After reaching a low point in the late 1990s, new studies are showing that black lung disease has made a startling resurgence, especially among coal workers in the central Appalachian region.

More than 10 percent of America’s coal miners with 25 or more years of experience have black lung disease, also known as coal workers’ pneumoconiosis. In central Appalachia — areas of West Virginia, Kentucky, Virginia, and Tennessee — it’s even higher. More than 20 percent of coal workers in the area with the same amount of tenure have been diagnosed with the disease, according to a new study by experts at the federal government’s National Institute of Occupational Safety and Health (NIOSH).

The dramatic increase in cases of black lung disease is occurring at the same time that the Trump administration is seeking ways weaken coal dust rules that protect coal miners from the disease — a move that would reduce costs for coal companies, which have been strong financial backers of Trump.

Black lung is a common term for several respiratory diseases that share a single cause: breathing in coal mine dust. Over time, black lung disease causes a person’s lungs to become coated in the black particulates that miners inhaled during their time in the mines. Their passageways are marked by dark scars and hard nodules.


The new study, “Continued Increase in Prevalence of Coal Workers’ Pneumoconiosis in the United States, 1970-2017,” also found that the most severe form of the disease — progressive massive fibrosis — now occurs in five percent of veteran miners in the central Appalachian region, the highest rate ever recorded.

“We can think of no other industry or workplace in the United States in which this would be considered acceptable,” the researchers concluded.

The researchers reviewed nearly fifty years of coal miner X-rays taken as part of a national NIOSH effort to identify disease among working coal miners. They compared the last five years of X-rays with those taken earlier.

It appears lawmakers, however, have not been spurred to take action to help protect coal miners in response to the rise in black lung cases. Kentucky lawmakers, for example, passed a bill earlier this year that will make it harder for miners to obtain workers’ compensation benefits. Kentucky is one of the states that has witnessed the resurgence in the most advanced form of black lung disease.


The new law, which went into effect on July 14, drastically reduces the number of physicians in Kentucky permitted to read the chest X-rays when coal miners file a black lung claim. Six doctors in Kentucky will now be eligible to conduct the exams, according to an NPR review of federal black lung cases.

Only five years ago, a study found that the disease was sickening about seven percent of underground miners with more than 25 years’ experience, significantly lower than the 10 percent figure cited in the most recent study.

Researchers find rate of black lung disease among #coal miners highest in 25 years. Says one: "We can think of no other industry or workplace in the United States in which this would be considered acceptable." https://t.co/HXEtmkgdiE — Appalachian Voices (@AppVoices) July 20, 2018

The growth in cases of black lung disease is occurring as President Donald Trump has pledged to revive the beleaguered industry. At the same time as Trump is trying to put more coal miners back work, his administration is examining ways to weaken rules aimed at fighting the disease. The administration explains such moves could create a “less burdensome” regulatory environment for coal companies.

On April 4, in response to industry complaints about coal dust rules imposed by the Obama administration, Trump’s Mine Safety and Health Administration (MSHA) submitted a draft request for information on the agency’s regulation to protect coal miners from black lung disease. This was part of a first step toward diminishing protections for coal workers.


Titled “Regulatory Reform of Existing Standards and Regulations: Retrospective Study of Respirable Coal Mine Dust Rule,” the notice said MSHA would seek ways that the coal-dust rule could be made “less burdensome.”

It said the goal is to accommodate “less costly methods,” including whether the dust-control requirements “could be streamlined or replaced in frequency.”

The Coal Mine Dust Rule was published in August 2014 and was phased in over the subsequent two years. It included a reduction in the allowable concentration of respirable coal dust to which miners could be exposed from 2.0 milligrams per cubic meter of air to 1.5 milligrams. It marked the first time in 45 years that federal officials have updated labor rules to prevent black lung disease.

The mining industry strongly opposed the updates to protections for coal workers. Both the National Mining Association and coal producer Murray Energy filed separate lawsuits against MSHA. Murray Energy claimed MSHA “clearly seeks to destroy the coal industry and the thousands of jobs that it provides.”

In their study released this week, the NIOSH researchers emphasized that the 2014 standards successfully closed several loopholes that were allowing miners to be exposed to coal mine dust. But they also emphasized that they are not aware of any evidence of a decline in black lung disease that would justify the Trump administration relaxing the 2014 standards.

“Enhancement and diligent enforcement of the 2014 standards remains critical for reversing these trends,” the researchers said.