Black Lung Is Back: Easily Cheated Regulations and Little Oversight Lead to Severe Cases in Young Miners
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PRESTONSBURG, Ky. — Ray Marcum bears the marks of a bygone era of coal mining. At 83, his voice is raspy, his eastern Kentucky accent thick and his forearms leathery. A black pouch of Stoker’s 24C chewing tobacco pokes out of the back pocket of his jeans. “I started chewing in the mines to keep the coal dust out of my mouth,” he says.
Plenty of that dust still found its way to his lungs. For the past 30 years, he’s gotten a monthly check to compensate him for the disease that steals his breath — the old bane of miners known as black lung.
In mid-century, when Marcum worked, dust filled the mines, largely uncontrolled. Almost half of miners who worked at least 25 years contracted the disease. Amid strikes throughout the West Virginia coalfields, Congress made a promise in 1969: Mining companies would have to keep dust levels down, and black lung would be virtually eradicated.
Marcum doesn’t have to look far to see that hasn’t happened. There’s his middle son, Donald, who skipped his senior year of high school to enter the mines here near the West Virginia border. At 51, he’s had eight pieces of his lungs removed, and he sometimes has trouble making it through a prayer when he’s filling in as a preacher at Solid Rock Baptist Church.
There’s James, the youngest, who passed on college to enter the mines. At 50, his ability to breathe is rapidly declining, and his doctor has already discussed hooking him up to an oxygen tank part-time.
Both began working in the late 1970s — years after dust rules took effect — and both began having symptoms in their 30s. Donald now has the most severe, fastest-progressing form of the disease, known as complicated coal workers’ pneumoconiosis. James and the oldest Marcum son, Thomas, 59, have a simpler form, but James has reached the worst stage and is deteriorating.
Men with lungs like the Marcums’ are not supposed to exist. In the hard-won 1969 law, Congress demanded that dust be controlled and new cases of disease be prevented. The idea was that, even if black lung didn’t disappear, there would be a small number of mild cases and virtually no one like Donald and James Marcum, said Dr. Donald Rasmussen, a pioneer in recognizing and diagnosing black lung.
“In 1969, I publicly proclaimed that the disease would go away before we learned more about it,” Rasmussen, now 84 and still diagnosing miners, said in a recent interview at his office in Beckley, W.Va. “I was dead wrong.”
Throughout the coalfields of Appalachia, in small community clinics and in government labs, it has become clear: Black lung is back.
The disease's resurgence represents a failure to deliver on a 40-year-old pledge to miners in which few are blameless, an investigation by the Center for Public Integrity and NPR has found. The system for monitoring dust levels is tailor-made for cheating, and mining companies haven’t been shy about doing so. Meanwhile, regulators often have neglected to enforce even these porous rules. Again and again, attempts at reform have failed.
A Center analysis of databases maintained by the federal Mine Safety and Health Administration found that miners have been breathing too much dust for years, but MSHA has issued relatively few violations and routinely allowed companies extra time to fix problems.
MSHA chief Joe Main issued a statement in response to the findings: “The current rules have been in effect for decades, do not adequately protect miners from disease and are in need of reform. That is why MSHA has proposed several changes to overhaul the current standards and reduce miners' exposure to unhealthy dust.” Similar attempts at reform have died twice before.