Black Lung Disease: An Ongoing Crisis Among Coal Miners

Tim Balthis, a miner with advanced black lung disease, appears healthy, sitting with his wife Fran on their porch in Pound, Va. However, his lungs are filled with fibrotic tissue, a condition so severe that a doctor was amazed he is still alive.

Marcy Freeman, a respiratory therapist, doesn’t need research to see the impact of coal mining. She has over 150 funeral programs from former patients at her pulmonary rehabilitation clinic in Norton, Virginia. Each program represents a life lost to black lung. These were hardworking men who went to work to provide for their families, paying the highest price — their health.

Freeman has treated many miners with black lung at her clinic, including her own husband, a coal miner for 27 years. The situation is more critical than anticipated. New data from the National Institute for Occupational Safety and Health (NIOSH) shows that black lung disease is at its highest rate in nearly 50 years among central Appalachian miners.

X-rays reveal that one in three miners with over 25 years of underground work tested positive for black lung. This rate hasn’t been seen since 1978. Even miners with as few as 15 years of work show higher disease rates than in 40 years.

“This isn’t getting better,” said Scott Laney, a NIOSH research epidemiologist. “We’re watching these men succumb to black lung like disposable items.”

An earlier NIOSH study reported over 1,700 coal miner deaths from 2020 to 2023 due to black lung. The fact that NIOSH screened 280 miners, with 91 testing positive, highlights this ongoing crisis.

Former mine-safety regulator Celeste Monforton states these findings should shock anyone who cares about workers. Despite decades of lung dust exposure limits, the disease’s prevalence is surging, especially in Appalachian miners suffering from various stages of the disease.

Niosh’s recent findings confirm this. Data from black lung clinics treating retired or laid-off miners support the rising disease prevalence. Despite strict dust exposure regulation imposed by Congress in 1977, the disease rate has climbed from 7% in 1999 to over 30% today.

Radiologist Brandon Crum, specializing in detecting black lung signs, first reported severe black lung cases among younger miners in 2016. Today, the trend continues, showing a worrying health crisis. With Appalachia’s biggest coal seams mined out, miners face more silica dust exposure, increasing disease risk. Mining companies digging through rock expose miners to dangerous, silica-rich dust.

Exposure to coal mine dust is the sole black lung cause, states NIOSH research. The inhalation of silica dust is notably toxic, aggravating disease patterns seen today. Despite supposed compliance to silica dust standards by mining companies, miners encountered toxic dust over 5,000 times since 2014.

Though mining companies cite safety compliance rates, even minimal overexposure poses profound risks. Former regulator Monforton highlights thousands of exposures equate thousands of disease opportunities. The rising frequency of black lung, despite MSHA’s new silica dust regulation, shows urgent need for action.

Political and legal challenges delay necessary enforcement. Federal responses to industry lawsuits have indefinitely delayed rule enforcement, and Trump-era policies did not prioritize miners’ safety. Although new rules have been set, implementing strict exposure limits remains challenged.

Protections could eliminate this disease, asserts Dr. Drew Harris, from Stone Mountain black lung clinics, which sees heavy case loads. Over 2,400 new black lung cases were diagnosed there in just five years.

The disease’s rise affects miners seeking state and federal benefits, drawing significant financial resources. The financial burden of lung transplants and the federal black lung trust fund weighs heavily on public resources.

Tim Balthis’s struggle with black lung exemplifies miners’ traumatic journeys. Everyday tasks are arduous as his condition worsens. Even a lung transplant offers only limited reprieve, often leaving miners with less-than-seven-year survival expectations.

This article reflects collaboration across multiple news outlets to highlight this critical issue continuing to affect miners today.