U.S. Department Of Labor To Hold Black Lung Benefits Educational Events

West Virginians with black lung will have the opportunity to learn about eligibility for benefits at upcoming educational events.

West Virginians with black lung will have the opportunity to learn about eligibility for benefits at upcoming educational events. 

Events held in Fairmont and Madison from March 19-21 will allow current and former coal miners suffering from black lung to get assistance with filing or refiling claims and receive eligibility information.

According to the U.S. Department of Labor, there are currently 4,200 people receiving program benefits in West Virginia.

The events are hosted by the U.S. Department of Labor’s Federal Black Lung Program.

“The U.S. Department of Labor encourages current and former coal miners, and survivors in these areas to attend one of these events to learn more about eligibility for benefits under the Black Lung Benefits Act,” said Division of Coal Mine Workers’ Compensation Director Mike Chance. “Attendees can get assistance with filing or refiling claims and get information on eligibility and the adjudication process.”

The events are open to the public and do not require preregistration to attend.

The events will be held as follows:

  • March 19 – Marion County Public Library, 321 Monroe Street, Fairmont, W.Va. from 9:30 a.m. to 6:30 p.m.
  • March 20 – Boone Madison Public Library, 375 Main Street, Madison, W.Va. from 11 a.m. to 4:45 p.m.
  • March 21 – Boone Madison Public Library, 375 Main Street, Madison, W.Va. from 9 a.m. to 4:45 p.m.

For more information and assistance on submitting any bills for black lung related medical treatment, services or medical supplies, contact the Federal Black Lung Program at 1 (800) 347-2502.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.

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.

The Rise Of Advanced Black Lung, Inside Appalachia

This week on Inside Appalachia, black lung disease is back. In fact, it never went away. Now, younger and younger miners are living with a particularly nasty form of black lung disease. Regulators and the coal industry have known about the problem for decades — but they’ve been slow to respond. One reporter asks, “What would happen if thousands of workers in any other industry got sick and died just because of where they worked?”

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

Black lung disease is back. In fact, it never went away. Now, younger and younger miners are living with a particularly nasty form of black lung disease. 

Regulators and the coal industry have known about the problem for decades — but they’ve been slow to respond. 

One reporter asks, “What would happen if thousands of workers in any other industry got sick and died just because of where they worked?” 

This week, we’re talking about the black lung epidemic, Inside Appalachia.

In This Episode:


Advanced Black Lung Cases Rising

The blackened lungs of a coal miner who received a transplant at age 60.

Credit: Mine Safety and Health Administration

Advanced black lung is rampant across the coal-producing regions of central Appalachia, in West Virginia, eastern Kentucky and southwestern Virginia. 

This is different from simple black lung, which is debilitating, but advanced black lung is known as progressive massive fibrosis. It’s the result of miners digging at increasingly thin coal seams. To get at the coal, they cut into quartz, which creates silica dust. 

Breathing the mix of silica and coal dust is much more destructive, and like simple black lung, there is no cure. 

Advanced black lung has been documented for decades, but it’s getting new attention from federal officials. 

As part of our special program, we aired a 2018 NPR segment with Howard Berkes, where he met with dozens of Appalachian miners with advanced black lung disease.

Federal Regulators Are Crafting New Rules

Most coal production has been declining for years, but the metallurgical coal industry has been ramping up production to meet global demand. With increased demand, experts predict more cases of black lung. 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.

WVPB’s Emily Rice reported.

Recent Investigations Into Black Lung

Howard Berkes has continued to report on advanced black lung, even after retiring from NPR. Recently, he helped lead a new investigation into advanced black lung cases, co-published by Public Health Watch, Louisville Public Media and Mountain State Spotlight.

Mason Adams spoke with Berkes about what they found. 

——

Our theme music is by Matt Jackfert. Other music this week was provided by John Hurlbut and Jorma Kaukonen, Tim Bing, June Carter Cash and Steve Earle.

Bill Lynch is our producer. Zander Aloi is our associate producer. Our executive producer is Eric Douglas. Kelley Libby is our editor. Our audio mixer is Patrick Stephens.

You can send us an email: InsideAppalachia@wvpublic.org.

You can find us on Instagram, Threads and Twitter @InAppalachia. Or here on Facebook.

Sign-up for the Inside Appalachia Newsletter!

Inside Appalachia is a production of West Virginia Public Broadcasting.

***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.

A New Investigation Into Black Lung And Our Song Of The Week, This West Virginia Morning

On this West Virginia Morning, advanced black lung disease, or progressive massive fibrosis, affects miners who breathe in quartz rock dust. A new investigation looks into advanced cases.

On this West Virginia Morning, advanced black lung disease, or progressive massive fibrosis, is rampant across coal country. It’s caused when miners breathe in quartz rock dust as they try to get at seams of coal. Inside Appalachia Host Mason Adams recently spoke with Howard Berkes about a new investigation into advanced black lung cases he helped lead that was co-published by Public Health Watch, Louisville Public Media and Mountain State Spotlight.

Also, in this show, our Mountain Stage Song of the Week comes to us from world-renowned jazz singer and guitarist John Pizzarelli. We listen to his performance of “I Want to Be Happy.”

West Virginia Morning is a production of West Virginia Public Broadcasting which is solely responsible for its content.

Support for our news bureaus comes from Shepherd University.

Our Appalachia Health News project is made possible with support from CAMC and Marshall Health.

West Virginia Morning is produced with help from Bill Lynch, Briana Heaney, Caroline MacGregor, Chris Schultz, Curtis Tate, Emily Rice, Eric Douglas, Liz McCormick, and Randy Yohe.

Eric Douglas is our news director. Caroline MacGregor is our assistant news director and producer.

Listen to West Virginia Morning weekdays at 7:43 a.m. on WVPB Radio or subscribe to the podcast and never miss an episode. #WVMorning

Black Lung Health Fair Held In Oak Hill

A free health fair on Tuesday gave the community of Oak Hill the opportunity to be tested for black lung disease.

The New River Health Association hosted the National Institute of Occupational Safety and Health (NIOSH) mobile health bus to offer free screenings for black lung on Tuesday.

“NIOSH is here doing a free service,” said Lisa Emery, Breathing Center director at the New River Health Association’s Black Lung Clinic. “And we’re really excited because the numbers of black lung are skyrocketing here in Appalachia. So we want to take care of our coal miners.”

In addition, miners had the opportunity to register for state and federal benefits with the assistance of a benefits counselor.

“As far as your benefits go, we’re going to educate you on how to file state claims,” Emery said. “There’s definitely time limits with state claims. And we don’t want you to miss out on any opportunities to file your federal or your state black lung claim.”

According to Emery, one in five coal miners develops complicated pneumoconiosis, and younger coal miners are getting black lung earlier than ever before.

“It’s no longer your grandfather’s disease,” Emery said. “It’s no longer your husband’s disease. It’s your son’s disease, too, because younger and younger coal miners are developing this.”

“We hear a lot about miners who are in their 20s,” said Cindy Whitlock, director of School Health at New River Health Association.  “I think the youngest patient we have ever had is 33. And, it’s one of those West Virginia things. It just seems to be pervasive in every family. It doesn’t matter who you talk to, you’ve got somebody in your family that has black lung.”

Whitlock said the convenience of the resources available at the fair could be life-changing for someone with black lung.

“I think having a one-stop easy, you know, come in and when you leave, it’s done,” Whitlock said. “I think that’s very exciting, even though it’s a sad state of affairs to see this many people at these various ages affected by black lung.”

Roger James is a retired coal miner diagnosed with black lung. He does pulmonary rehab at New River Health and said the clinic motivates him to stay active.

“It motivates me to be able to come out and do the exercising that I do, because when you lay around, your body deteriorates quickly,” James said. “So you need to stay active, and when you cannot breathe, it’s hard to stay active because you get frustrated. Really easy. So it means a lot to just be able to get out and do for yourself.”

According to Emery, in total, black lung benefits counselors were able to help 53 miners fill out their federal black lung applications. In addition, NIOSH performed breathing tests and black lung x-rays on 86 miners and New River Health did five breathing tests on patients who came in curious about their breathing and interested in the pulmonary rehab program.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Rare Cancers In PA Community And Health Fair Tests For Black Lung On This West Virginia Morning

On this West Virginia Morning, a free health fair Tuesday offered the community of Oak Hill the opportunity to be tested for respiratory problems and black lung disease.

On this West Virginia Morning, a free health fair Tuesday offered the community of Oak Hill the opportunity to be tested for respiratory problems and black lung disease. Emily Rice has more.

Also, in this show, at a recent public meeting in Washington County, Pennsylvania, scientists from Pitt announced they had found a link between fracking and some serious health effects. But some in the crowd wanted the study to tell them more about why children in their community have gotten rare cancers. The Allegheny Front’s Reid Frazier reports.

West Virginia Morning is a production of West Virginia Public Broadcasting which is solely responsible for its content.

Support for our news bureaus comes from Concord University and Shepherd University.

Eric Douglas is our news director and produced this episode.

Teresa Wills is our host.

Listen to West Virginia Morning weekdays at 7:43 a.m. on WVPB Radio or subscribe to the podcast and never miss an episode. #WVMorning

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