Advanced Black Lung Disease Story Archives - West Virginia Public Broadcasting

Will The New Silica Dust Standard Rule Be Implemented?

Before a new MSHA rule to limit miner’s exposure to silica dust could take full effect, opponents threw up a new roadblock.

A human takes on average 20,000 breaths per day. Imagine each breath heavy and tight from a career underground working a seam for coal or valuable minerals, a constant reminder of what you sacrificed for your family’s well-being.

“I worked in the coal mine for 27 and a half years,” Gary Hairston, the National Black Lung Association’s president said. “I come out at 48 [years old] with black lung.”

Since leaving the mines, he has been advocating for miners’ rights and safe working conditions.

“I’m worried about young coal miners,” Hairston said. “I don’t want [them] to be like I am.”

The nation’s top health officials have urged the Mine Safety and Health Administration (MSHA), the federal agency in charge of mine safety, to adopt strict rules to protect miners from rock dust.

Black lung and silicosis are both forms of pneumoconiosis, a condition where inflammation and scarring make it hard for the lungs to get enough oxygen. It is incurable but steps can be taken to slow the disease and improve quality of life.

Black lung diagnoses doubled in the last decade. Advanced disease has quadrupled since the 1980s in Virginia, West Virginia and Kentucky.

In recent decades, cases have risen further as miners dig through more rock layers to get to less accessible coal, generating deadly silica dust in the process.

“What’s happening is a lot of these mines, especially in Appalachia have been mined for hundreds of years decades and they are now mining rock, and so it’s this constant hitting of rock from these machines that is causing an increase of silica dust in these mines,” said Erin Bates, director of communications for the United Mine Workers of America (UMWA).

Respirable crystalline silica is a carcinogen. It can cause lung disease, silicosis, lung cancer, progressive massive fibrosis and kidney disease. Coal dust containing silica dust has been shown to increase the severity of black lung cases and affect miners even as early as their 30s and 40s.

Mine operators are supposed to ventilate mine work areas to lower the concentration of coal and rock dust, as well as methane.

But how much silica dust is too much? For years, MSHA set an upper limit of 100 micrograms per cubic meter averaged over an eight-hour shift.

But after years of pressure from advocates like Hairston, it cut that in half, to 50 micrograms per cubic meter.

Mine operators have a legal requirement to maintain safe levels of exposure in the mines at all times. Under the new rule, if levels are too high, mine operators must take immediate corrective action to lower the concentration of respirable dust to at, or below, the respirable dust standard and contact MSHA, according to Assistant Secretary Chris Williamson.

“That was one of the new provisions in the final rule, that the mine operator will have to notify MSHA, because we want to know that too. They have to take immediate corrective action,” Williamson said. “And resample to be able to verify, did that corrective action address the issue?”

Under the new rule, when respirable silica dust levels go above the 50-microgram limit, mine operators must provide miners with respirators and ensure they are worn until exposure levels are safe.

The use of respirators when levels are high is part of the rule that many advocates and miners say doesn’t go far enough.

“We truly believe that instead of requiring a miner to wear a respirator, they should shut that mine down and improve the ventilation in that mine, so that there is not any extreme case of silica dust exposure in that area,” Bates said.

The new, stricter safety rules went into effect in June, although coal producers have 12 months to comply.

Advocates like Vonda Robinson, the vice president of the National Black Lung Association, celebrated the new rule.

“I think with this new ruling, I think it’s going to be great for the coal, the coal mines, and also the coal miners,” Robinson said.

As a retired miner, Hairston won’t benefit from the new safety measures, but he’s worked tirelessly to push it through, visiting Capitol Hill to testify about working conditions in the mines.

“The rule is pretty good,” Hairston said. “There’s a lot of stuff we got put in, it is good. The thing is, is the defunding.”

In July, the U.S. House Appropriations Committee passed a spending bill for the federal Department of Labor that includes a line preventing any funds from being used to implement the new rule.

“To cut the funding from MSHA, an organization that already has very limited funding in the first place, is a travesty to all miners out there,” Bates said.

According to Policy and Advocacy Associate with the Appalachian Citizens Law Center, Brendan Muckian-Bates, MSHA’s Coal Mine Safety and Enforcement program has already lost about half its staff over the last decade.

“One of the challenges that MSHA faces is they’ve never been funded at the appropriate level, the level that they have requested of Congress,” Muckian-Bates said. “In fiscal year 2023 for example, the agency requested over $423 million, and that year received just shy of $388 million. And this is a real challenge that the agency has, because with the new silica dust rule, certainly there will be a need for more mine safety and health inspectors, who are already overworked, who already have to travel and conduct appropriate inspections and make sure, obviously, that the health and safety of miners is taken care of.”

Sam Petsonk is an Oak Hill-based lawyer who practices employment law and represents miners seeking black lung benefits. He said the rule would benefit the coal industry and coal mining by saving money and lives.

“The silica rule is 30 years overdue, and this administration has implemented it, and the Republicans in Congress are trying to repeal that new rule legislatively, by defunding the agency,” Petsonk said.

Some miners and their advocates are also dubious about relying on mine operators to tell MSHA about increases in dangerous dust.

“Our concern is that, if left to their own devices, operators will find another way, another loophole around this silica dust rule, and miners will continue to be exposed to dangerous levels of silica dust,” Muckian-Bates said.

But Williamson said he’s already heard from mine operators who, because of the new rule, are evaluating their mines to get ahead of things.

“We’re moving full steam ahead to implement this rule,” Williamson said. “So unless there’s, you know, a law that’s passed that tells me that I cannot do that, or there’s a court that, you know, put something in place, like an injunction, or issues an injunction that says I can’t, we’re moving full steam ahead. And we’ve asked everybody in the mining community, labor industry, everybody to come together and really do what’s right, and all of us to focus on protecting, you know, miners’ health.”

Since the fate of the new rule is now in the hands of the U.S. Congress, West Virginia Public Broadcasting reached out to all the state’s federal lawmakers to learn where they stand.

Replying by email, Sen. Joe Manchin’s office said they could not say anything on the record about the new rule or its implementation.

Also by email, Sen. Shelley Moore Capito said, “The safety of miners’ health is paramount,” and noted that the Senate version of the bill would actually increase funding for MSHA, not cut it, like the House version.

Representatives Carol Miller and Alex Mooney did not respond to our request for comment.

“I have full confidence that the Senate Democratic Caucus will prevent the Republicans from blocking this new silica rule,” Petsonk said. “But you know, if control of the Senate changes in the next year, this rule may be in jeopardy.”

Editor’s Note: This story is part of a series we’re calling “Public Health, Public Trust,” running through August. It is a collaboration with the Global Health Reporting Center and is supported by the Pulitzer Center.

How A Reporter’s Investigation Of Appalachia’s Black Lung Epidemic Pushed Federal Officials To Respond

Miners are suffering from an advanced version of black lung disease known as progressive massive fibrosis. It’s the result of digging at increasingly thin coal seams. That means they’re also cutting into quartz, which creates silica dust. Advanced black lung results from breathing in that blend of silica and coal dust.

Updated on Oct. 10, 2023 at 11:30 a.m.

This story originally aired in the Oct. 8, 2023 episode of Inside Appalachia.

The coal-producing regions of central Appalachia are at the center of an epidemic of advanced black lung cases among coal miners. New reporting by a retired NPR reporter has shown how federal officials underestimated the sheer number of cases across West Virginia, eastern Kentucky and southwestern Virginia, and now regulators seem to be responding.

Miners are suffering from an advanced version of black lung disease known as progressive massive fibrosis.

It’s the result of digging at increasingly thin coal seams. That means they’re also cutting into quartz, which creates silica dust.

Advanced black lung results from breathing in that blend of silica and coal dust.

Retired NPR reporter Howard Berkes has been covering this story for years.

He worked with NPR and the PBS series Frontline, and spent more than a year investigating fears that federal regulators and mining companies were failing to protect coal miners from toxic dust.

He and his team obtained documents and data showing federal mine safety officials had evidence of the danger dating back more than 20 years, but never addressed it.

Howard Berkes spent 38 years as an NPR Correspondent. His investigative reporting exposed an epidemic of advanced black lung disease affecting thousands of coal miners, and decades of failure of federal regulators to take steps to prevent it.

*Credit: Wanda Gayle*

In 2018, Berkes reported that more than 2,000 miners were dying of illness related to that toxic dust. Since that story aired, at least four of the miners in it who appeared have died, and at least two have received double-lung transplants. Danny Smith, who was prominently featured, is being assessed for a double-lung transplant.

Danny Smith spent just 12 years mining coal in eastern Kentucky and was diagnosed with the advanced stage of black lung disease at 39. Both are shocking numbers because it used to take decades of mining for coal miners much older to get as sick as this.

*Credit: Elaine McMillion Sheldon/PBS Frontline*

Lately, the metallurgical coal industry has been ramping up production to meet global demand, and experts predict even more advanced black lung cases will appear. After years of inaction, though, federal officials are addressing the issue.

Over the summer, the Mine Safety and Health Administration proposed a rule intended to protect coal miners from exposure to silica dust. By the time the comment period closed in September, the draft rule had attracted 157 comments.

Now, Berkes is part of a new investigation into advanced black lung cases that was co-published by Public Health Watch, Louisville Public Media and Mountain State Spotlight. Inside Appalachia Host Mason Adams spoke with Berkes about what his team found.

The New Beginnings Pulmonary Rehab Clinic in South Williamson, Kentucky, features photos of coal miners with advanced black lung disease, including those who have not survived.

*Credit: Elaine McMillion Sheldon/PBS Frontline*

The transcript below has been lightly edited for clarity.

Adams: So your work in the past, your investigations have in the past have seemed to have resulted in some action. Now MSHA has proposed some new regulations for monitoring silica dust.

Berkes: Yeah, MSHA has taken two very significant steps in this proposed rule. One is to make the exposure limit for silica dust twice as tough as it has been. That was recommended by the National Institute for Occupational Safety and Health back in 1974, and it was recommended again by the Labor Department’s own mine dust advisory committee in 1996.

It’s taken all these years for MSHA to finally adopt what has been long recommended, this tougher limit to exposure to silica dust. That’s a major, major improvement. The second thing that they did is that they decided to regulate overexposure to silica dust directly. In the past, they applied a complicated formula: If a mining company had too much silica dust, then the mining company had to lower the amount of overall mine dust, coal dust and silica dust in the air. That was supposed to bring down the silica dust exposure to an acceptable level. But it’s not a one-to-one relationship.

What we found in our previous investigation was 9,000 overexposures to silica dust, even after the mining companies responded to the regulation that was in effect at the time. So now MSHA is directly regulating silica dust. There can be citations and fines associated with exceeding the silica dust level, that has never happened in the past. So those are two very promising elements of this proposed rule.

This slogan appeared in a Department of Labor document warning about silica dust exposure in workplaces, including mines, in 1997, 26 years before the Mine Safety and Health Administration proposed tougher restrictions on exposure to silica dust.

*Credit: Mine Safety and Health Administration*

Adams: There have also been some criticisms of the proposed rule as well.

Berkes: Yeah, mostly on enforcement and oversight. There really is no regular oversight built into the rule. The rule requires mining companies to conduct an enormous amount of sampling of dust, and to record the results of those samples. If they show that there’s overexposure to silica dust, the rule requires that the mining companies then make changes in the way they’re mining so that the silica dust is reduced. There are various things that can be done: they can increase the ventilation, they can make sure that their water sprays on the mining machines are working properly. Those are two key elements in managing dust in coal mines. They can slow down the mining machines and not mine so quickly. They can stop mining a seam that has so much quartz in it. Those are all things that mining companies are required to do once there’s excessive dust. And while they’re doing those things, they’re allowed to continue to mine.

They’re allowed to let miners continue to work in what are dangerous levels of dust. But miners must wear respirators; that has its own set of problems. We’ve interviewed dozens and dozens of miners since 2016, and they all complain about the dust masks not working properly clogging up, inhibiting their breathing, getting too hot, inhibiting their ability to communicate with fellow miners in a very dangerous environment.

There are new helmets out that are very effective for protecting miners from dust, but they can block vision and can block communication in ways that can become dangerous in a coal mine. The main problem with all of this is that MSHA is not going to be watching all the time. Mine inspectors only go into coal mines four times a year, and they’ll do their own sampling when they’re in there. They can ask to see the results of the sampling the mining companies have done. But what this means is that most of the time, there will be no Mine Safety and Health Administration oversight and enforcement of this new rule. It’ll be up to the mining companies. And as coal miner after coal miner after coal miner who we’ve interviewed over the years will tell you, some mining companies have conducted fraudulent sampling over the years. As recently as last year, there was a criminal prosecution in Kentucky for fraudulent dust sampling.

A display at the National Institute for Occupational Safety and Health in Morgantown, West Virginia shows how much damage results from exposure to coal and silica dust.

*Credit: Howard Berkes/NPR*

Adams: MSHA has been collecting comments on these proposed rules and they’ve been hearing from miners and advocates in the coal industry. By the time this segment airs, that comment period will have come to a close. But in the last few days, Public Health Watch has published a new investigation with Louisville Public Media and Mountain State Spotlight that calls into question some of MSHA’s projections on which it’s basing this rule. Can you tell us a little bit about that investigation and what your team found?

Berkes: Sure. One of the things that really struck me in the very extensive and dense document that MSHA has produced to justify what it wants to do, is they project how many lives will be saved, and how much disease will be avoided if this new rule is permitted to take effect. What really shocked me was that the projection for coal mines was 63 deaths avoided over 60 years — a little more than one a year — and 244 cases of black lung disease avoided over 60 years. That just doesn’t make sense, given how much disease has actually occurred, which MSHA never mentions in its document. And so we calculated how much disease has occurred by continuing our survey of black lung clinics — both independent clinics and clinics that are funded by the federal government.

What we found, which MSHA doesn’t mention, is that in just the last five years, there have been 1,500 new cases of progressive massive fibrosis, the advanced stage of black lung disease, as reported by these clinics. The total since 2010, since that’s as far back as we go in our survey of clinics, is over 4,000 cases of this horrific, fatal disease. There is no cure. We also, by the way, looked at how many excessive exposures there have been in coal mines in recent years. At the new limit — say the new limit was in place since 2016 — we found over 5,000 excessive exposures at the new limit.

So what these numbers sort of provide is a sense of how serious this situation is, how much over exposure continues to occur, and how much disease continues to occur. That’s not in this proposed rule making. In fact, the numbers presented for silica dust exposure since 2016 by the Mine Safety and Health Administration, they just have numbers from 2016 to 2021. They don’t report how many excessive exposures there were in this document. They report that there were 93 percent of exposures that were within the limit. Well, that sounds like a great number, 93 percent. It sounds like, “Oh, things aren’t so bad.” But that other 7 percent represents more than 5,000 excessive exposures. And because this is such a toxic substance, that’s a lot of potential disease and death. You got to understand that for proposed rule making that this process involves.

Federal Mine Safety Chief Christopher Williamson addresses a crowd gathered in Arlington, Virginia, on Aug. 3, 2023, for a public hearing on proposed silica dust regulations. Williamson is the first mine safety chief to directly address overexposure to toxic silica dust.

*Credit: Justin Hicks/Louisville Public Media*

So right now, it’s proposed, you mentioned that there’s this comment period that has taken place, that the industry and the public and mine safety advocates and miners get to comment on it. Before there’s a final rule, the Department of Labor has to approve whatever the final rule might be. The Office of Management and Budget has to approve this final rule. We’ve got an election year coming up. There’s often sensitivity from the White House and the Office of Management and Budget on anything that might make voters not vote for candidates that the administration supports or might not vote for the president again, if there’s something in this that offends them.

I’ve seen this happen in the past, where regulatory action was stalled in order to hold off until after an election. There may be other reasons that there could be concerns or objections, budget-wise or otherwise, from the impact on the industry. So it’s important, if you’re going to state your case, to state it as strongly as possible. This rule making does not state that case as strongly as possible. There may be lawsuits from the mining industry over this. So it’s puzzling to me why they didn’t do that. When we asked the Mine Safety Administration, they said, “The comment period exists so that people can tell us what we might need to do better. And this will be one of the things that we consider if people comment on this.

Adams: It’s mind-blowing to think that this represents thousands of people. And behind each of these numbers is a human being. You’ve interviewed dozens of these miners. What have you taken away from those interviews that’s not necessarily reflected in the data?

Berkes: I want to point out that every one of those miners had progressive massive fibrosis. We interviewed miners who had the worst stage of disease. One of the things they all talked about was what their prospects were for the future. Many of them watched fathers, brothers, uncles, grandfathers die of black lung disease, and so they know what they face. This is a tragedy that strikes generations and families: Fathers that won’t see their kids grow up. Fathers that won’t see their daughters at their weddings, won’t see high school graduations. And actually, it’s not just men, there are women miners with this disease as well.

The tragic nature of this is just so astounding and moving and deep. When you talk to a miner with severe disease at advanced stages, they can hardly get a sentence out without coughing or without having to pause for very deep breaths. A miner in my story, Danny Smith, who was diagnosed at 39, he’s 51. Now, he has his grave site picked out. I tried to call him in the last couple of weeks, and his breathing is so labored, he said he can’t get through a phone call. So we were communicating by text message.

Lungs riddled with fibrotic tissue from complicated black lung disease are displayed in the office of radiologist Dr. Brandon Crum in Pikeville, Kentucky.

*Credit: Elaine McMillion Sheldon/PBS Frontline*

Danny was featured in our 2018 story. We’ve been in communication since then. And he’s in terrible shape, and it’s so bad. He loved coal mining, but it’s so bad. He said now he wishes he never stepped foot in the mine. And this was a job he loved. It was a job that made a good life for him and his daughters. He’s a single parent. And there’s an enormous amount of regret, of buying into this bargain of a great life for mining coal. You know, part of what I don’t understand is, in any other workplace in our country, if you had thousands and thousands of people who were sick and dying from a disease, there would be outreach, and there would be response, and there would be response quicker than what has come.

I don’t know why people don’t seem to care about coal miners. There are 40,000 coal miners still working today. I don’t know what it takes to get a response that gets this going in a way that really protects and helps coal miners. But they are people like you and me who have done a job to make lives better for their families. They’re caught up in this whole thing and it’s killing a lot of them.

Retired coal miner Roy Keith undergoes a spirometry test at the New River Health Clinic in Oak Hill, West Virginia as part of the process of measuring lung capacity and diagnosing the onset of black lung disease.

*Credit: Allen Siegler/Mountain State Spotlight*

Adams: Howard Berkes, thank you for your important work on this topic. This is an important subject that has such a deep, deep impact here in central Appalachia. Thanks for coming on Inside Appalachia and speaking with us about it.

Berkes: Always a pleasure to be with you.

A statue at the courthouse in Grundy, Virginia, honors the coal miners of Buchanan County.

*Credit: Howard Berkes/NPR*

——

After the Public Health Watch/Louisville Public Media/Mountain State Spotlight investigation documenting thousands of advanced black lung cases was published in August, mine safety advocates and Congress members cited it in comments to MSHA about its proposed silica dust rule.

MSHA responded with a statement that said the agency was considering “suggestions that the [proposed rule] underestimates the benefit” as it develops a final version of the rule.

***Editor’s Note: The U.S. Mine Safety and Health Administration collected 157 comments on its proposed silica dust rule. A previous version of this story misstated the number of comments the agency received.