Black lung disease is still killing miners. The coal industry doesn't want to hear it

https://www.theguardian.com/us-news/2018/dec/13/dr-dust-the-man-who-discovered-a-hidden-black-lung-epidemic

Elyssa East
Thu 13 Dec 2018

Dr James Brandon Crum was alarmed. For months, unemployed coalminers had been coming into his clinic in Coal Run Village, Kentucky, seeking chest radiographs.

•••••

Crum started asking his patients detailed questions. There was a mystery: why was he suddenly seeing so much severe black lung – an old man’s disease – thought to be an illness of the past, appearing in younger men with significantly less time in the mines?

Between the miners visiting his clinic and the cases coming to him as a federally certified B-reader, or expert in special x-ray readings to classify dust diseases affecting the lungs, Crum was shocked. Coal workers’ pneumoconiosis, commonly known as black lung disease, an incurable but entirely preventable illness caused by inhaling coalmine dusts, was showing up in x-rays at his clinic far above rates reported by the National Institute for Occupational Safety and Health (Niosh).
Trump rolls back climate change rule that restricted new coal plants
Read more

After Congress passed the Federal Coal Mine Health and Safety Act in 1969, which made the elimination of black lung a national goal, coal workers’ pneumoconiosis dropped to historically low rates by the 1990s. Progressive massive fibrosis, the severe or complicated form of the disease, fell to such scant levels it was considered rare. By 2012, though, Niosh announced that black lung was rising.

•••••

“The media here buried this thing,” says Linda Adams, 53, who recently lost a fifth family member to the disease this past July. She and others affected by black lung’s resurgence held rallies and tried to get legislators to confront the crisis as far back as 2014. “But then Brandon Crum came in here and blew the lid off of this whole thing.”

•••••

By December of that year, Niosh (National Institute for Occupational Safety and Health) confirmed Crum’s discovery. The number of black lung cases in Crum’s office was eight times their rates. His single clinic also charted 60 cases of complicated black lung over a 20-month period. This was far and above the 99 cases in the entire nation that Niosh had identified over a five-year period going back to 2011.

An additional study corroborated Crum’s findings: 416 cases of severe black lung had been reported in three Virginia clinics. Niosh recently declared that the US is facing an epidemic, affecting one in 10 miners nationally, and one in five – twice the national rate – in the central Appalachian states of Kentucky, Virginia and West Virginia.

Today’s black lung rates are higher than the ones that inspired miners and physicians to push for the Federal Coal Mine Health and Safety Act of 1969 almost 50 years ago.

•••••

Earlier this year, Kentucky’s Republican-led legislature passed House Bill-2 (HB-2), which curtails worker’s compensation, including black lung benefits, to 15 years. The bill also cuts radiologists like Crum from the certification process, limiting the doctors who can approve benefits to four pulmonologists. Three of whom consult for the coal industry.

Black lung advocates see HB-2 as singling out Crum. Pikeville black lung claimant attorney Phillip Wheeler openly refers to the bill as “The Dr Brandon Crum Exclusion Bill”. The Appalachian Citizens’ Law Center staff attorney Evan Barret Smith, who edits the blog Devil in the Dust, which is devoted to the disease, says, “He saw more severe black lung coming into his office than any of the official statistics said he should be seeing. By the way, that’s the same reason that the industry people say he must be wrong.”

•••••

Unless Congress takes action in these final weeks of 2018, the federal Black Lung Disability Trust Fund will add to the current crisis on 1 January 2019 when the coal tax that pays for it reverts to 1977 levels, which will reduce its revenue by 55% in the middle of the epidemic. As the Lexington Herald Leader reports, the coal industry has poured over $7m into congressional races in the past two years. Taxpayers, rather than the coal industry, may end up footing the bill for a disease caused by industry negligence and cheating.

•••••

A bipartisan pair of local legislators are pushing back, though. In mid-November, Angie Hatton, a Democrat, and Robert Goforth, a Republican, pre-filed a bill to reverse HB-2’s restriction of B-readers to pulmonary specialists. The bill will be taken up in the 2019 general assembly starting in January.

•••••

Now that thicker seams of coal have been mined out and more rock must be cut, miners have been exposed to greater amounts of respirable crystalline silica dust, which is largely to blame for the spike in complicated black lung.

There are other causes, too: more powerful machinery, longer workdays, fewer days off for miners to rest their lungs and a culture of company fealty that stretches back to coalmining’s earliest days.

•••••

Coalmining is also rife with bent rules. Just because a federal protection is in place doesn’t mean companies and miners observe it – employees of Armstrong Coal were recently indicted in western Kentucky for conspiring to falsify dust readings.

•••••

“What we’re seeing in central Appalachia right now is the prequel to what you will see occurring in the rest of the United States coal fields, over the decades to come,” Crum says of the current crisis. He predicts that all of the other coal-producing countries – Canada, China, India, Australia and others – will see an increase in black lung disease as higher-quality seams of coal are mined out. “This is a massive problem. And it’s just gonna get worse.”

•••••