Black lung disease has been on the rise in recent years. This deadly disease that primarily effects coal workers was a major epidemic in the 1970s, but by the end of the 1990s, it had almost been wiped out (largely due to new laws and regulations). Since 2000, black lung disease has come back with a vengeance, and a new report by the National Academy of Sciences, Engineering, and Medicine says that a “fundamental shift” is required on the part of the coal industry to address this rapidly growing problem.
What is Black Lung Disease?
Black lung disease, also known as coal workers’ pneumoconiosis, results from continuous exposure to coal dust over an extended period of time. This type of exposure commonly occurs when coal miners are working underground. It can also occur during the process of strip mining (mining just below the earth’s surface) and above ground while the coal is being processed.
Black lung disease starts when the body’s immune system attempts to get rid of the small particles of coal dust that are trapped in the lungs. As the scavenger white blood cells become overwhelmed, they release enzymes that inflict damage on the lungs, creating scar tissue. Over time, the scar tissue builds up, shrinking the volume of the lungs and inflicting further damage on the surrounding tissue.
The mildest form of pneumoconiosis is known as anthracnosis. This condition is relatively minor and common among urban dwellers because of air pollution. Ongoing exposure to high levels of coal dust for an extended period of time leads to more severe forms of the condition, such as simple coal workers’ pneumoconiosis, and complicated coal workers’ pneumoconiosis (also known as progressive massive fibrosis).
In its early stages, black lung disease can be difficult to identify. During the initial stages, it is not uncommon to have no symptoms at all. As the condition progresses, sufferers may start to develop chronic cough, shortness of breath, and similar symptoms. To make matters worse, other conditions such as emphysema and chronic bronchitis often develop in conjunction with the disease.
As coal dust exposure continues and the condition progresses to complicated coal workers’ pneumoconiosis, sufferers find it increasingly difficult to breathe and may eventually experience respiratory and/or heart failure. At this stage of the condition, the only cure is a lung transplant, but the problem is these transplants are only given to coal workers who are healthy enough to qualify.
Largest Cluster of Severe Black Lung Disease Cases Ever Identified
Prior to the National Academy of Sciences, Engineering, and Medicine report, a research letter published by the Journal of the American Medical Association (JAMA) identified and confirmed 416 cases of progressive massive fibrosis (complicated black lung disease) in three clinics across central Appalachia during a four-year period from 2013 to 2017.
Scott Laney, an epidemiologist who was involved in the study, called this, “the largest cluster of progressive massive fibrosis ever reported in the scientific literature”. This is a stunning report considering that progressive massive fibrosis had been nearly wiped out by the end of the last century.
Sadly, the figures reported in the JAMA study vastly understate the scope of the problem we are now facing. Mr. Laney went on to say, “even with this number, which is substantial and unacceptable, it’s still an underestimate.” National Public Radio conducted its own investigation that identified nearly 2,000 cases of complicated black lung disease across Kentucky, Virginia, West Virginia, Pennsylvania, and Ohio.
In addition to the mind-blowing number of complicated black lung disease cases across Appalachia, the JAMA study and NPR investigation uncovered another highly disturbing fact; coal workers are developing progressive massive fibrosis at younger ages than in the past, and after fewer years working in the mines.
In the past, progressive massive fibrosis typically affected miners who were in their 60s, 70s, and 80s. The latest cluster of cases shows an increasing number of younger miners being affected. Miners in their 50s, 40s, and even 30s are now developing the most severe form of black lung disease. The JAMA study reports that a “high proportion” of complicated black lung disease sufferers they identified had worked in the mines for less than two decades.
NPR believes that one of the major reasons for the massive spike in complicated black lung disease is longer work shifts in the mines. In an effort to increase efficiencies, many mining companies have laid off workers and asked those who remain to put in longer hours. NPR’s investigation also points to the machinery required for the mining of thinner coal seams. This type of mining produces silica dust, which is far more toxic than coal dust.
Regulations are Not Enough to Fight Black Lung Disease, According to Latest Report
In 2014, the federal government implemented new regulations on the mining industry designed to help combat the sharp rise in black lung disease. While mining companies have been mostly in compliance with these regulations, it has not been enough to effectively fight the disease. The National Academy of Sciences, Engineering, and Medicine report says that mining companies need to be much more proactive to protect the workers who are exposed to the coal dust and other hazards they face on a daily basis.
The report calls for a comprehensive approach to combat black lung disease that includes implementation of enhanced monitoring technologies and additional research in order to gain a more in-depth understanding of what is causing this epidemic.
“Determining the causes of that increase and eliminating occupational lung disease in coal miners is a complex scientific, engineering, medical, regulatory, social, political, economic and legal problem,” the report says.
The report recommends several actions that should be taken to address the black lung disease problem, such as:
- Better miner participation in voluntary medical surveillance (for early disease detection);
- Better miner education on the risks and hazards of coal mine dust diseases;
- Better training to ensure that miners know how to use continuous personal dust monitors (CPDMs) properly;
- Improving CPDMs by reducing their weight and lowering their cost;
- The development of a real-time crystalline silica monitor;
- A comprehensive investigation into the challenges mining companies face in implementing a “beyond compliance approach to monitoring”;
- A comprehensive research and development effort to address important information gaps regarding sampling and monitoring.
Where Do We Go from Here?
It is abundantly clear that we have a black lung disease epidemic on our hands. And the National Academy of Sciences, Engineering, and Medicine report rightly points out that this epidemic is complex and involves countless factors that reach into numerous areas of our society. Underneath all the complexities, however, there are 50,000 coal workers whose lives hang in the balance.
These men and women are far more than just subjects of “research and monitoring”. They are individuals with hopes and dreams of a better life, and many have families who depend on their paycheck to put food on the table. Hopefully, the coal mining industry will take this report to heart and finally get serious about protecting their most precious resource; their workers.
If you or a loved one has been injured or killed as a result of complications resulting from black lung disease, contact Bailey Javins & Carter at (304) 932-4639 or through our website contact form. The experienced mine accident injury attorneys at Bailey Javins & Carter will work diligently to make sure you receive the damages you deserve.