‘Little to no change’: Central Appalachia black lung disease hits 50

A new report shows that rates of black lung disease have hit a 50-year high in Virginia, Kentucky and West Virginia, outpacing the rest of the country’s rates by nearly 10 times. It confirms what the region’s researchers have been saying for a decade.While miners working 25 years or more are most likely to contract the disease, the National Institute for Occupational Safety and Health research notes the disease is rising among people with just 10 years of experience, too — meaning younger miners are affected more than they once were. The NIOSH findings were first reported to millions through NPR, Kentucky Public Radio and Public Health Watch, featuring insight from local experts. Advocates in the region don’t know how else to bring attention to the problem. “People that have been involved in it so long like myself are just kind of getting frustrated,” said Dr. Brandon Crum, a radiologist at United Medical Group in Pikeville, Kentucky who also works with Stone Mountain clinics in Southwest Virginia. “We’re a decade out and we’ve shown and we’ve shown and we’ve shown and shown just how bad the problem is and how severe it is, with little to no change in anything that would hopefully help our miners.” Crum said the NIOSH studies confirm what they’ve seen in Central Appalachia for about a decade. He first documented unprecedented numbers of complicated black lung in the region in 2016. The pulmonologist was part of a push to implement a silica rule under the Biden administration, which lowered the amount of breathable crystalline silica that miners could be exposed to. The particles can be up to more than 20 times more toxic than regular coal mine dust.
Enforcement of the rule has been indefinitely delayed by a federal court in response to challenges from industry groups.Along with many others, Crum has contributed to national news coverage and documentaries to address the stalled rule. They’ve also met with U.S. Sens. Tim Kaine and Mark Warner, D-Va. And last October, a delegation of 100 protested outside of the U.S. Department of Labor in Washington, D.C. “Our best hope would be that that gets implemented like it’s supposed to,” Crum said. “We’re just cautiously optimistic because we’re a decade [out] and there’s still not been anything that’s been significantly done.” In its challenge to the rule, the National Mining Association, a trade group that represents the mining industry, said it was supportive of lower limits, but that the rule’s methods were arbitrary and capricious. In a 2023 comment before the rule implementation, the group stated that “miners today work in one of the most health and safety-conscious industries in America,” because of improved technology, diligence and regulations.National Black Lung Association Vice President and native Southwest Virginian Vonda Robinson is still frustrated and disheartened by the rule’s standstill, and the studies that confirm what she saw long ago. “It upsets me tremendous to see,” Robinson said. “That’s why we worked so hard to get the silica rule passed, and we did, because we knew this was going to start happening.”It’s fine if President Donald Trump wants more coal, she added. The Trump administration is investing millions into expanding national coal infrastructure in an effort to boost domestic energy production. But Robinson and Crum agree that if the nation doesn’t protect the workforce they have now, it’ll lose it, especially with more young miners contracting the disease.  “They’ll never see their children graduate, they’ll never see them get married, they’ll never see great grandchildren, or just grandchildren,” Robinson said. “And it just frustrates me so much that the Trump administration is allowing this to happen.” Crum wishes more politicians and coal companies would step up to the plate. He also believes there’s a dire need for large universities or healthcare companies to add to research and treatment. “That is a very, very important need right now because we have so many people sick, and we have a limitation to access to medical care with our specialties and things like that here in rural Appalachia,” he said.The advocates show no sign of stopping. Robinson said she’s going to sit on a Capitol Hill panel soon with other activists and documentarians. She’s working everywhere to bring attention to the issue, she added, because that’s what it’s going to take to make people see what is happening. “It just frustrates me knowing that these miners are going in and they’re giving their lungs to power America,” she said. “And we can’t get any help?”