Study Finds Hundreds of Black Lung Cases in Appalachia

February 12, 2018

A new research letter published in a medical journal details hundreds of cases of black lung disease in the Central Appalachian coalfields.

Three clinics in southwestern Virginia identified 416 coal miners with the disease from January 2013 to February 2017, according to the study published recently in the Journal of the American Medical Association. Of those, 157 lived in eastern Kentucky, it said.

The Lexington Herald-Leader reports that the study provides further evidence that progressive massive fibrosis, commonly called black lung, has surged in recent years among coal miners in Central Appalachia.

“It’s shocking and it shouldn’t be happening,” said Scott Laney, one of the authors of the study and a researcher with the National Institute for Occupational Safety and Health.

Most of the miners identified in the study were retired and had worked in mines for more than 25 years. But more than 20 percent worked for 10 to 20 years before being diagnosed.

The study “provides a lot of credence to what we’ve been saying now for almost a decade, which is this is a very serious problem,” Laney said.

Progressive massive fibrosis is an irreversible disease caused by inhaling dust created during coal mining. The dust scars the lungs, making it difficult to breathe and often leading to premature death. Because progressive massive fibrosis can take years to develop, new cases will continue showing up for years, Laney said.

“We can’t just turn this tap off,” he said.

For Henry Yonts, the first signs of black lung became noticeable about a year after he retired in 2009 from a 32-year career working in underground coal mines.

Yonts, of Letcher County in Kentucky, noticed he became quickly exhausted when walking up hills during hunting trips.

“Years ago I could walk to the top of the mountain,” he said.

Yonts said he was officially diagnosed with black lung in 2013. He now uses an inhaler in the mornings and evenings, and needs to rest more frequently when playing with his grandchildren.

The level of dust in the mines during his last 10 years was significantly better than when he started in 1977, Yonts said.

“The companies I worked for, they done the best they could do,” he said. “It’s just a hard thing to keep down, you know, I mean 100 percent down.”

Congress passed legislation in 1969 requiring coal companies to reduce the amount of dust inhaled by miners in hopes of eradicating the disease. By some measures, the effort was largely successful.

By the late 1990s, the Coal Workers’ Health Surveillance Program, a federal initiative to record levels of progressive massive fibrosis, rarely found miners afflicted with the disease, according to the study.

But in the 2000s, the disease started to reemerge, according to a 2012 report in the American Journal of Public Health.

In 2016, a report showed a single radiologist in Pike County, Kentucky, had identified 60 cases, the majority from Pike, Knott, Floyd and Letcher counties in eastern Kentucky.

NOISH estimates more than 76,000 miners have died from progressive massive fibrosis since 1968.

Laney said NIOSH is working to create the first concise database that shows the full scope of the disease’s impact.

Evan Smith, an attorney with the Appalachian Citizens’ Law Center in Whitesburg, Kentucky, who represents miners seeking black-lung benefits, said a number of factors have likely led to the increasing prevalence of the disease.

“I think what we’re seeing now really is a remnant of the `90s and 2000s,” Smith said.

Those factors include longer shifts that cause miners to inhale more dust; the mining of thinner coal seams, which requires cutting through more sandstone rock that creates a more harmful dust; and the use of heavier equipment, which churns up more dust.

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