It's a long word. The sort of word that would eliminate most contestants in a spelling bee. It was the word that my Italian born grandmother could barely understand when the doctor uttered it to her:
pneumonoultramicroscopicsilicovolcanoconiosis
You know it as black lung disease.
It comes from breathing a mixture of coal and silica dust. The coal dust turns the inside of the lungs black and produces a black spittle. The silica scratches the lung tissue, causing fibroids to form. Both elements labor the breathing. As the lungs become less efficient, the heart enlarges and strains and eventually, fails.
It was three years after the diagnosis when my grandfather died. I was four years old and barely remember him.
In 1967, the State of Pennsylvania, where he lived, passed a law that compensated all black lung victims for medical expenses and damages. My grandmother lived on that monthly check until she died in 1996.
Two years later, the US Congress passed the Coal Mine Safety Act, later amended in 1977. The legislation strengthened mine safety and safey enforcement and ordered compensation for all miners disabled by black lung. But it was too late for Grandpa. He died in 1967.
In 1997, The Department of Labor made some changes to its regulations that gave doctors a bigger say in determining whether or not a claimant had black lung and therefore could be compensated. After two challenges and appeals by the National Mining Association, with full backing from the Bush Administration, the courts upheld the new rules. But for two years, between 2001 and 2002, cases languished.
Even today, however, mining companies aggressively fight most new claims.
The number of victims began decreasing after the legislation passed in 1967 until 2003, when the Centers for Disease Control started finding increases in Southwest Virginia and Eastern Kentucky.
The increase both in the number of cases and their severity "justifies a comprehensive assessment of current dust-control measures," the recent report said.
Researchers examined 328, or 31 percent, of some 1,055 coal miners who were working underground in Lee and Wise in March and May of this year. They ranged in age from 21 to 63 and had worked in the mines for an average of 23 years.
Thirty of the miners had evidence of black lung, and 11 of the cases were advanced, according to the report.
Why is the rate rising if dust control measures are in place? And why in just these two areas?
The miners with the advanced cases had an average age of 51 and had spent an average of 31 years working in underground coal mines.
Researchers suggested several possible reasons for the increase and severity of the black lung cases: that the allowable dust limit may be too high; that the levels of coal dust reported may be underestimated; and that the toxicity of the coal being mined may be higher.
But is that the whole answer?
National Institute for Occupational Safety and Health investigators have suggested that they are seeing more cases of miners with black lung disease in small, nonunion mines.
The same institute cites studies that show black lung victims are getting younger.
The report identifies 22 counties in Pennsylvania, Kentucky, Virginia, and West Virginia as "hot spots." It also notes a handful of other such counties in Alabama and Colorado.
In these states miners in their 30s, 40s, and early 50s are getting black lung. That's about 10 to 30 years sooner than in the past. Thirty-five percent of the cases were described as rapidly progressive, meaning the scar tissue in the lungs was spreading about twice as fast as normal.
By comparison, my grandfather suffered his symptoms at age 60.
The study tracked X-rays of more than 29,000 miners between 1996 and 2002. It found about 3 percent had black lung, or coal miners' pneumoconiosis. That compares to 10 percent in 1969. This study was conducted before the recent boom in coal production and the related speedup by the mine owners and their profit-driven disregard for safety. This has resulted in the deaths of 37 miners so far this year, overwhelmingly at nonunion mines.*
The study cites Somerset County, Pennsylvania, as one of the worst counties in the country for black-lung rates. George Ellis, Pennsylvania Coal Association president, said the findings contradict much of what he hears, reported the Tribune Democrat. "It's the first I've heard of a problem in Pennsylvania," he said.
My grandfather died in Somerset County, Pennsylvania almost 40 years ago. It's a shame we haven't made greater progress.
* In the citations, you can find more information about why non-union mines are so dangerous. But in short, their intake/exhaust systems are not as reliable or effective. They do not provide equally adequate protection for miners working all parts of the extraction process.