Howard Berkes: It's not just West Virginia. We're talking about West Virginia, Kentucky, and Southwestern Virginia as the central Appalachian states that are really the epicenter. of the current epidemic of severe black lung disease and the newly reported extraordinarily high rates of simple black lung disease. This Appalachian region has a long history with black lung disease going back more than a century. And in the coal fields of West Virginia, Kentucky and Virginia, it's quite common to run into people who not only have generations in coal mining, but also generations of relatives with black lung disease. So, it's long been associated with coal mining in these states.
What's new is that the rate of disease now, as reported by the National Institute for Occupational Safety and Health, for working coal miners in these three states underground is one in three. 32.5% of the miners they tested in the last five years have black lung disease. It hasn't been that high since 1978. And even miners with less tenure underground have rates of disease going back to the 1980s. And this is really extraordinary because even though black lung disease was quite common, rampant, 100 years ago, 70 years ago. In the late 1960s, Congress finally paid attention and passed laws to deal with black lung disease in 1969 and then also again later in the 1970s. And the rate of disease dropped precipitously so that by 1999, maybe one in 10 coal miners tested had black lung. Now it's one in three. So, it's really astonishing that there's been this resurgence of disease in a region that has known it historically, but it's not historic, it's current.
Patrick Center: As you continue to research this topic, what has been revealed? Is there a reason? Is there a scientific explanation for this?
Howard Berkers: Yeah, it's really pretty obvious now and both scientifically backed up by research. What's happened in the coal fields of central Appalachia over the last several decades is that the biggest coal seams were mined out and what remains are thinner seams and the mining machines aren’t any smaller. And so, what happens when the mining companies go after the thinner seams, and we're talking about seams that can be as little as a few inches to maybe just a few feet. So, when the mining machines dig into those thinner seams, they're also cutting into rock. And that rock in Appalachia typically is quartz. And when you cut up quartz with these mining machines, you end up with these really fine and respirable particles of silica dust. And silica dust is 20 times more toxic than coal dust alone.
Silica tends to embed in the lungs forever. The particles are not expelled. Because they're so toxic, they can immediately begin to form fibrotic tissue in the lungs. The lungs fight back against the presence of silica by forming fibrotic tissue and that can grow and grow and grow. So, this evolution of thinner seams in Appalachia being mined, more silica dust resulting from that mining, because that dust is so easily respirable, more miners then becoming not only sick with black lung disease, but with the more advanced stage of black lung disease and getting sick younger and the disease escalating more quickly to advanced stages and know black lung is incurable. The advanced stage is there is no resolution other than death unless a minor is lucky enough to get a double lung transplant.
The connection to silica dust is quite clear. The Mines Safety and Health Administration identified this connection, by the way, back in 1996. And the National Institute for Occupational Safety and Health has recommended tougher controls on exposure to silica dust starting in 1974.This was well known to begin with. And there's evidence even in the lungs of minors that have been taken out in autopsies or in transplants where they're finding particles of silica embedded in people's lungs.
Black lung is a disease caused by inhaling coal dust and silica dust. And what happens as a result of those particles being in the lungs is that the lungs try to fight back the presence of these foreign substances. And that happens with the buildup of fibrotic tissue in the lungs. And so that the ability of the lungs to perform their breathing function is severely compromised. As the fibrotic tissue grows and grows, and this can get so bad that one of the miners in our film describes how when he had his double lung transplant, the surgeon told him that they had to scrape his lungs out of his chest.
Usually for lung transplant, you just lift them out. But his lungs had so much of this fibrotic tissue, they were stuck to what was around the lungs and they had to scrape the lungs out of his body. And ultimately, as one pulmonologist says in our film, ultimately that the lungs get so compromised that the miners essentially suffocate to death.
In terms of what is done to prevent the inhalation of coal and silica dust, commonly in coal mines, coal mines have to have robust ventilation. There are massive fans that draw in outside fresh air and push them through the mines. And that fresh air at the coal face is supposed to then push away the dust before miners can breathe it. And if the ventilation is adequate, that's a good prevention of this disease. Mining machines have on them water sprays and those water sprays help tamp down dust. And so, if the water sprays are working and the ventilation is good, then the dust is not getting to where miners can breathe it in. But the reality is that, you know, coal mines can have miles and miles and miles and miles of mine shafts and maintaining ventilation in that kind of environment doesn't always work. And water sprays get clogged. They break and unless the mining company keeps up with maintaining them properly, making sure they don't get clogged, cleaning them out and replacing the broken water sprays, then they're not performing an adequate function.
We've looked at the data going back to the 1980s and there have been thousands and thousands and thousands and thousands of instances of overexposure to silica dust in particular. And that's because those basic functions that are supposed to clear away the dust weren't working the way they were supposed to, and the mining company didn't respond in the way it was supposed to.
Patrick Center: Is the federal government going to put in place strict regulations to address this?
Howard Berkes: In 2020, for the Biden administration, came in, appointed Christopher Williamson, the great grandson of a coal miner with black lung to run the agency. That's the federal regulatory agency that controls coal mining. And he did something that no other head of that agency had done in the history of the agency, which is that he developed a regulation that was imposed in 2024 that made the silica dust limit in coal mines twice as tough and provided for the first time direct regulation of overexposure to silica dust so that mining companies could be cited and fined and the agency could even shut down a mining section if there was excessive silica dust that the mining company was not addressing it properly. And that tough new regulation went into effect in 2024.
Enforcement was delayed so the mining industry could prepare for it. Then the Trump administration came in, and also mining companies sued to block that rule, that regulation, the Trump administration came in, a federal court put on hold enforcement of that regulation and the Trump administration didn't oppose that and in fact agreed with that federal court ruling and told the court, yeah, let's keep it on hold because we're going to now change that regulation. We're going to look at changing that regulation. So, the regulation exists, a tougher regulation exists, but it's not being enforced.
Patrick Center: Frontline presents, Coal's Human Cost, it airs tonight at 10 o'clock on WGVU Public Television correspondent and award-winning journalist, Howard Burkes, thank you so much.
Howard Berkes: Thank you.