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As Black Lung Strikes Younger Coal Miners, Kentucky Restricts Medical Benefits [1]

['Austyn Gaffney']

Date: 2024-06 

Brandon Crum was a fourth-generation coal miner. As a teenager, he spent his summers, holidays, and weekends working in the coal fields of eastern Kentucky. “I was raised with it,” says Crum. “My grandfather and my father were mine operators. From the time I was six I’ve been riding in bulldozers and cutting machines and scoops.”

He left mining at 21, but Crum didn’t stray too far from his roots. For the past 16 years, he’s been a radiologist and “B reader,” which means he is certified to evaluate chest X-rays for pneumoconiosis, or black lung, a debilitating respiratory disease. Caused by long-term exposure to coal mine dust, black lung is fairly common in coal miners in their sixties and seventies. Crum’s grandfather died from it, and his father has it, too. But in 2014, Crum began noticing a spike in severe black lung cases—and he was seeing them in younger and younger coal workers.

He contacted the National Institute for Occupational Safety and Health (NIOSH), which studied the X-rays of Crum’s patients. After multiple B readers in the region confirmed the diagnoses, Crum and NIOSH published their findings in December 2016. Continued research led NIOSH to conclude that one in five coal miners in central Appalachia has black lung. Even more shocking, one in twenty suffers from progressive massive fibrosis, the most severe form of the disease. Together, Crum and NIOSH uncovered the story of a fatal epidemic in Appalachia’s coal country.

“If one in five people who worked as nurses ended up with an incurable, chronic disease, people would lose their minds. In any other work this would be completely unacceptable,” says Evan Smith, an attorney for the Appalachian Citizens Law Center in Whitesburg, Kentucky. “It’s scary. It’s an incurable disease that will eventually lead to these people suffocating to death.”

Not Your Grandfather’s Coal Dust

The uptick of a coal-mining disease during a time when coal production and employment rates are in sharp decline may seem strange—until you consider how the industry must now get that coal out of the ground.

“A lot of the big, thick coal seams in Appalachia have been mined out. What’s left are center seams bounded by rock, usually sandstone,” says David Blackley, an epidemiologist for the respiratory health division of West Virginia’s NIOSH. The rock contains silica, which is many times more toxic than coal dust. Blackley says that the miners’ machines are cutting into almost as much rock as coal, and that while many factors may be contributing to the rise in black lung cases, the increased amount of fine silica inhaled by the miners is playing a part.

Smith agrees. “The dust that coal miners, especially in Appalachia, have been mining in recent history is, pound for pound, worse than what my grandfather was mining in the 1940s. And that has to do with thinner seams,” he says.

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[1] Url: https://www.nrdc.org/stories/black-lung-strikes-younger-coal-miners-kentucky-restricts-medical-benefits

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