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Study: Black lung growing, especially in central Appalachia

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The rate of black lung disease in coal miners is growing, particularly in miners who work in central Appalachia, according to a study published in the American Journal of Public Health this week.

One in five coal miners who’ve worked in West Virginia, Kentucky or Virginia for more than 25 years has coal workers’ pneumoconiosis (CWP), according to the study, which was published Thursday. Nationally, more than 10 percent of miners with the same amount of experience have the debilitating and irreversible disease, which is caused by exposure to coal dust.

Of those miners with at least 25 years of experience, one in 20 has black lung disease that’s progressed to progressive massive fibrosis.

The rate of black lung started declining in 1969, when Congress shifted its focus on limiting dust exposure. But scientists have found an increase in the disease since 1997, especially in younger miners whose careers started after 1969.

“We can think of no other industry or workplace in the United States in which this would be considered acceptable,” wrote the study’s authors, David Blackley, Cara Halldin and A. Scott Laney. All are with NIOSH, which is part of the Centers for Disease Control. The study was first reported by National Public Radio.

“Can you imagine working where you do, if one in every five person had a chronic disease caused by the newsroom?” Laney said by phone Friday. “It’s just unthinkable.”

The study looked at radiographic data from the Coal Workers’ Health Surveillance Program between 1970 and 2017 and compared the last five years of data to X-rays taken before that window. Because the disease is progressive, these trends could be reflected in the future, the study says. The study notes new standards introduced in 2014 that lower the concentration of respirable dust in mines, and the Department of Labor’s December 2017 request for public comments on existing standards and regulations.

It’s still too soon to tell what kind of impact that will have, the study says. Still, it’s a “step in the right direction,” Laney said.

Amy Louviere, a spokeswoman for the U.S. Department of Labor’s Mine Safety and Health Administration (MSHA), said the administration is reviewing the study.

The problem deserves a greater sense of urgency, said Celeste Monforton, a lecturer on public health at Texas State University who worked for the Department of Labor for 11 years. That falls on the MSHA, plus coal operators, plus lobbyists, as well as lawmakers who run for office — and re-election — on anti-regulatory platforms.

“The evidence just keeps coming out that the regulations that were in place just were not adequate to be protecting miners,” Monforton said.

Last month, a study in the National Academies of Sciences, Engineering and Medicine, called the “Monitoring and Sampling Approaches to Assess Underground Coal Mine Dust Exposures,” said a “fundamental shift” is required in the way coal miners are monitored and protected from coal dust. The study also noted that MSHA and NIOSH should be getting more miners to participate in voluntary medical surveillance and figuring out why some don’t.

Participation in free radiographic screening fluctuates, the American Journal of Public Health’s study says, but it’s been between 30 and 40 percent annually in the last few decades.

“I don’t know if that’s because the coal mining industry historically, and up until this point, it’s ‘ho hum, black lung, it’s part of the industry and there will always be people getting black lung,’ ” Monforton said. “And ... I think some of that is miners themselves have very little confidence in the system.”

In the NPR story, reporter Howard Berkes talked to Jackie Yates, a Virginia coal miner diagnosed with the most severe form of black lung disease five years ago. There’s a photo of him in the article.

“It’s extremely troubling from a public health perspective, but for me personally, looking at that guy’s face, it’s like, ‘Wow, I was working at the agency that was supposed to be protecting him,’ ” said Monforton, who worked at MSHA for six years. “And the rules we had in place, and I guess the way they were being enforced, you know, didn’t work. I mean, they really failed.”

Reach Kate Mishkin at, 304-348-4843 or follow @katemishkin on Twitter.

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