The New Generation of Black Lung


For many years we thought that black lung was a disease of the past. But it has actually stricken a whole new generation of miners, and in some ways, it’s worse than before. 

In 2016, an investigation by NPR investigative reporter Howard Berkes discovered a surge in black lung cases throughout Appalachia, and now federal officials are confirming those results for the first time, in the Journal of the American Medical Association.

This week we’ll dive deep into what some are calling a black lung epidemic in central Appalachia and hear from miners battling the disease and doctors trying to understand it.

In this episode, we’ll hear from Robert Bailey, a retired coal miner from Mercer County, West Virginia who suffers from black lung. West Virginia Public Broadcasting first met him in 2014, a year before he underwent a double-lung transplant the next year, an operation paid for through a federal fund that covers black lung medical benefits for bankrupt coal companies. We’ll hear how Robert Bailey’s health is today.

We’ll also hear the tale of two miners: Jerry Helton and Edward Brown. Both men contracted severe black lung disease from working in mines in southwestern Virginia. But as Benny Becker reports, they’ve experienced very different outcomes.

The reality, as NPR reported, is that black lung has long been severely underreported. Some close to the disease, including Anita Wolfe, who works for the Coal Workers Health Surveillance Program at National Institute of Occupational Health and Safety, noticed its resurgence as early as the late ‘90s — namely in miners in their late 30s and early 40s.

When we talked to her more than a decade ago, she said that X-rays in the late 90s showed “younger miners progressing from beginning stages of the disease to the advanced stage of the disease … at a very accelerated rate. Much quicker than we’ve ever seen before.”

Doctors have developed theories on what might be causing the recent uptick, and we’ll hear from them too. They think cutting through rock to get to remaining coal in an area where thick coal seams were already tapped might be to blame.

“Rock can contain high levels of silica, and we all know that silica is incredibly toxic when inhaled, and mixtures of coal dust and silica dust are probably playing an important role in some of the trends that we’ve seen recently,” Dr. David Blackley, a public health researcher, told WBUR’s Here and Now in WHEN.

And Inside Appalachia host Jessica Lilly will close the episode with a personal essay. For her, the illness hits close to home: It affected her grandfather and Nick McCroskey, her childhood classmate who died in the Upper Big Branch mine disaster. An autopsy revealed that McCroskey had black lung.

“He was younger than me. These miners have been dying for years. But it took an NPR investigation to get federal officials and the national medical community to pay attention,” she said. “So let’s hope this is a wakeup call, and nobody else’s friends or papaws suffer or die such a horrible death.”

We had help producing Inside Appalachia this week from NPR’s All Things Considered, WBUR’s Here and Now, the Ohio Valley ReSource,  and WMMT.

Music in this episode was provided by Lobo Loco, Anna and Elizabeth, Stacy Grubb, and Dr. Turtle.

Inside Appalachia is a production of West Virginia Public Broadcasting. Scott Finn edited this episode. Patrick Stephens is our audio mixer. Jesse Wright is our executive producer. 

We’d love to hear from you. Find us on Twitter — @inappalachia, or email