A new research letter published in the Journal of the American Medical Association details a cluster of black lung disease in Central Appalachia that researchers believe is the largest ever recorded.
The study, published Tuesday, said three clinics in southwest Virginia identified 416 coal miners with the deadly disease from January 2013 to February 2017. Of those, 157 lived in Eastern Kentucky.
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.
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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.
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 just 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.
Because progressive massive fibrosis can take years to develop, new cases will continue showing up for years, he said.
“We can’t just turn this tap off,” Laney 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, 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.
In 2016, a report showed a single radiologist in Pike County had identified 60 cases, the majority from Pike, Knott, Floyd and Letcher counties.
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.
The database will gather information from a number of sources, including clinics that provide X-Rays to miners as part of a federal surveillance program, lung transplant data and death certificates.
Evan Smith, an attorney with the Appalachian Citizens’ Law Center in Whitesburg 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; cheating on the reporting and enforcement of dust-related rules; and the use of heavier equipment, which churns up more dust.
Smith said new regulations created in 2014 and largely put into effect in 2016 may help curb the prevalence of the disease, but he said it is too early to tell if the regulations will be successful.
The new rules include a lower limit on the permissible level of dust, and require miners to wear personal dust monitors, which tell them how much dust is currently in the mine.
According to the latest study, between April 2016 and June 2016, 99 percent of operator-provided samples from mines were in compliance with the new rules.
“I’m hopeful that they will be effective,” Stephen Sanders, director of the Appalachian Citizens’ Law Center, said of the new regulations.
He also said they were “way overdue.”
Yonts is more circumspect. The regulations may help, but there will always be dust in a coal mine, he said.
“That’s just the way the job was,” he said.