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Black Lung

As Calls For Action On Black Lung Disease Grow, Regulators Show Little Indication Of Change



Radiologist Brandon Crum delivers grim findings from his clinic in eastern KY. Photo: Sydney Boles, Ohio Valley ReSource

This article was originally published by Ohio Valley ReSource.

Harold Sturgill was disabled by black lung disease when he was 58 years old. Now he advocates for disabled miners.

“When it comes to the mining companies, and it comes to the worker, it’s still all about production,” Sturgill said. “They could care less about me, how much dust I suck in, or how long I’m going to live because somebody else is there to take my place.”

Sturgill worries that without meaningful action to protect miners, his son, who is also a miner, will contract the same illness. “A man’s gonna feed his family whether it kills him or not,” he said.

Sturgill shared his story at the West Virginia Black Lung Association conference the first week of June. It was the first such meeting since an NPR investigation and PBS Frontline film put the spotlight on central Appalachia’s growing epidemic of black lung disease and the failure of regulators to meaningfully address it.

As many as one in five experienced coal miners in the region has some form of black lung, which is progressive, debilitating, deadly and preventable. At the conference, researchers presented more evidence of the growing number of cases, and specific practices likely putting mine workers at risk, and the head of the mine workers’ union issued a rousing call for action.

Congressional leaders have scheduled hearings later this month to investigate. But federal mine safety regulators show little indication of making any meaningful change to policies meant to protect miners from harmful dust exposure.

A Growing Epidemic

An investigation by NPR and the Ohio Valley ReSource beginning in 2016 found that far more miners had progressive massive fibrosis, a more serious type of black lung disease than had been recognized in government reports. More than 2,000 miners have PMF, and rates of the disease are significantly higher in central Appalachia than in other coal-producing regions.

An X-ray image of an Appalachian coal miner with black lung lesions. Photo: Adelina Lancianese, NPR

Brandon Crum, a radiologist in Pikeville, Kentucky, was among the first caregivers to sound the alarm about the remarkable number of sick miners he encountered. He says the last 12 months have been the worst of his career as more cases added up.

“I started out with 60,” he told the conference audience in Pipestem, West Virginia. “As of last week, I had 246 cases of complicated black lung in my clinic alone.”

Crum says there are even more cases of simple black lung, chronic bronchitis and other forms of lung disease that result from dust exposure in coal mining.

Crum has seen younger miners disabled by black lung, and a surge in a new form of the disease called diffuse dust fibrosis, or DDF.

“This is something I’ve been picking up over the last six to 12 months, and it’s increasing in frequency and it’s also increasing in severity,” Crum said.

DDF can quickly make it hard for miners to breathe, and Crum said an increasing share of lung transplant surgeries are for miners with DDF. The condition is likely attributable to increased exposure to silica dust.

Silica dust is formed when mining equipment cuts into surrounding rock layers and it is far more toxic than coal dust alone. The rock in central Appalachian coalfields is higher in silica than the rock in other mining regions, and miners are drilling thinner coal seams, requiring them to cut through more rock to gain access to coal.

Researchers at the National Institute for Occupational Safety and Health, or NIOSH, say they are finding more evidence of silica dust exposure in the images of the lungs of sick miners.

“There’s a specific type of abnormality that’s associated with silicosis,” NIOSH researcher Scott Laney said. “And what we’ve seen is a six-fold increase in the time that we’ve been looking at it, since the 80s, in these silicotic nodules on the X-rays.”

According to a 2019 NIOSH research paper, the prevalence of silicotic nodules has remained steady in non-Appalachian coal mining regions but it has skyrocketed within central Appalachia.

Fellow NIOSH researcher David Blackley said his team had also found an increase in lung transplants in recent years.

“We think there have probably been between 60 or 80 transplants done for coal worker’s pneumoconiosis since the 90s,” Blackley said. “And then just over the last couple of years, we’ve seen 10, 12, 15 per year.”

Blackley said the registry that tracks lung transplants likely undercounts the number of transplants for black lung, also known as coal worker’s pneumoconiosis, because the condition can be misdiagnosed.

The transplants are risky and can cost upwards of $1 million, but as a last resort, the surgery can add a few years to a sick miner’s life.

Stalled Regulation

The mining community has known since the 1970s that silica is far more toxic than coal dust alone, and federal researchers and miner advocates have fought for decades to implement more stringent coal dust standards. But those efforts have stalled, often because of pressure from industry.

In 2014 the Mine Safety and Health Administration, or MSHA, approved a rule further limiting coal dust exposure and fully applied the rule to industry practice in 2016. It was hailed as an important and overdue move to protect miners but that rule did not specifically address silica dust exposure.

Photo: Adelina Lancianese. Illustration: Alexandra Kanik. Read more about living with black lung >>

Currently, when a mine exceeds coal dust or silica exposure limits, the portion of the mine with elevated levels is placed on a reduced exposure standard for coal dust overall, but not for silica specifically. Regulators say measuring silica dust is difficult and they essentially use coal dust measures as a proxy indicator of silica dust exposure. However, the NPR investigation and a new NIOSH study found thousands of instances where lowering overall dust levels did not reduce silica dust to safe levels.

Despite the mounting evidence of silica’s role in the epidemic, there is little sign that regulators are planning to do anything differently to control dust exposure. Under the Trump administration, legislators and regulators have made moves to change some health and safety controls and raised concerns among health advocates that the changes would weaken protections in order to reduce costs for the mining industry.

David Zatezelo, a former mining executive President Trump appointed to lead MSHA, said in a speech at West Virginia University in September that silica must be controlled. But in an interview immediately afterward, he told NPR “the science isn’t in” yet on a link between silica exposure and severe black lung disease.

Former mining executive David Zatezalo leads the U.S. Mine Safety and Health Administration. Photo: Jesse Wright, WVPB

The ReSource caught up with Zatezelo at a reception following the formal events at the conference in West Virginia. As bluegrass played in the background, Zatezelo pulled up MSHA’s latest regulatory agenda on his phone.

Zatezelo said that because black lung disease can take 10 to 15 years to manifest after dust exposure, it’s too soon to say whether the 2014 rule is working or not. “We’ve put out an RFI on it,” he said, referencing the agency’s request for information from stakeholders. “We’re soliciting feedback.”

Calls for Change

Speaking at the West Virginia conference, United Mine Workers president Cecil Roberts called for increased regulation of silica dust.

“You could draw a circle around southeast Kentucky, southwest Virginia, and southern West Virginia. That’s where it is,” Roberts said, referring to the alarming rise in cases in central Appalachia. “That’s where miners are getting sick. That’s where miners are dying. And anybody who tells you, ‘We need more information.’ They’re lying.”

Roberts called on Congress to step in if regulators would not, and he may get his wish. Democratic Congressman Bobby Scott of Virginia, who chairs the House Committee on Education and Labor, pledged to conduct hearings in response to NPR’s 2018 investigation.

“Despite the stronger mining safety standards adopted during the Obama administration, the long-standing failure to meaningfully limit mine workers’ exposure to crystalline silica—which is 20 times more toxic than coal dust–has resulted in a surge of the most lethal form of black lung disease,” Scott said in a statement. “Congress has no choice but to step in and direct MSHA and the mining industry to take timely action.”

A committee staffer confirmed on background that those hearings are scheduled for June 20.

Black Lung

New Kentucky Memorial Honors Miners Who Died Of Black Lung



The memorial lists hundreds of local miners who have died from black lung. Photo: Sydney Boles/Ohio Valley ReSource

This article was originally published by Ohio Valley ReSource.

Coal miners and family members of miners who have died from black lung disease gathered Sunday in Whitesburg, Kentucky, to dedicate a new memorial to miners who perished from the workplace disease. 

While Appalachian coal country has several memorials to mining disasters, this is believed to be the first memorial to remember the thousands of men and women who died from black lung.

A dedication service for the new black lung memorial in Whitesburg, Kentucky. Photo: Sydney Boles/Ohio Valley ReSource

The engraved black stone memorial stands at Riverside Park in Whitesburg and will list the names of some 200 Letcher County coal miners who died of the disease.

William McCool was the first person to suggest the memorial after his father died of the disease.  

“You know, let’s give these men the honor they deserve. Let’s not forget them,” he said.

The total number of coal miners who have died from the disease is unknown, but the Department of Labor says more than a thousand coal miners die of black lung each year. Black lung cases are surging in the Ohio Valley, and health officials say about one in five experienced miners in central Appalachian has some form of the disease. 

Experts say the epidemic is getting worse because miners are working in thinner seams of coal, and are exposed to higher levels of silica, or quartz dust, from the surrounding rock layers, which is more toxic than coal dust alone.

McCool also suffers from black lung. He expects his name will be on the stone memorial one day, too.

“It would be a blessing to be with them boys,” he said.

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Black Lung

Federal Agency to Hear Comments on Silica Dust as Black Lung Epidemic Rages



In this Wednesday, May 11, 2016 photo, Scott Tiller, left, a coal miner of 32 years, talks with Donnie Coleman, chief safety director and a coal miner of almost 40 years, about a new federal regulation they must adhere to as they work at an underground coal mine in Welch, W.Va. Photo: David Goldman/AP Photo

This article was originally published by Ohio Valley ReSource.

The Mine Safety and Health Administration will host a public meeting Thursday as it considers action on regulating respirable silica, one of the major contributors to Appalachia’s skyrocketing rates of black lung disease. 

MSHA issued a request for information in response to calls for increased regulation after a 2018 investigation from NPR and PBS Frontline. That investigation found that the agency had failed to adequately protect miners despite knowing that silica, or quartz dust, was contributing to an epidemic of black lung. Silica dust is produced from cutting into layers of rock surrounding coal seams. At least 10 percent of coal miners with 25 or more years of underground work experience suffer from the disease, a sharp increase from the 1990s. 

A 2014 rule strengthened controls on mine dust overall, but did not address silica specifically. The agency’s meeting and request might signal interest in further regulation. However, some critics say it is too little, too late. Former MSHA regulator Celeste Monforton has spoken out against MSHA’s lack of action on silica exposure and said she sees little progress now. 

“They’re not suggesting in any way that they’re planning to do a regulation. They don’t even mention that in this request for information,” Monforton said of MSHA. “All MSHA is doing is saying, ‘We are aware of these cases, there’s a suggestion that it’s related to silica, so tell us what you think about this, let us know if you have any ideas.’”

MSHA said in its announcement of the hearing that it would also consider the viability of personal protective equipment such as air-flow helmets to keep silica below existing standards. That stance is in keeping with mining industry groups’ preferred method of control. Such an approach would place greater responsibility for the safety of workers themselves. Some public health experts say personal protective equipment is most effective in combination with rigorous environmental controls. 

Assistant Secretary of Labor David Zatezelo leads MSHA in the Trump administration. A former coal company executive, Zatezelo has been reluctant to agree with the growing scientific consensus on silica’s ongoing role in the black lung epidemic. He told a Congressional panel in June that he wanted to wait to see what effects the 2014 coal dust rule would have on limiting exposure to silica. 

“Due to the decades-long latency period between exposure and disease manifestation, a medically valid study cannot be completed in the near term,” Zatezelo said. “But MSHA anticipates the study will confirm that dramatic increases in sampling and compliance translate into reduced black lung incidence going forward.”

At that hearing, the administrator said MSHA would be reluctant to act unless it was to implement personal protective equipment. 

Lawmakers are facing increased pressure to address the epidemic. Over the summer, dozens of disabled coal miners made the day-long trip from central Appalachia to Washington, D.C., to urge lawmakers to support a black lung benefits fund and strengthen regulatory controls for current miners.

House Education and Labor committee chair Rep. Bobby Scott said in a statement in June that, “Today’s silica standards are not sufficient to protect miners,” and if MSHA did not act, “Congress has no choice but to take action on behalf of workers and their families.”

Monforton, the former MSHA official, said MSHA’s new request for information is an effort to thread the needle by appearing to take some action without committing to changing regulations in a meaningful way. 

“MSHA would be in an awkward position to not take some step,” Monforton said. “I wouldn’t even call it a regulatory step, but because it’s technically listed on the regulatory agenda, the agency can describe it as a regulatory step.”

The hearing is scheduled to last for eight hours and will take place at MSHA’s Washington, D.C. headquarters. 

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Black Lung

Mining Regulators Seek Information On Silica Dust Exposure




This article was originally published by Ohio Valley ReSource.

The federal Mine Safety and Health Administration announced Wednesday it will collect information on how dust from silica, or quartz, has contributed to Appalachia’s worsening epidemic of black lung disease, and ways that mining operations might prevent exposure. 

The announcement comes after an NPR investigation last year found that MSHA had failed to sufficiently regulate silica dust exposure, contributing to the increase in disease among coal miners. Silica dust comes from quartz found in rock layers near coal seams and can be far deadlier than coal dust alone. MSHA’s existing standards on coal dust can indirectly serve to limit miners’ exposures to quartz in respirable dust. But its standards are less stringent than those that the Occupational Safety and Health Administration applies to other kinds of workplace exposures. 

The move marks a departure from MSHA’s previous stance, which was that a request for information on the effects of a 2014 coal dust rule would be sufficient. That rule further limited coal dust exposure and was hailed as an important and overdue move to protect miners, but it did not specifically address silica dust exposure. 

In the request for information, which will be published Thursday, MSHA said it “recognizes the importance of controlling miners’ exposure to quartz and seeks information and data to determine if existing engineering and environmental controls can continuously protect miners.”

The request for information seeks input on economically and technically feasible solutions to silica exposure, including a lower silica dust standard and controls such as masks and respirators to help achieve compliance. 

Miners exposed to quartz can develop lung diseases that are preventable, progressive and may lead to death. As many as one in five experienced coal miners in the Appalachian region has some form of black lung. 

Rates of black lung disease are particularly high among Appalachian coal miners. Credit: Alexandra Kanik/Ohio Valley ReSource

Coal miners are exposed to more quartz dust now than in the past because they are often mining thinner seams of coal and are using machinery that can produce more dust than was produced with older forms of mining. 

“MSHA is aware that there may be conditions where existing engineering or environmental controls may not be adequate to continuously protect miners’ health in areas where there are high levels of quartz dust,” MSHA said in the request for information. 

The mining industry has known since the 1970s that silica dust was harmful to miners’ health. But efforts to regulate the dust have stalled, largely due to pressure from industry groups. 

“The Department of Labor is committed to having the information to make important decisions in order to best protect America’s miners,” said Acting Secretary of Labor Patrick Pizzella in a press release. 

MSHA will accept comments for 60 days.

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