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Black Lung Is Back: Easily Cheated Regulations and Little Oversight Lead to Severe Cases in Young Miners

Researchers are struggling to explain why black lung is striking younger and younger miners and robbing them of their breath faster and faster.

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In a triangle of Appalachia — southern West Virginia, eastern Kentucky and western Virginia — the numbers were even higher. The rolling unit found a disease prevalence of 9 percent in Kentucky from 2005 to 2009, for example.

A wake-up call for some came after the Upper Big Branch explosion in southern West Virginia in April 2010, which killed 29 miners. Of the 24 who had enough lung tissue for an autopsy, 17 had signs of black lung. Some had fewer than 10 years of experience in mines; they ranged in age from 25 to 61.

The disease leaves miners’ lungs scarred, shriveled and black. They struggle to do routine tasks and are eventually forced to choose between eating and breathing.

“No human being should have to go through the misery that dying of [black lung] entails,” said Dr. Edward Petsonk, who treats patients with black lung and works with NIOSH. “It is like a screw being slowly tightened across your throat.  Day and night towards the end, the miner struggles to get enough oxygen. It is really almost a diabolical torture.”

Underpinnings of an epidemic

There are theories about why the disease has returned, but no definitive answers. One likely explanation: Miners are breathing a more potent mix of dust. Coal seams are surrounded by rock, much of which contains the mineral silica. When ground up, silica is more toxic to the lungs than coal dust and can cause faster-progressing disease.

With larger coal seams becoming mined out, companies are turning to thinner seams surrounded by more rock. At the same time, because of the price of coal and advances in mining equipment, it now makes more sense economically for companies to cut through large amounts of rock to get at the coal. Companies haul it all out and then separate the rock from the coal at processing plants.

“In central Appalachia, you look at what’s coming out of the mines, and it’s probably 60 percent rock on a good day,” said Rick Honaker, a University of Kentucky professor who consults for mining companies and has seen their data.

NIOSH research suggests this may be having an effect. A particular marker on a chest X-ray is often indicative of silica-related disease. Comparing miners’ X-rays taken from 2000 to 2008 with those taken during the 1980s, researchers found that the proportion bearing these markers had nearly quadrupled and, in central Appalachia, had increased almost eight times over.

Rules are supposed to limit the amount of silica in the air in mines, but a Center analysis of MSHA’s dust sampling database, obtained under the Freedom of Information Act, shows that the agency has long failed to control silica dust.

In each of the past 25 years, the average of all silica samples — taking into account only those deemed valid by MSHA — has been higher than the allowed limit. Last year, for example, roughly 40 percent of the valid samples were above this limit. What’s more, the limit MSHA enforces is already twice the level NIOSH determined to be safe in 1974.

The National Mining Association contends that what appears to be a nationwide increase in black lung is actually a spike in silica-related disease in Appalachia. “The problem here is, look, these people were overexposed to horrendous levels of silica, for God’s sake,” said Bob Glenn, an expert hired by the association. “Why hasn’t something been done?”

To the association, this means there is no need for a new rule on coal dust, just better enforcement of the silica standard.

 
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