black lung

Coal Miners Respiratory Clinic

When former coal mine employees in western Kentucky faced arraignment Wednesday on federal charges that they conspired to falsify the required monitoring of coal dust, the hearing brought renewed attention to the region’s surge in black lung disease.

The case highlights the many challenges miners face in the workplace. And health officials in black lung clinics say sick miners also face an increasingly Byzantine bureaucratic process that determines if those afflicted with the lung disease receive benefits.


Becca Schimmel

Eight former employees of two western Kentucky coal mines entered not guilty pleas at an arraignment hearing Wednesday. Those defendants are being federally charged with cheating on safety monitoring which is meant to reduce the risk of black lung disease.

Miners who work in the dustiest areas routinely wear monitoring devices. The indictment alleges those workers would be replaced mid-shift with miners who were not wearing the devices. Officials at Armstrong Coal Company are also accused of fabricating tests and submitting results from days when the mine wasn’t operating.

Region’s Black Lung Rates Highest In 25 Years

Jul 19, 2018
Howard Berkes/NPR

A new study by federal health officials finds the recent surge in cases of black lung disease is especially concentrated among coal miners in central Appalachia.

Researchers at the National Institute for Occupational Safety and Health say the rate of black lung disease among experienced miners in central Appalachia is the highest they have seen in a quarter century.

Epidemiologist Cara Halldin supervises the coal workers’ health surveillance program for NIOSH, and is one of the study authors. She said the cases are concentrated among miners in Kentucky, Virginia, and West Virginia.  


Adelina Lancianese NPR

A new report from the National Academy of Sciences says the coal mining industry needs a “fundamental shift” in the way it controls exposure to coal and rock dust in order to prevent lung disease among miners.

Despite improvements such as an Obama-era rule to strengthen monitoring and control of dust in mines, the experts on the National Academies panel said more work is needed to address the deadly surge in cases of severe black lung disease, which is especially prevalent among Appalachian miners.


Benny Becker

A new study from the Government Accountability Office finds that the federal fund supporting coal miners with black lung disease could be in financial trouble without congressional action. As NPR has reported, the GAO found that the fund’s debt could rise dramatically at the same time that black lung disease is surging.

Most federal benefits for coal miners disabled by back lung are paid from the Department of Labor’s Black Lung Disability Trust Fund, which covers the cost for companies that have gone bankrupt.


A new government report says that the federal black lung trust fund that helps sick and dying coal miners pay living and medical expenses could incur a $15 billion deficit in the next 30 years. That's if a congressionally mandated funding cut occurs as planned at the end of the year.

Jerry Helton

The Appalachian coalfields are in the midst of an epidemic of severe black lung disease. The debilitating and even deadly disease has recently begun to affect miners as young as 30. Dust from coal mines has scarred these miners’ lungs, so little of the air they breathe gets absorbed. In central Appalachia, researchers say, one in every five experienced miners have some form of impairment, and one in every 20 now have the most advanced and disabling form of black lung.

A new study shows that as black lung cases have surged there has also been a dramatic increase in one very expensive and risky surgical treatment — lung transplant. A new set of lungs can make it easier to breathe again, but the surgery introduces a whole new set of medical issues. Most transplant recipients die within 5 years.


Updated at 8 p.m. ET

The federal agency that trains, tests and certifies the physicians who read X-rays and diagnose the deadly coal miners' disease black lung said today it was not consulted by Kentucky lawmakers in the 14 months they considered a new law that mostly limits diagnoses to pulmonologists working for coal companies.

Howard Berkes/NPR

The American College of Radiologists, a professional organization representing radiologists, is asking Kentucky to repeal a new law that changes how coal miners receive benefits for black lung disease.

The law’s changes to Kentucky’s workers’ compensation system removed radiologists from the claims process, even though radiologists are specialists in reading in X-rays and are generally considered to be the most qualified among doctors certified to diagnose black lung disease.

“This is a matter of life and death for many people and politics should be left out of it,” wrote William T. Thorwarth Jr., a radiologist who serves as the organization’s CEO. “We hope that the Kentucky legislature will rescind this new law and work with the medical provider community to save more lives.”

Rural medical clinics that are struggling to respond to an epidemic of a fatal lung disease plaguing coal miners received a 40 percent boost in federal funding with the passage of the omnibus spending bill last week.

Adelina Lancianese, photos; Alexandra Kanik, illustration.

The central Appalachian coalfields are in the middle of an unprecedented epidemic of severe black lung disease. In a recent issue of the Journal of the American Medical Association federal researchers released the results of a study conducted at just three black lung clinics. The study confirmed 416 cases of the most severe form of black lung disease, Progressive Massive Fibrosis.

According to the authors, it’s the largest number of severe black lung cases ever documented, and one of the worst industrial epidemics in American history.


Michael Sullivan/Getty Images/Science Source

Epidemiologists at the National Institute for Occupational Safety and Health say they’ve identified the largest cluster of advanced black lung disease ever reported, a cluster that was first uncovered by NPR 14 months ago.

In a research letter published Tuesday in the Journal of the American Medical Association, NIOSH confirms 416 cases of progressive massive fibrosis or complicated black lung in three clinics in central Appalachia from 2013 to 2017.

c-span

The Trump administration’s Office of Management and Budget has announced a review of an Obama-era rule that protects coal miners from exposure to the dust that causes black lung disease.

That has some health and safety advocates concerned. The review comes amid a tide of regulatory rollbacks by the Trump administration and at a time that black lung disease is on the rise in Appalachian coal country.


Benny Becker

Federal health researchers are visiting health clinics and medical schools in the Appalachian coalfields to recruit allies in the fight a resurgence of black lung disease. The worst form of the disease may affect as many as 5 percent of experienced working miners in the region, and the researchers fear that rate could be even higher among retired miners. 

Medical students filled an auditorium at the University of Pikeville, Kentucky, to hear the latest on this scourge of coal communities, a disease many think should be history by now.

If we come to your town there’s generally something bad going on there,” said Dr. Scott Laney, an epidemiologist with the National Institute for Occupational Safety and Health, or NIOSH. He was part of a research team that identified a resurgence in the worst form of black lung disease in a study published late last year. 

Howard Berkes/NPR

A bipartisan group of legislators has asked President Donald Trump to make more money available for black lung health clinics as they face an increase in cases of the disease among coal miners.  

More than 20 clinics would benefit from the $3.3 million increase lawmakers are requesting. The clinics provide miners with health screenings, medical care, and assistance in securing black lung benefits.

The lawmakers wrote in a letter to the president and the White House budget director that the level of funding for clinics has been frozen for the past five years.  

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