Signature Sponsor
Black Lung Disease is Affecting More Coal Miners in West Virginia. Here's What to Know.



September 7, 2023 - Earlier this summer, the U.S. Mine Safety and Health Administration announced its plan to address a mining safety hazard their predecessors failed to meaningfully deal with: silica dust. The administration’s 168-page rule proposal touches on the systems within the mining industry that put workers at risk of developing black lung, a devastating respiratory disease that doctors can’t cure.

It’s been more than 50 years since Congress, in response to miners across West Virginia demanding action, passed legislation to eliminate the conditions that cause the disease. But since the 1990s, more and more miners are being diagnosed with the most serious form of black lung, and the disease is plaguing younger miners than it did before. 

Partnering with Public Health Watch and Louisville Public Media, Mountain State Spotlight recently published two stories that examine MSHA’s rule proposal and highlight what’s at stake for West Virginia miners. Here, we explain what black lung is, how it’s related to silica dust, who’s most affected and how regulators hope to limit the health threat.

What is black lung? Who’s impacted by black lung?


Danny Johnson, a retired coal miner diagnosed with silicosis and black lung disease, on his porch in Rock, West Virginia. Photo by Roger May.

Coal workers’ pneumoconiosis, also known as black lung disease, has been a known health threat for nearly two centuries. The family of diseases can develop when miners are exposed to high levels of coal dust over a period of years. 

The condition often disables people’s lungs, and early symptoms can be shortness of breath or uncontrollable coughing. In its later stages, it can lead to early death through a variety of ways, including by stroke or heart failure. A 2018 Centers for Disease Control and Prevention study found that progressive massive fibrosis, the most severe stage of black lung, reduces life expectancy by around eight to 13 years compared to people without the illness.

Severe black lung continues to disproportionately affect Central Appalachia; from 2019 to mid-2023, nearly 30% of Americans diagnosed with progressive massive fibrosis, also known as “complicated black lung,” at federally-funded black lung clinics were West Virginians, according to the Black Lung Data and Resource Center at the University of Illinois Chicago.

Why is black lung becoming more common? 


Mercer County Bluefield railroads
The Bluefield Rail Yard played a pivotal role in the opening of the Pocahontas Coalfields. Photo by Roger May. 

Complicated black lung is on the rise. Experts have widely attributed its resurgence to miners being more frequently exposed to respirable silica dust that’s created when large rocks are crushed. A 2018 investigation by NPR and PBS Frontline revealed that high levels of silica dust have been found in mines frequently since 1986.

After more than two centuries of mining coal in Central Appalachia, there are few large, thick coal seams left in the region. Now, workers in Kentucky, Virginia and West Virginia grind through more rock filled with quartz to reach the coal. Grinding that quartz creates silica dust, which is 20 times more toxic than coal dust alone.


What’s being done to reduce silica dust exposure? 



UMWA public comment
A United Mine Workers of America member testifies at a Mine Safety and Health Administration public meeting about a proposed silica dust rule. Photo by Allen Siegler. 

Over the past decade, MSHA has taken action to limit coal workers’ exposure to coal dust. In 2014, the agency finalized a rule that lowered the coal dust exposure limit, implemented new technology for monitoring dust levels and changed how the agency would enforce regulation. 

But that was for coal dust; not much changed for silica dust regulations, despite long-standing recommendations from the National Institute for Occupational Safety and Health, or NIOSH, to dramatically lower its permissible exposure limit. 

Unlike its 2014 coal dust rule, MSHA’s new proposal focuses overwhelmingly on silica dust and the health threat it poses. It cuts the dust’s permissible exposure limit to the silica standard NIOSH has been calling for since 1974, and it outlines ways the agency will try to make mining companies follow the law. It also extends the regulations beyond coal mines to metal and nonmetal mines.

Will MSHA’s rule proposal change anything?



Go and Cline
John Cline (right) and Dr. Leonard Go (left) watch the Mine Safety and Health Administration public meeting in Raleigh County. Photo by Allen Siegler


While the rule proposal, in its current form, requires regular dust sampling, much of its effectiveness will depend on mining companies sampling their own mines and responding accurately and honestly. There’s a long history of coal mining companies, when left to their own devices, cheating dust safety standards.

Health advocates have already expressed mixed feelings about the rule: while many are grateful that MSHA is acting, some are worried whether the rule as written will actually protect miners.

The rule proposal is in a public comment period until September 11, 2023. After that, MSHA officials will consider the comments and can change the proposal as they see fit. But a rule proposal does not guarantee that regulations will be finalized and implemented, and there are many examples of planned mining regulations not making it to the finish line.