This week, a poet and musician draws inspiration from a distant family connection to the Grand Ole Opry’s Little Jimmy Dickens. Also, for 15 years, a Virginia library has been hosting a weekly Dungeons & Dragons game for teens.
And, a taxidermist in Yadkin County, North Carolina found her calling before she could drive a car.
A makeshift billboard depicting a miner working in a “low coal” mine shaft greets drivers leaving Fleming-Neon, Kentucky.Photo Credit: Justin Hicks/Louisville Public Media
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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:
Looking Back At The Rise of 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.
Mason Adams spoke with Berkes about what they found.
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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.
On this West Virginia Week, another round of school consolidations in the state, the Republican caucus lays out plans for the upcoming legislative session and a Nashville poet and songwriter channels a connection to LIttle Jimmie Dickens.
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This week, a poet and musician draws inspiration from a distant family connection to the Grand Ole Opry’s Little Jimmy Dickens. Also, for 15 years, a Virginia library has been hosting a weekly Dungeons & Dragons game for teens.
And, a taxidermist in Yadkin County, North Carolina found her calling before she could drive a car.
A lot of people who came of age listening to the Grand Ole Opry know Little Jimmy Dickens. With his clever songs and his rhinestone-studded outfits, the West Virginia native influenced a generation of performers. Now he’s remembered in a new book of poetry.
For some Americans, this year’s political earthquakes hit close to home. Trey Kay reflects on federal budget cuts, the elimination of programs and agencies and the resulting layoffs of hundreds of thousands of workers. 2025 was also a year highlighting escalated immigration enforcement, and the deployment of National Guard troops in U.S. cities. One of those missions resulted in the tragic loss of a West Virginia National Guard soldier. On this end-of-year episode of Us & Them, we examine how today’s culture-war battles are reshaping the nation’s foundation.