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Making an Unwanted Comeback: Black Lung

Wednesday, July 11th, 2012

If you have heard of black lung disease, you may think of it as one of those “old time” diseases, like smallpox or polio, that’s not a problem any more. Or, you might associate it with coal mines of generations ago, not with modern mining.

However, it seems the bad old days are back, and so is black lung disease.

Coal workers’ pneumoconiosis is called “black lung disease” because it actually turns lungs black. When coal workers breathe in coal dust it can accumulate in the lungs. If the accumulation is severe enough the coal causes lung impairment, disability, and death.

Although coal miners always have been at risk for black lung, the problem became worse in the 20th century as new mechanized drills stirred up more dust. By mid-century, about half of miners who worked with coal for 25 years or more developed black lung.

Still, it wasn’t until the 1950s that the connection between coal dust and black lung was suspected. Then in the 1960s medical researchers carefully studied afflicted mine workers to determine exactly why they were getting sick. The researchers determined that if miners could be protected from breathing coal dust, they wouldn’t develop black lung.

This was about the same time that other research finally showed a clear link between exposure to asbestos and mesothelioma. Both diseases have a very particular cause — coal dust and asbestos — and most people who develop these diseases got them in the workplace. But while asbestos manufacturers successfully fought safety regulation and a partial asbestos ban for a couple of decades, the government responded more quickly to the problem of black lung.

The Mine Health and Safety Act of 1969 limited coal dust in mines to 2 milligrams per cubic feet of air. It also provided for free chest x-rays of miners and set up a fund to take care of black lung victims. The number of reported cases of back lung was dramatically reduced. Some pulmonologists thought that with a little more work, black lung could be eradicated.

Instead, it’s making a comeback. In the last ten years, the number of black lung diagnoses has doubled. NPR interviewed Donald Rasmussen, a pulmonologist in Beckley, W.Va., who said he began seeing an increase in black lung cases about 15 years ago.

Further, black lung is showing up in younger workers to an unprecedented degree. Years ago, it was considered an “old man’s” disease. But autopsies of the 29 miners killed in the Upper Big Branch disaster in 2010 found that several of them had black lung, including two miners who were only in their 20s.

Lax enforcement of mine safety regulations, which was a factor in the Upper Big Branch deaths, is a suspected cause of the comeback of black lung. There are accusations of cheating in air dust sampling. It’s also noted that today’s miners work longer hours than their grandfathers did, increasing their exposure to dust. Also, today’s high-powered mining machines cut through coal seams laced with silica-bearing quartz and sandstone, releasing silicon dioxide. The presence of silica in the coal dust is thought to make it more dangerous.

Whatever the cause, expect the mining industry to fight any additional regulations to reduce black lung.