining companies out of business," Hicks reports, noting that the rule "comes after years of clamoring for stricter measures to address a surge in the incurable lung disease commonly called black lung."

The hearing was held in Arlington, Va. Additional hearings will be held Thursday, Aug. 10 in Beckley, W.Va., and Aug. 21 in Denver. Details are here. The Beckley hearing will be held at the National Mine Health and Safety Academy auditorium, 1301 Airport Rd., starting at 9 a.m.

Labor Department proposes rule to give miners same protection against silica dust as those in other industries

After decades of delay, federal regualators have proposed to limit the exposure of miners to silica dust to the same limits that apply to workers in other industres. Silica dust, produced from sandstone, has been linked to "the rising death toll from lung disease among mining industry workers," West Virginia's Mountain State Spotlight reports.

The Mine Safety and Health Administration, part of the Labor Department, announced the proposal Friday. Before it can take effect, it must be published in the Federal Register and MSHA must hold public hearings. It says those will be held in Arlington, Va., and Denver, but did not announce dates.

The change would reduce the exposure limit to 50 micrograms per cubic meter of air from 100. “This is a good day for miners, although it has been a long time coming,” said United Mine Workers of America President Cecil Roberts. "Just two weeks ago, the UMWA had noted that MSHA under the Biden administration had not yet proposed a new silica dust rule in a statement announcing that the union was not ready to make an endorsement in the 2024 presidential race," Mountain State Spotlight notes.

"In 2018, a landmark investigation by NPR and PBS Frontline focused on the impact of silica dust on a resurgence in deadly lung disease among miners. A 2020 inspector general’s report also criticized MSHA’s inaction on the issue," Mountain State Spotlight notes. The increases were especially large in Central Appalachia, where the depletion of thick coal seams and reliance on thinner ones has led to more generation of silica dust from sandstone that lies next to coal seams.

"The National Mining Association criticized the proposal, because MSHA would allow personal respiratory protection equipment in limited situations, but not as the central compliance tool," Mountain State Spotlight reports.

Stricter rules to prevent black-lung disease and fibrosis, 25 years in the making, are expected to be proposed soon

Michael and Liz Williams pose for a photo outside their home in

McRoberts, Ky. He mined coal for 40 years and has advanced-

stage black lung disease. (Photo by Taylor Sisk, Kaiser Health News)

It's been known for years that black-lung disease and fibrosis among coal miners has increased because coal seams have become thinner and miners are cutting into more sandstone that lies between the seams, but federal regulations still "allow miners to be exposed to twice as much airborne silica as the Occupational Safety and Health Administration permits for workers in other industries," reports Taylor Sisk of Kaiser Health News. "Five U.S. senators representing parts of Central Appalachia believe the Mine Safety and Health Administration has been dangerously slow to fix the discrepancy."

“The Department of Labor has indicated that we could see a proposed rule as early as April, so I’ll be watching this closely and will continue to push for proper protections for coal miners,” Sen. Mark Warner, D-Va., told Sisk. Warner was among senators who wrote MSHA November seeking a new standard. MSHA Administrator Chris Williamson said in February that he plans to announce new rules soon, and noted that the rulemaking process began 25 years ago.

“It’s cruel that this would happen in such a rich country,” Wes Addington of the Appalachian Citizens Law Center said of the persistence of black lung. He told Sisk, “We know how to prevent it, and never in my wildest dreams would I have imagined that we’d be in a situation where we’re having that same conversation” about progressive massive fibrosis, the lung ailment caused by silica dust.

"The dust turns to sharp particles that become trapped in lung tissue, causing inflammation and scarring and reducing the lungs’ capacity to take in oxygen. The condition is debilitating and potentially fatal," Sisk notes. "In central Appalachia, a region primarily comprising West Virginia, eastern Kentucky and southwestern Virginia, the increase in the disease’s most deadly form, progressive massive fibrosis, has been especially pronounced. Since 2005, black lung cases have tripled in the region and PMF has increased tenfold among long-term miners. A study published last fall identified the driving force behind the spike in severe black lung disease as silica dust."

“We were seeing much more severe disease,” said Dr. Robert Cohen, director of the Mining Education and Research Center at the University of Illinois-Chicago and the study’s lead author. “We were seeing disease in younger miners, with lesser exposures, so, therefore, more intense exposure.”

How to protect your lungs from wildfire smoke; interactive map shows smoke in your area

The big wildfires right now are in the West, but the smoke is drifting all the way to the Atlantic, so rural areas that usually don't have much air pollution are getting a big dose.

Wildfire smoke contains hazardous gases and particulate matter that can damage the lungs. The Washington Post has a great explainer on what's in wildfire smoke, who's more vulnerable to it, and what people can do to protect themselves, especially on poor-air-quality days. Read more here.

For information about how the air fares locally, see the interactive Fire and Smoke Map, created by the Environmental Protection Agency and the U.S. Forest Service.

Quick hits: Idaho Senate approves bill to kill 90% of state's wolves; federal pandemic aid isn't reaching some of the poor

Here's a roundup of stories with rural resonance; if you do or see similar work that should be shared on The Rural Blog, email us at heather.chapman@uky.edu.

A Black high school baseball team in rural Virginia won the state championship in 1969, but their hometown didn't celebrate their victory. But last weekend county officials made sure they got their dues—and championship rings—over 50 years later. Read more here.

A study investigates severe lung injury among e-cigarette users in rural Appalachia. Read more here.

The Idaho Senate has approved a bill to kill 90% of the state's wolves. Read more here.

In a recent survey, nearly half of Americans who plan to move said climate change and associated issues like wildfires and rising sea levels were a factor in deciding where to move, and that they wouldn't relocate to an area with more climate risk even if it were more affordable. Read more here.

Though the federal government is expanding the social safety net, the funds aren't reaching many impoverished Americans. Read more here.

An increasing number of Americans believe in conspiracies, partly because of decreased trust in the news media and criticism of the news media from prominent figures, according to a recent poll. Read more here.

Rural migration during the pandemic may accelerate a trend of e-commerce expansion into rural America. Read more here.

A rural South Dakota high school rodeo club canceled its annual 'slave auction' fundraiser after local pushback about its name. Read more here.

San Joaquin farmworkers beset by heat, smoke, pandemic

California's San Joaquin Valley is a critical agricultural area that supplies a wealth of fruits, vegetables, and nuts to the rest of the nation. But the workers who pick those crops, many without access to health care, are being hit with a triple whammy of the pandemic, scorching hot weather fueled by climate change, and wildfire smoke. Somini Sengupta reports for The New York Times.

So far this year, more than 7,000 fires have scorched 1.4 million acres, and there is no reprieve in sight, officials warned," Sengupta reports. "Summer days are hotter than they were a century ago in the already scorching San Joaquin Valley; the nights, when the body would normally cool down, are warming faster. Heat waves are more frequent. And across the state, fires have burned over a million acres in less than two weeks. One recent scientific paper concluded that climate change had doubled the frequency of extreme fire weather days since the 1980s."

Farmworkers in many areas face such hazards, but it's particularly bad in the valley, where industrial activity and the valley geography make for some of the nation's most polluted air. "Rates of asthma and chronic obstructive pulmonary disease run high, according to doctors at Clinica Sierra Vista, a network of medical centers in the valley," Sengupta reports. "Kidney functions decline with prolonged dehydration among many agricultural workers, doctors in the region say. Diabetes — associated with eating inexpensive, starchy food — is common. There’s even a respiratory ailment named for the area: Valley Fever, caused by coccidioides fungus in the soil."

Armando Elenes, secretary-treasurer of the United Farm Workers of America, told Sengupta the poor working conditions are "the price of cheap food." California and Washington are the only two states that require employers to accommodate outdoor workers in hot weather. Workers must be provided with shade (usually a bench under a canopy) and water. Some labor contractors stop work when it's too hot, but the law doesn't require that at any certain temperature. The law was passed in California 15 years ago after a string of farmworker deaths; UFWA is lobbying for similar nationwide legislation. 

But some workers may choose not to take breaks so they can make decent money. "If you work fewer hours, you make less," Sengupta reports. "And for those who get paid at piece rates — wine grape pickers generally get paid by the bin — there can be a perverse incentive to work as fast as possible, even if it means skipping a water break."

Black women fearing covid-19 choose home birth, adding to their underlying risk of complication, especially in rural areas

Getty Images photo via Stateline

African American women are two to three times more likely to die from causes related to pregnancy than white women, regardless of income or education, but many of them are joining a national trend of having babies at home for fear of covid-19, reports April Simpson of Stateline.

"Black midwives could be part of the solution, especially during the coronavirus pandemic, but restrictions on midwifery make it difficult to practice in many states," Simpson reports. She begins her story by noting a booked-up midwifery center in Memphis, which serves Tennessee, Arkansas and Mississippi "rural areas far from hospitals and obstetrics units. The center’s clients are primarily black and other women of color."

“They’ve told us they’re going to risk it all and have an unassisted home birth,” Nikia Grayson, the center's director of perinatal services, told Simpson. “That’s very scary, and that’s what people are researching and seeing as a viable option. ... It can go left real fast.”

Simpson writes, "The stakes are especially high for rural black women soon to give birth in Southern states. They have less access to health care providers and travel longer distances to care, while systemic racism and health care inequities put their lives at risk."

Citing costs of pandemic, coal companies asks Congress to reduce coal tax that pays black-lung benefits

Citing the economic cost of the coronavirus pandemic, coal companies are asking Congress to let them pay less of the excise tax that pays for miners' black-lung benefits. The move would force the Black Lung Disability Trust Fund, a Labor Department program already about $4 billion in debt to the Treasury, to borrow more money from the federal government to remain solvent, Will Englund reports for The Washington Post. The fund borrowed $1.9 billion in fiscal year 2019 alone.

"The National Mining Association asked Congress last month for a 55 percent cut in the excise tax for the trust fund, and a suspension of another fee that pays to clean up abandoned mines," Englund reports. "Altogether the operators say they could save about $220 million. While the level of taxation to back the fund has fluctuated sharply over the past two years, it currently stands at $1.10 for every ton of coal mined underground and 55 cents for surface coal."

The fund pays for benefits for 25,000 coal miners, and coal industry lobbyists have long sought to reduce their obligation to pay for such benefits, either by seeking cuts to the excise tax or by making it more difficult for miners to be diagnosed with black-lung disease. "Wes Addington, director of the Appalachian Citizens Law Center in Whitesburg, Ky., . . .said that the push would allow the industry to shed liability for a lung disease it caused," Englund reports.

Coal-company bankruptcies have already shifted about $865 million in liability for black-lung disability claims to federal taxpayers in recent years, according to a recent report from the Government Accountability Office.

Epidemiologists projecting virus's impact on state health-care systems begin to make estimates at the county level

CovidActNow map; gray areas have insufficient data to make projections. (For a slightly larger version, click on it)

A group of epidemiologists have formed a working group called CovidActNow to project how the coronavirus pandemic would affect health-care systems. Its first projections were state by state; now it is beginning to make projections for counties where sufficient data are available.

The state-by-state projections are updated frequently, if not daily. They show when a state's hospitals would be overloaded, depending on compliance with social-distancing orders. Here is the chart for Kentucky, which shows that its hospitals would be overloaded June 11 if compliance is poor but would be far from overloaded at the peak if compliance is strict:

The state-by-state projections also include estimates of the number of covid-19 deaths under both circumstances. In Kentucky, it estimates 13,000 with poor compliance, 2,000 with strict compliance. Gov. Andy Beshear has used a simplified version of the chart to justify his social-distance orders.

Feds end support for state testing, but plan new program for smaller cities and towns that haven't been heavily hit yet

The coronavirus crisis has been worsened by the lack of testing, which has been especially scant in rural areas, but federal officials plan to end support for it tomorrow, and that means some sites will close, local officials told Jeff Brady of NPR.

However, the Trump administration "is developing plans to get the U.S. economy back in action that depend on testing far more Americans for the coronavirus than has been possible to date, according to people familiar with the matter, Mario Parker reports for Bloomberg. "The effort would likely begin in smaller cities and towns in states that haven’t yet been heavily hit by the virus. Cities such as New York, Detroit, New Orleans and other places the president has described as 'hot spots' would remain shuttered."

The Department for Health and Human Services told NPR, "The transition will ensure each state has the flexibility and autonomy to manage and operate testing sites within the needs of their specific community and to prioritize resources where they are needed the most." Federal support for testing was intended as a stopgap, but states have relied on it to "help prop up their own testing efforts in the absence of a national coordinated testing strategy," Matt Steib writes for New York magazine, and he argues that more testing would help Trump reopen the economy:

"Expanded coronavirus testing should be a priority, as it will help determine just how high mortality and hospitalization rates really are — two variables that, because they remain in the dark, have required countries to implement all-systems shutdowns. Most likely, increased testing and serology testing — which determines if coronavirus antibodies are in patients’ blood, showing they’ve been exposed to the virus — would prove that hospitalization and mortality rates are far lower than originally anticipated. That good news, if proven by comprehensive testing, could then help determine a date to safely open the economy."

However, the crisis will peak at different times state by state, and it will largely be up to governors to scale back social-distancing measures that have tanked the economy. "It isn’t clear that they will respond if Trump urges Americans to resume normal business practices and socializing before the outbreak abates," Parker writes.

Seniors live longer these days, but not as long in rural areas, and their lifespans lag many other developed nations

Life expectancy for seniors at age 65 increased across the board from 2000 to 2016, but not nearly as much in rural areas, according to a newly published data analysis.

Urban and coastal seniors survive much longer than seniors in rural areas and the nation's interior—especially areas like Appalachia and the East South Central states (Kentucky, Tennessee, Alabama and Mississippi). The geographic gap emerged around 1999 or 2000 and has been widening since 2000, Judith Graham reports for Kaiser Health News.

University of Pennsylvania demographer Samuel Preston spotted the trend using data from the Census Bureau and the National Center for Health Statistics. The longest-living seniors tend to be found in metro areas on the Pacific coast, and the ones with the shortest lifespans live in the rural East South Central states; the life expectancy gap between those two regions was nearly four years.

Men and women had differing life expectancies, according to co-author Yana Vierboom, a researcher at Germany's Max Planck Institute for Demographic Research; by 2016, "life expectancy at age 65 for women in large metropolitan areas was 1.63 years longer than for those in rural areas. For men, the gap was 1.42 years," Graham reports. "Disparities were also highlighted when researchers examined life expectancy at 65 in the U.S. and 16 other developed nations, using 2016 data. Overall, the U.S. was near the bottom of the pack: American men ranked 11th while American women were in 13th place, behind leaders such as Japan, Switzerland, Australia, France, Spain and Canada."

Preston's study identified a reduction in deaths from cardiovascular illnesses like strokes or heart attacks as the biggest reason Americans are living longer. Such illnesses are the number one cause of death in the United States. Preston speculated that rural seniors might be more apt to die from heart attack or stroke because of lack of medical access, and said smoking rates likely had an impact, too. The study did not consider race, income, or education, which probably play a role, Graham reports.

Federal report shows that coal companies' bankruptcies shifted $865 million in disability claims to taxpayers

"A new report from the U.S. Government Accountability Office revealed that shoddy government enforcement has allowed coal companies to transfer $865 million of disability liabilities to taxpayers during bankruptcies in recent years," Will Wright reports for the Lexington Herald-Leader. "The issue revolves around the Black Lung Disability Trust Fund, which exists to ensure that black lung victims receive workers’ compensation payments if their employer becomes insolvent or otherwise fails to provide those payments."

Some coal companies buy insurance to cover such claims, but other companies post collateral with the federal government to show that they have the means to cover the claims. But the report showed that the collateral is often far short of what's needed. "With several more-recent coal company bankruptcies looming in Eastern Kentucky, West Virginia and elsewhere, it is unclear how many millions of dollars of liabilities those companies may soon transfer to taxpayers," Wright reports.

"Coal companies pay into the fund via a tax on the coal they produce, but the fund also borrows billions of dollars from the U.S. Treasury. In fiscal year 2019, it borrowed about $1.9 billion, according to the GAO report," Wright reports. And when coal companies declare bankruptcy and their collateral doesn't cover its black-lung claims, the cost for those claims is shifted to taxpayers.

The GAO report shows that the Labor Department has failed to take steps to prevent this liability shift over the years. According to the report, "the department declined to use enforcement tools to force the company to post adequate collateral, failed to regularly review the financial condition of the coal companies, and did not factor in the companies’ future benefit liability amounts, Wright reports.

Last week the House Subcommittee on Workforce Protection held a hearing on the GAO findings. Labor Department officials said they have strengthened their policies and will take stronger action against companies that don't post adequate collateral, Wright reports.

Under change in Kentucky law, fewer coal miners qualify for black-lung benefits

In March of 2018, Kentucky enacted a law that opponents feared would make it harder for miners to get compensation for black-lung disease. A review of state records shows that the share of Kentucky miners "diagnosed by state-approved experts as having the disease fell from 54 percent before the law change to just 26 percent," Sydney Boles reports for Ohio Valley ReSource, a public-radio consortium. "An analysis of state data by the Ohio Valley ReSource also suggests that the doctors now making decisions on claims more often side with coal companies than with coal miners."

To get black-lung benefits, a miner or family member files a claim with the state Labor Cabinet that includes evidence of diagnosis: a blood-gas analysis showing breathing impairment, and an X-ray showing evidence of black lung. "Once the claim is filed, the miner’s most recent employer’s insurance company can request to have an X-ray read by a physician of their choosing, and the judge overseeing the case can require a third reading from a 'designated evaluator,' whose analysis is presumed to be correct unless there is overwhelming evidence to the contrary," Boles reports.

Before the law was passed, radiologists were allowed to diagnose black lung, since evaluating X-rays is their specialty. But under the new law, only certain pulmonologists, doctors who specialize in the lungs, are allowed to diagnose it, Boles reports. At the time the law was passed, only six Kentucky pulmonologists had the federal certification to diagnose black lung, and four of them were routinely hired by coal companies or their insurers, Howard Berkes of NPR and Benny Becker of OVR reported at the time. The law also excluded out-of-state doctors from diagnosing the disease.

Only two pulmonologists, both with ties to the coal industry, chose to serve as designated evaluators. Data showed that both disagreed with an initial black lung diagnosis in 85.5% of cases, Boles reports.

"The changes to state law have not resulted in a backlog of cases, as opponents had feared. But state records indicate that the restrictions have had an impact on the share of miners who win their claims," Boles reports. "The ReSource found that 161 benefits claims were filed but only 16 coal miners were awarded black lung benefits in 2019. That’s the lowest ratio of claims awarded to claims dismissed in the past seven years." Boles notes that not all claims are resolved in the same calendar year in which they are filed.

Report: cutting black lung funding will cost taxpayers billions

A recent cut to the tax coal companies pay to help miners with black-lung disease will cost taxpayers at least $15 billion by 2050, according to a new report from national watchdog group Taxpayers for Common Sense.

"An excise tax rate on mined coal that funds the Black Lung Disability Trust Fund expired at the beginning of 2019 due to inaction by Congress. That led to a reduction in the amount coal companies pay into the fund, which pays benefits and medical bills for miners diagnosed with black-lung disease," Dylan Lovan reports for The Associated Press. "An excise tax rate of $1.10 per ton of underground mined coal was cut by more than half to about 50 cents in the new year. The fund took in about $450 million in revenue in fiscal year 2017."

Autumn Hanna, vice president of Taxpayers for Common Sense, said that Congress was shifting billions of dollars in liability from coal companies to taxpayers; the report said the fund's debt could reach $26 billion by 2050. The Labor Department confirmed earlier this year that a shortfall in the Black Lung Trust Fund would be dealt with by borrowing from the U.S. Treasury, Lovan reports. The fund was at least $4.3 billion in debt in July.

Black-lung disease has killed about 78,000 since 1968, and has seen a major uptick in recent years among younger miners, Lovan reports. However, there has been little movement on meaningful improvement to safety policies meant to protect miners from the silica and coal dust exposure that causes black-lung disease.

Study: Surface coal miners more exposed than underground miners to silica dust that causes lung disease

Appalachian coal miners who work at surface mines are consistently overexposed to the silica dust that causes a form of black-lung disease, and dust from surface coal mines contains more silica than dust from underground coal mines, according to new research from the National Institute for Occupational Safety and Health. The research shows that, while much attention has been paid to the risk of black lung among underground miners, surface miners are similarly at risk.

"The research is the first to specifically analyze long-term data on exposure to toxic silica dust for workers at surface mines," Sydney Boles reports for Ohio Valley ReSource. "Black lung disease has been identified in coal miners in every coal-mining state at both surface and underground mines. NIOSH researchers were specifically interested in surface miners’ exposure because those mines produce the most coal and, in 2017, twice as many miners worked at surface mines compared to underground mines."

The researchers analyzed more than 50,000 surface mine coal dust samples from between 1982 and 2017, and found that about 15 percent of those samples had too-high levels of silica dust. Silica dust, which comes from quartz in the rock near coal seams, is much more harmful to the lungs than coal dust. Lead researcher Brent Doney told Boles that, while exposure to coal dust declined over time, silica exposure didn't drop.

That could be why black-lung disease has seen a resurgence among coal miners—especially in Central Appalachia—for the past twenty years, after decades of successful reduction in the disease through mining safety regulations, Boles reports. That's straining the already underfunded federal Black Lung Disability Trust Fund and hurting rural Appalachian mining towns.

"Unfortunately, I’m not sure this is a particularly novel finding," NIOSH epidemiologist Scott Laney told Boles. "The evidence is very clear. We know that silica and mine dust are toxic, and we have the technology to suppress it, and yet coal miners are still exposed to way too much of it. So from a public health perspective, there’s ample evidence to suggest that further safeguards are necessary."

McConnell on bipartisan bill to protect coal miners' pensions

A bipartisan Senate bill introduced Wednesday would "secure the pensions for nearly 90,000 retired coal miners as a recent wave of coal company bankruptcies threatens the solvency of the federal pension fund," Valerie Volcovici reports for Reuters. "If passed, the bill would secure the pensions of around 92,000 retired and working coal miners and ensure health care for 12,000 retirees."

The telling news was that Senate Majority Leader Mitch McConnell of Kentucky joined fellow Republican Shelly Moore Capito and Democrat Joe Manchin of West Virginia to sponsor the bill. It would use money from the federal Abandoned Mine Land program, funded by a coal tax, to prevent the United Mine Workers of America's pension plan from becoming insolvent.

"A bankruptcy filing last week by one of the largest coal mining companies, Murray Energy, was expected to hasten the insolvency of the pension fund - estimated to occur by 2022, Volcovici reports. "Eight other coal companies have filed for bankruptcy over the last two years as natural gas has taken over as the primary fuel for U.S. power plants."

The miners' union has been asking Congress to pass such legislation for years, and called the bill a breakthrough. However, the bill does not address the future solvency of health insurance for miners with black-lung disease. "Manchin had included a measure to restore a higher coal excise tax to boost the Black Lung Disability Trust Fund in an earlier version of a pension bill, but said Wednesday he would introduce a separate bill to tackle that issue," Volcovici reports. "For now, he said the Senate has a path forward to address the looming crisis facing the pension fund."

Quick hits, from Appalachia to Mississippi to Colorado to Minnesota to Canada

Here's a roundup of stories with rural resonance; if you do or see similar work that should be shared on The Rural Blog, email us at heather.chapman@uky.edu.

Exploring Southern Appalachia: Conquistadors made Spanish the first European language spoken in Appalachia. Read more here.

Lack of shelters in rural Minnesota makes the homeless an 'invisible problem': Read more here.

"The Mountain Minor," a film about the spread of Appalachians and the roots of bluegrass and country music, is winning multiple awards. Read more here.

Mississippi Rural Broadband Summit reveals hurdles to cross. Read more here.

The Rural Health Information Hub has created a toolkit for rural communities wanting to implement Chronic Obstructive Pulmonary Disease programs. Read more here.

A White House Office of National Drug Control Policy representative listened to government officials and health-care providers in Northern Colorado speak about their experiences with the opioid epidemic. Read more here.

The rural-urban divide is defining politics in other countries, as shown by Canada's recent election. Read more here.

The University of Colorado hosted a day-long conference on entrepreneurship in rural America. View the event info here and watch a livestream capture video of the event here.

Coal miners urge Congress to replenish black-lung fund

About 120 coal miners with black-lung disease and their families went to Capitol Hill Tuesday to ask lawmakers to fully restore a coal tax that pays for medical care and some living expenses for miners with their condition. "The tax was cut more than 50 percent at the end of last year. It supports the federal Black Lung Disability Trust Fund, which is more than $4 billion in debt," Howard Berkes and Huo Jingnan report for NPR. Berkes has reported doggedly on black lung for years, and his reporting helped earn him a Tom and Pat Gish Award for courage, integrity and tenacity in rural journalism.

"The Government Accountability Office has said without an extension of previous tax levels the fund’s debt will rise from $5 billion to $15 billion by 2050 – a burden that would likely have to be met by U.S. taxpayers instead of coal companies," Valerie Volcovici reports for Reuters. "Coal company bankruptcies and a resurgence of the disease are accelerating the risk of insolvency for the fund, according to the accountability office."

Some miners told Volcovici they were left disappointed after a meeting with Senate Majority Leader Mitch McConnell. She reports: "McConnell, the Republican leader who represents Kentucky, one of the states that has seen a rebound in the progressive respiratory illness, told them their benefits would be safe, but gave no assurances about the excise tax and left without answering questions or offering details, several of the miners who attended the meeting said."

George Massey, a retired miner from Harlan County, Kentucky, who is on disability, told Volcovici he was disappointed by the brief meeting: "We rode up here for 10 hours by bus to get some answers from him because he represents our state . . . For him to come in for just two minutes was a low-down shame."

The miners' presence in Washington was meant to increase pressure on the Mine Safety and Health Administration, "which has resisted direct and quick responses to the epidemic and silica dust exposure," Berkes and Jingnan report. "As NPR and PBS Frontline have reported, MSHA and the mining industry failed to respond to clear agency data showing three decades of overexposure to toxic silica dust. They also failed to respond to warnings more than 20 years ago about clusters of sick miners exposed to silica and to an urgent call for direct and tougher regulation of silica dust in coal mines. In the wake of the NPR/Frontline investigation, the agency did restart an abandoned effort to consider direct and tougher regulation of silica, but the process could take years."

The miners' visit came a week after the National Institute for Occupational Safety and Health published a summary of studies that confirmed an increase in black lung among coal miners, especially in Appalachia. "NIOSH cited NPR and PBS Frontline reporting in the review, including detailed and systematic interviews of 34 miners from Pennsylvania, West Virginia, Virginia and Kentucky, all diagnosed with PMF," Berkes and Jingnan report. The reporting of Berkes in the last few years formed the basis of a recent documentary on "Frontline."

As miners head to D.C. Tuesday to seek black-lung funds, NPR and PBS set screening of documentary on disease

NPR and the PBS program "Frontline" will hold a special screening of their documentary Coal's Deadly Dust from 7 to 8:30 p.m. July 23 at NPR headquarters in Washington, D.C.

Howard Berkes (Salt Lake Tribune photo)

The film, first released in January, explores the rise of advanced black-lung disease among coal miners and the government's limited response. After the screening, there will be a panel discussion with people in the film, including recently retired NPR reporter Howard Berkes, who reported tirelessly on black lung for years and whose reporting was the basis for the documentary; coal miners Greg Kelly and Danny Smith, who both have black lung; epidemiologist Scott Laney of the National Institute for Occupational Safety and Health; respiratory therapist Marcy Tate; and former federal mine safety official Celeste Monforton.

The event is free and open to the public, but an RSVP is requested. Click here for more information or to reserve a seat. If you're not able to attend, click here to view the film.

Also Tuesday, about 120 coal miners, many with black lung, will be in Washington to urge Congress to restore a tax that finances the Black Lung Disability Trust Fund. The tax, paid by coal companies, helps pay medical expenses of black-lung patients, but in January the tax was cut in half. The fund is at least $4.3 billion in debt, The Associated Press reports.