Coal miners continue to be plagued with black lung disease at high rates, now attributed to smaller, thinner coal seams

Vedrana Filipovic via Sunsplash

Efforts to increase black lung benefits were highlighted in The Rural Blog in a July 14 post, and today we draw attention to a report about a growing number of black lung cases, decades since those benefits were signed into law.

In an Aug. 5 NPR report, Howard Berkes and Justin Hicks cite data in a letter from the National Institute for Occupational Safety and Health (NIOSH), whose researchers “found that working veteran underground coal miners in central Appalachia are suffering from the incurable and fatal lung disease at the highest rates in nearly 50 years.” The research shows that miners in Kentucky, Virginia and West Virginia with as little as 15 years underground have contracted the disease at rates as high as those of 40 years ago. And 32.5% of those with 25 years in the mines tested positive for black lung in X-rays taken in the last five years. The study said that more than 1,700 died from the disease over the three-year period from 2020-2023.

Clinics in the region note that a spike in claims has come subsequent to recent mine closures, reversing an encouraging decline after Congress stiffened regulations limiting miners’ exposure to coal mine dust. Those regulations are credited with a drop in the presence of the disease that hit a low point in 1999, 30 years after the legislation was enacted. More retiring or laid off miners are now seeking benefits, and the results of their tests are raising concerns.

Industry representatives point to the fact that miners in the study were initially exposed years or decades ago. “These incidences do not reflect the conditions, practices, protections or regulations that are in place today,” said Ashley Burke, a National Mining Association spokesperson.

But miners say that companies have faced thinner seams as they go deeper into the source. “That requires cutting lots of rock, and in Appalachia, that rock typically contains quartz, which is rich in silica,” the NPR report states. “The result is clouds of both coal dust and highly toxic silica dust.”

“It’s like opening your front door and letting the sunshine [in],” one miner told NPR. “And then multiply that by 10 billion times. … It’s like a fog.”

While there is a high rate of compliance with government standards regarding the level of exposure to silica dust, a small level of overexposure still can lead to thousands of miners being at risk, the report states. A 2018 NPR and FRONTLINE investigation reviewed 30 years of data and found 21,000 instances of overexposure. They also found instances of complicated black lung in more than 4,000 miners since 2010.

Bill to increase black lung benefits gets bipartisan local support, faces uphill climb in Congress

Black lung disease, as depicted in the above 

X-ray photo, has affected thousands of coal miners. 

Efforts to increase those benefits have been ongoing 

but have thus far failed. (Photo courtesy of Unsplash.com)

Efforts to increase benefits to coal miners suffering from pneumoconiosis, commonly known as “black lung disease,” have stalled in Congress despite bipartisan support at the local level across coal-producing states. Liam Niemeyer reports in the Kentucky Lantern that “dozens of county and city governments — comprised of both Republicans and Democratic leaders — across multiple Appalachian states have passed resolutions to urge an increase in benefits to support the approximately 25,000 recipients of black lung disability benefits.”

The Save Our Miners Act was introduced June 30. The Lantern story notes that it “would seek to increase benefits all the way back to the same funding level, relative to inflation, as miners received in 1969.” The average monthly benefit in 2026 is $794 or about two thirds of what the check would have been in 1970, adjusted for inflation. But while local officials from both parties sound the alarm, partisan ideologies on Capitol Hill have prevented change.

The trust fund pays miners when coal companies deemed responsible can’t be identified or have gone out of business. The revenue comes from a tax on mined coal. “That fund has taken on hundreds of millions of benefit liabilities because of coal mine bankruptcies, a larger trend seen with the rapid decline in the state’s coal mining industry,” Niemeyer reports.

Republicans are hesitant to support the increased spending, citing concerns about the solvency of the fund, and they accuse Democrats of waging a war on coal companies who pay into the fund. Democrats say their proposals would require only modest investment to provide the needed benefit increases.

The Save Our Miners Act is sponsored by Rep. Summer Lee (D-PA) and co-sponsored by Rep. Chris DeLuzio (D-PA) and Rep. Morgan McGarvey (D-KY). It goes next to the House Education and Workforce Committee.

CDC says 4% of Central Appalachian surface miners tested have black-lung disease

Nearly 4 percent of surface coal miners who work in Central Appalachia who were tested for a study by the Centers for Disease Control and Prevention have black lung disease, compared to 2 percent of all U.S. surface miners and 3.2 percent of underground coal miners. (Getty Images photo)

Though the study didn't test Kentucky separately from the 14 other states assessed, Laura Ungar of The Courier-Journal in Louisville asked about it and found that "13 of 230 Kentucky surface miners tested — or 5.7 percent — had black lung," she reports, quoting Cara Halldin, a CDC epidemic intelligence service officer, as calling that number " a disproportionate burden."

It's not clear why the incidence is higher in Central Appalachia than other parts of the country, but Halldin suspects it has to do with "more years spent mining, area geology or the safety culture at mines," Ungar reports. One study showed miners who work in Central Appalachia typically work 28 years in the mines while non-Appalachian miners work average 20 years.

Black-lung disease, or coal workers' pneumoconiosis, is the result of miners repeatedly inhaling the dust that comes from extracting coal. That dust occurs whether the miner is under- or above-ground. "Coal mining is really, really dusty. Don't matter what you do, you're in the dust," said John Bud Ritchie, a retired surface miner who has black lung disease. "It's real rough. You can't hardly keep the dust down on hot days."

The federal exposure limit for "respirable dust" in underground and surface mines is 2 milligrams of coal dust per cubic meter of air. That limit was set in 1969, along with a law that set up "a surveillance system for assessing prevalence of black lung among underground coal miners," Ungar reports. "But the requirement for surveillance doesn't extend to surface miners." Haldin said, "Industry should recognize this is a problem and their workers are at risk and bring down the levels." (Read more)

In the wake of the CDC study, the National Institute for Occupational Safety and Health is offering free black-lung screenings in Eastern Kentucky, Hazard, Ky.'s WYMT-TV reports. The screenings will be at various locations in Eastern Kentucky throughout the summer and will be confidential. They will include a work history questionnaire, chest X-ray and a spirometry test, with the whole process lasting about 25 minutes. NIOSH will provide participants with results of their screenings, and will not release information to the public or give it to coal companies. For a list of when and where the screenings will take place, click here.