Wow, What A Surprise: As Federal Enforcement Of Coal Mine Safety Collapses, Number Of Black Lung Cases Soars

EDIT

Coal mining has always been a hazardous occupation. But today’s miners face a new danger because they’re inhaling something worse than the coal dust that settles in lungs, triggering immune cells to form nodules, masses, and scarified black tissue. Most of the large coal seams in the mountains of Appalachia are gone now.

To reach smaller seams, miners must cut through much more rock with high levels of quartz, which gets pulverized into crystalline silica. When tiny particles of silica are inhaled, they act like minute shards of glass, leading to severe tissue scarring and inflammation and eventually to progressive massive fibrosis, the most severe form of black lung disease. Researchers from the National Institute for Occupational Safety and Health (NIOSH) estimate the disease now afflicts one in 10 working miners who have worked in mines for at least 25 years. Rising rates of the disease have led to stark increases in lung transplants and mortality. Between 2013 and 2017, hundreds of cases of progressive massive fibrosis were identified at three Virginia clinics alone, leading NIOSH to declare a renewed black lung epidemic Black-lung-associated deaths, which declined between 1999 and 2018, rose between 2020 and 2023.

The disease is on the uptick at a time when the Trump administration is calling for the expansion of coal production. Last fall, the U.S. Department of Energy announced it was investing $625 million in coal projects, and this month, President Trump signed an executive order reaffirming coal as essential to national security, a move that will direct billions of dollars in federal funding to the industry. But while the administration is calling for more coal, it is simultaneously delaying implementation of new regulations that would protect miners from deadly silica.

EDIT

Black lung diagnoses continue to mount. Doctors and miner advocates say the condition is underdiagnosed, as many miners are reluctant to undergo testing for fear of losing their jobs should their employer find out. “I think there’s always going to be that fear of retribution,” said Istik. But eventually, she added, the symptoms become debilitating. Smarsh, a patient of Lungs at Work, didn’t see a doctor about his labored breathing until his wife, Alicia, insisted he had no choice. Black lung clinics are seeing more and more patients like Smarsh, who’ve gotten sick in their 30s and 40s. In earlier generations, miners might have needed decades of coal dust exposure to develop serious disease, if they got sick at all. “My dad and my pap were both miners, and they didn’t get it,” Smarsh said. “So, I thought, ‘Who says I’m going to?’” But today’s workers, who are breathing a much higher proportion of silica, can develop a disabling illness in much less time.

EDIT

https://e360.yale.edu/features/black-lung-pennsylvania