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.”

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.