The Continued Prevalance of Black Lung Disease Among Coal Miners: A Preventable Tragedy and Yet Another Reason to Move Away from Coal

The Continued Prevalence of Black Lung Disease Among Coal Miners: A Preventable Tragedy and Yet Another Reason to Move Away from Coal

A graphic on the Mine Safety and Health Administration website notes that since 1968 there have been 76,000 deaths from Black Lung disease at cost of $45 billion in Federal compensation. Black lung includes a series of maladies caused by long term chronic exposure to coal dust and silica dust, which scars lung tissue. This black particulate matter can coat the lungs causing difficulty in breathing and eventually death. The deadliest form or advanced phase of black lung is a malady called progressive massive fibrosis (PMF) or complicated black lung. The National Institute Occupation Safety and Health (NIOSH) announced in February that there have been 416 confirmed cases of PMF in central Appalachia from 2013 to 2017. Since that study 154 new cases have been confirmed. That is a huge uptick and it shows that the disease is not slowing down as it was thought to be in the 1990’s. Out of 50,000 coal miners still working, 1%, or 1 out of 100 (of that total as some of those w/PMF may no longer be working) have the worst form of black lung and presumably many more have lesser versions heading toward PMF. That is concerning. Perhaps most concerning is that 5% of all veteran miners and 10% of those with more than 25 years of mining experience in central Appalachia have PMF which is the highest level ever recorded. More than 20% of miners in Appalachia have been diagnosed with some form of the disease. That is rather astounding.

The new data of rising PMF black lung cases suggests two things to some health researchers: 1) it would be considered a serious health crisis if it occurred in other industries, and 2) the new data show that dust control regulation and/or enforcement and/or fines have been inadequate.

The Coal Mine Dust Rule was first put in effect in 2014. The Mine, Safety, and Health Administration (MSHA), a branch of the U.S. Dept. of Labor, explains this ‘respirable dust rule.’ First implemented in August 2014, it required an initial year of continuous dust sampling in mines and certification every three years of samplers. This showed that compliance with the planned reductions was achievable. Phase III went into in August 2016 and requires lower limits for coal mine dust in the mines and at air intakes. The limit for dust in the mines dropped from 2mg/cubic meter to 1.5 mg/cubic meter. The initial proposal was to drop it to 1 mg/cubic meter as recommended by NIOSH. Negotiations over 3-1/2 years with coal producers and politicians led to the compromise. This was the first time there was any implementation of a regulation against coal dust for 45 years. The previous law in 1969 made eliminating black lung a national goal. The rate of contracting the disease did drop in subsequent years as better mining ventilation systems became standard, water-spraying dust control was widely implemented, and monitoring was required. The level of black lung was cut by nearly 60% from the 1970’s to the 1990’s. That was a clear regulatory success in terms of health outcomes. Then the level flattened and has been back on the rise in recent years. In studies, a rise was first noted in 2007, a general rise was noted in 2012 and a bigger rise in 2016.  

The MSHA calls the respiratory dust rule “a historic step forward in the effort to end black lung disease.” NIOSH researchers stated that “Enhancement and diligent enforcement of the 2014 standards remains critical for reversing these trends” The mining industry strongly opposed the rule with the National Mining Association and coal producer Murray Energy filing lawsuits. Murray Energy claimed that MSHA “clearly seeks to destroy the coal industry and the thousands of jobs that it provides.” However, the Trump MSHA with former coal executive David Zatezalo now in charge, seeks to ‘reform’ the rule, first gathering their own data in support of their presumed idea of reducing required sampling frequency and “accommodating less costly methods.” He insists they do not seek to roll back the rule, only to tweak it, although it has been labeled by MSHA as a ‘deregulatory’ action which has raised eyebrows. In April Trump’s MSHA submitted the draft request for information about the rule titled “Regulatory Reform of Existing Standards and Regulations: Retrospective Study of Respirable Coal Mine Dust Rule”

In 1998 there was an expose’ by a Louisville newspaper that found extensive cheating on mine dust samples by coal producers in Kentucky. A few years ago there was a case of admission of guilt in cheating on water samples taken for coal companies in West Virginia. These and other cases show that there is a need for regulatory enforcement. The same paper reported in 2007 on the initial resurgence of black lung. More recently, there have been several indictments for people from a few mines in Western Kentucky where some whistleblower miners told of routine manipulation of dust samples at the threat of harassment and/or job loss. This was at two Armstrong Coal mines between 2014 and 2017, Armstrong Coal has since gone bankrupt. Those charged include a section foreman, a safety director, and a superintendent. Armstrong Coal is named as an "unindicted co-conspirator." One might speculate that there was some 'pushback' against the new federal rule at least at those mines. Of course, when one company or group in a company conspire to avoid implementing compliance to a regulation and get caught then it makes all those who do comply look bad as well in a sense. In the case of the very well known dangers of black lung the cheating seems particularly devious. The Ohio Valley Resource article referenced below is a good summary of the case.

Other expose’s have shown doctors retained by coal companies had sought to limit black lung benefits to miners and even now there are severe limits in choosing doctors in Kentucky. The requirement is for the disease to be diagnosed only by a small group of certified pulminologists, lung specialists, rather than radiologists. Radiologists day they are perfectly qualified to diagnose the malady. This means that it could take over a year for people to even be seen by the lung specialists. Since early detection is key to mitigating the effects of black lung, this is a delay that certainly could negatively affect health outcomes.

All the data suggest that black lung can be significantly reduced – simply by adequate regulation, enforcement, and corporate accountability through fines and inspections. Regardless of the economics of coal producers, at 76,000 dead, over 10,000 ill, and $45 billion and counting  - this is a no-brainer. 

Update: Dec. 19, 2018: According to a news segment by NPR yesterday which will be seen in a Frontline/NPR TV special next month, there is some additional very interesting info. In recent years as coal seams are mined out there has been more cutting through non-coal rock, rock containing high amounts of silica dust. Silica dust is strongly suspected of being much more damaging to lungs than just coal dust. The Obama-era regs sought to address silica dust by addressing overall dust rates, which would be an improvement but not a drastic one for overall exposure to black-lung causing dust. The miners interviewed noted that this “cutting rock,” also known as “slope mining” has definitely increased and so too has the silica dust to which they were exposed. Trump’s new MSHA chief has publicly acknowledged that silica dust is suspected to be the culprit in increased black lung but also has privately said in contradiction that the link is not yet proven. The silica dust is regulated by other regulatory agencies, particularly OSHA. Other industries regulate silica dust via OSHA but the mines have kept the MSHA regs. A big factor that may miss the increased exposure is that sampling rates are probably inadequate. Even though mines now use third parties to do the sampling the rates of sampling are likely inadequate. The miners that operate the mining machines cutting rock also say that the dust is so heavy that it clogs up dust masks making it hard to breath and some mines don’t even require dust masks. Mine vents may be seen by the mine operators to be enough to mitigate the problem, but this is fairly obviously not the case. This latest increase in black lung and PMF likely due mainly to silica dust has been accurately described as a regulatory failure. Basically, with the increase in slope mining and the subsequent production of silica dust, “putting miners back to work” basically means hastening their suffering and death.

References:

Trump Wants to Weaken Coal Miner Protections as Black Lung Makes a Comeback – by Mark Hand in ThinkProgress, July 20, 2018

Black Lung Rate Hits 25-Year High In Appalachian Coal Mining States – by Howard Berkes, in NPR.org, July 19, 2018

Respirable Dust Rule: A Historic Step Forward in the Effort to End Black Lung Disease – by U.S. Dept. of Labor – Mine Safety and Health Administration (MSHA) (website) – 2014-2017

Black Lung Study Finds Biggest Cluster Ever of Fatal Coal Miners' Disease – by Howard Berkes & Adelina Lancianese, in NPR (All Things Considered) – Feb. 6. 2018

A Scourge for Coal Miners Stages a Brutal Comeback – by Ken Ward Jr. – in Yale Environment
 360, Nov. 11, 2014.

Federal Prosecutor Charges Coal Company with Faking Dust Samples Amid Black Lung Surge - by Jeff Young and Becca Schimmel, in Ohio Valley Resource, July 11, 2018