Jul 212012

In the 1950s, half of coal miners who worked 25 years contracted black lung, or coal workers pneumoconiosis. A 1969 federal law mandated dust controls in coal mines, and the incidence of black lung declined dramatically.

But that was temporary. A new report by the Center for Public Integrity and National Public Radio shows that black lung is back in Appalachia coal mining country, especially the most severe form of the disease, and it's occurring in miners who are younger and younger. The most severe form of coal workers pneumoconiosis is nearly back to its 1970s prevalence. After the Upper Big Branch explosion in West Virginia in April 2010, for example, 17 of the 24 dead miners autopsied had signs of black lung. Some were as young as 25 and several had fewer than 10 years of experience in mines.

The investigative reporters believe two causes are responsible: a more-potent mix of coal dust due to new techniques that cut through large amounts of silica to get to the coal seams. And--allegedly--rampant cheating with the inspections process by the supervisors and managers of coal mines. Whether or not cheating is occurring, it is an undisputed fact that when violations are uncovered, they rarely lead to meaningful penalties. (In each of the past 25 years,  average silica levels sampled have been above the legal limit -- which is itself double the level deemed safe back in 1974.)

In depositions, numerous coal workers reported leaving their "pumps" -- monitoring devices that collect coal dust for sampling to ensure safety -- hanging in clean areas while working in thick dust all day. Unless, of course, inspectors were around, when supervisors made sure miners wore them. (Back in the 1990s, some mining company employees would simply blow the coal dust off the white collection filter before handing it over to inspectors--leading to the "abnormal white center" scandal, with subsequent criminal convictions of company employees and contractors.)

In severe cases, coal workers pneumoconiosis is progressive, disabling and eventually fatal; there is no treatment, so prevention by avoidance of heavy exposure has always been the key. How bad is black lung? Dr Edward Petsonk told reporters,

No human being should have to go through the misery that dying of [black lung] entails. 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.

More rigorous rules were proposed, but killed in 2000 when President Bush took office (and did not resurface under Obama). A slanted story by those anti-American socialistic types at NPR and this lefty, nonprofit investigative news outlet? As Stephen Colbert famously opined to George W. Bush at the 2006 White House Correspondent's Dinner, sometimes "Reality has a well-known liberal bias."

Chris Hamby, "Black lung surges back in coal country," the Center for Public Integrity.

Liked this post? Get a weekly email update, and explore our library of clinical guidelines, practice updatesreview articles. and board review questions.

PulmCCM is an independent publication not affiliated with or endorsed by any other organization, society or journal referenced on the website. (Terms of Use | Privacy Policy)

Authors: contribute your work in a guest post.


Black lung resurges in Appalachian coal country; mining co’s not penalized (Ctr for Public Integrity)