Black Lung: The Appalachian Coal Miners’ Worst Nightmare

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PHOTO: A miner at the Black Lung Laboratory in the Appalachian Regional Hospital in Beckley, West Virginia, is having his lung capacity tested to determine whether he has the disease. Blood samples also are taken and his heartbeat is monitored while walking on a treadmill. These and other known testing methods are used to determine if miners have coal dust particles in their lungs which cause a progressive shortness of breath. Coutesy EPA.
PHOTO: A miner at the Black Lung Laboratory in the Appalachian Regional Hospital in Beckley, West Virginia, is having his lung capacity tested to determine whether he has the disease. Blood samples also are taken and his heartbeat is monitored while walking on a treadmill. These and other known testing methods are used to determine if miners have coal dust particles in their lungs which cause a progressive shortness of breath. Courtesy EPA.

I am the grandson of a West Virginia coal miner I never had the opportunity to meet.  My mother and grandmother tell me that he was strong, proud and tough.  A man among men in the coalfields of southern West Virginia.  Mountaineer proud.

Sadly, this man whom I have seen only in pictures and heard only through the voices of my relatives’ stories and memories of happier days was no match for the most dreaded nightmare of every Appalachian coal miner — not a mines collapse or entrapment, but rather coal workers’ pneumoconiosis, known in our parts simply as “black lung”.

As if crouching under a million tons of Appalachian bedrock ready to drop without a moment’s notice wasn’t bad enough for early miners, their lot in life also had them unwittingly destroying the insides of their bodies one deep breath at a time.

With constant blasting, picking, hammering and shoveling, the insides of mines were extraordinarily dusty and though the hazard all this dust created for explosions was quickly realized, would take generations for medical professionals to fully appreciate the affects this same loose dust was having on the lungs of miners.

It was not until a decade following World War II did the healthcare industry truly begin to grasp the severity that accompanied prolonged exposure to coal dust and by then, sadly, it was simply too late for thousands of miners and their families.

Much like silicosis from inhaling silica dust and long-term smoking attack the lungs, one microscopic needle at a time, inhaled coal dust progressively builds up in the lungs and can neither be removed from the body or destroyed.

The early tale tell signs of black lung was a persistent cough which could last from months to years.

Interestingly, the rise in miners suffering from black lung came as a direct result of advances in technology and mining equipment.

As mines rapidly mechanized and large machines were brought in to grind and drill coal, so too did the prevalence of black lung symptoms.

It has been said that the miners’ union, the United Mine Workers of America, realized these side effects of mechanization, but under John L. Lewis decided not to raise the black lung issue because it might impede the mechanization that was producing higher productivity and higher wages. Union priorities were to maintain the viability of the long-fought-for welfare and retirement fund, which would be sustained by higher outputs of coal. After the death of Lewis, the union dropped its opposition to calling black lung a disease and realized the financial advantages of a fund for its disabled members.

In the Federal Coal Mine Health and Safety Act of 1969, the US Congress set up standards to reduce dust and created the Black Lung Disability Trust.

The mining companies agreed to a clause, by which a ten-year history of mine work, coupled with X-ray or autopsy evidence of severe lung damage, guaranteed compensation. Equally important was a “rate retention” clause that allowed workers with progressive lung disease to transfer to jobs with lower exposure without loss of pay, seniority, or benefits. Financed by a federal tax on coal, the Trust by 2009 had distributed over $44 billion in benefits to miners disabled by the disease and their widows. A miner who has spent 25 years in underground coal mines has a 5–10% risk of contracting the disease.

Thanks to Congressional action in 1969, the percentage of American miners suffering from black lung disease decreased by about 90 percent.

According to Smithsonian, On-the-job mine safety has improved drastically in recent decades, with deaths due to accidents now counted in the tens, not hundreds, as they were in the 1970s and 80s. Long-term health, however, is a different story. As the administration seeks to fulfill the campaign promise to send miners in coal country back to work, black lung has made a comeback. Today, the disease sickens roughly 1 in 14 underground miners with more than 25 years experience who submit to voluntary check ups—a rate nearly double that from the disease’s lowest point from 1995 to 1999.

Even more worrisome, the disease is striking miners earlier and in a more deadly form than ever before. Though experts are still working out the causes for the rise in disease, many believe it is a combination of both longer hours on the job and new methods of rock extraction.

“Most of us studied these diseases in medical school, but were under the impression that they were relics of a bygone age,” writes Robert Cohen, a pulmonologist at the University of Illinois who specializes in black lung, in an editorial for the British Medical Journal last year. “We believed that modern mining technologies and dust controls, which have been in place for decades, had eliminated this scourge. We were wrong.”

As Appalachia’s miners are now enjoying the opportunity to work again, may we never forget just how dangerous this proud profession truly is — even in 2018.

Like articles like this? Then you would love Appalachian Magazine’s Mountain Voice: 2017: A Collection of Memories, Histories, and Tall Tales of Appalachia!  Click here to check out the book on Amazon!

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