Last week The Pump Handle featured an article by Carole Bass entitled Why is Black Lung back?  In response, a former coal miner offers his views on why coal miners in the U.S. continue to develop and suffer from this occupational lung disease that is 100% preventable.  He writes:

Thank you for your article on the resurrection of black lung disease.  As a former coal miner and someone who has worked in the field of workplace health and safety most of my life, I have a few insights that you should consider:

1.  NIOSH’s Dr. Petsnok and team have identified a sentinel event regarding the resurgence of black lung.  I suspect that what they haven’t been able to capture is a huge underreporting of the disease in its various progressive stages.  Only when miners or their widows file for black lung benefits are most cases identified.  If we had a more comprehensive occupational health/injury surveillance system we would know more and sooner.  Certainly some of NIOSH’s more recent aggressive screening will provide more information about rates and disease stages.

2.  I can tell you that miners never participated in the MSH Act/NIOSH run screening program.  Partly they didn’t know about it, partly out of fear of job reassignment and partly they didn’t trust it. There was barely a mention of the program at new miner orientation training.  After that it was never mentioned.  They never saw a NIOSH screening truck at the mine bathhouse.  NIOSH did a poor job of doing outreach and education to miners and their families.  Convincing them to participate would still be a challenge due to a real fear of retaliation and the ever important focus on safety.  Plus this widely held notion that if you work in a coal mine, well, then you get black lung.

3.   Air sampling under the Act is broken when it is run by the company.  One of those Congressional backroom compromises on the passage of MSH Act that really spelled doom for the air sampling program.  Back when MSHA had some teeth they actually prosecuted companies for falsifying data or altering the cassettes.  Some miners used to sabotage their filter cassettes since they were cynical about the intregity of the program.  So all this thinking that through air sampling, certain findings would lead to mining and ventilation changes and increased compliance activity was based on false premises/false program.  Plus of course, the PEL is not protective.

4.  The growing number of non-union mines and the reduced strength of the UMWA has had a huge impact on what miners can challenge management about regarding labor and health and safety issues.  The very idea of not being in a union and working in underground mining is frightening.  When you loose the right to refuse to do unsafe work you have to lower your expectations about your workplace, so dust controls/ventilation is way down on your priority list.  It’s no good being a leader without backing if you loose your job and can’t feed your family.

5.  Hopefully, NIOSH/MSHA has data that looks at what types of mining operations these miners worked in and some kind of exposure matrix.  There are real dust generation differences between continuous mining vs. longwall mining vs. pillaring.  Today, the ratio of the number of miners to the number of tons mined is incredible and yet the venitilation engineering controls have not changed much.  Also some mines take more top or bottom for various reasons and yes therefore more silica dust.  Silica on the rails for breaking and silica in roof bolting and silica in the limestone for rock dusting.

6.  The truth of the matter is that many miners have mixed lung disease, CWP but also silicosis, COPD and emphysema. That was how the battle was joined.  Was there enough CWP to be compensable?  If you looked at the work environment, smoking as an outlet for the stress and anxiety make a lot of sense.  Chewing tobacco and rubbing snuff in the mine was like mainlining nicotine and so smoking above ground wasn’t just a bad habit, but a real addiction.
I could go on but I won’t.  There is no true mystery here.  It’s not like we are just missing that one critical epidemiological study we need, to nail it down.

I once met a miner who was 22 years old and already had advanced CWP.  Needless to say he looked like he was 40 and his life was short and painful.  Maybe we don’t see miners like that anymore but being having CWP at 50 in an older body and having severe shortness of breath is no better.  Yes, there are many things that could be said about these findings by NIOSH.  A lot of finger pointing and hand wringing goes on.  More than anything these findings show that the black lung movement and the movement in the coalfields leading to the passage of breakthrough legislation and the creation of new regulatory and research agencies and the strengthening of the union all contributed to safer mines and reduced disease and fatalities.  The chipping away at them over the years took their toll.  The is no real mystery here. 

David Harrington has worked on preventing and promoting workplace safety and health for over 35 years.   In that time, he has worked as a coal miner, construction worker   and union organizer and has worked   for community- and workplace-based organizations, unions, law firms, university-based occupational medicine programs and state government-based public health programs.   He holds a bachelors degree from West Virginia University and a Masters in Public Health from the University of California at Berkeley.