In 1881, H.A. Lemen, a professor of medicine at Denver University and president of the Colorado Medical Society, presented a paper at the society’s annual meeting. In it, according to Alan Derickson, he reflected on his examination of a man who, after 30 years mining coal in Scotland, England, and Pennsylvania, had contracted an unspecified respiratory disease. Among the symptoms were a “harassing cough” and the spitting of up to a pint a day of a black fluid with a “decidely inky appearance.” Dr. Lemen wrote: “The sentence I am reading was written with this fluid. The pen used has never been in ink.”
Coal has always been a killer.
The Trump regime has nevertheless launched yet another effort to undermine an Obama-era rule designed to reduce that killing.
This time, the target is the Mine Safety and Health Administration’s landmark respirable dust rule. It cuts the mandated level of allowable dust in coal mines by 25 percent. If, after MSHA review, the rule is gutted, there will be no end to an ongoing surge in black lung cases. And that means thousands more miners will die a ghastly death. My grandfather died that way four decades ago.
The duplicity of Donald Trump is scarcely news to anyone. A year ago this month, while signing a roll-back of another rule—this one imposed to protect streams from coal pollution—he told a small group of miners: "We’re going to fight for you like I promised I would in the campaign. And you were very good to me, and I’m going to be even better to you, I promise you that."
The White House grifter’s trawling for support from coal miners is particularly grotesque given his willingness to trash health and safety regulations and slash the budgets to enforce them. Allowing miners to suck more dust particles into their lungs is “even better to” them how?
Inhaled, those particles—coal dust often mixed with rock dust—can cause black lung, known formally as pneumoconiosis, which gradually destroys the afflicted person’s ability to breathe. The reaping is particularly grim. In its worst form, black lung develops into “complicated pneumonconiosis,” or progressive massive fibrosis (PMF).
For decades after the passage of the far-reaching Federal Coal Mine Health and Safety Act of 1969, which among other things mandated a maximum allowable level of 2 milligrams of dust per cubic meter of air, coal miners’ deaths from accidents and black lung fell sharply.
However, as was first noticed by physicians in 1995, black lung—especially PMF—is making a big comeback. It’s showing up earlier, in some cases, among miners in their 30s.
Ron Carson, who directs Stone Mountain's Health Services black lung program, says, "When I first implemented this clinic back in 1990, you would see ... five [to] seven ... PMF cases." Now, he told National Public Radio earlier this month, Stone Mountain’s clinics see that many cases every couple of weeks.
In 1970, about 1 in 30 miners could expect to be diagnosed with black lung. Now, it’s 1 in 14. And that is probably still an undercount because many miners won’t get their lungs checked. In some instances, this comes out of pure denial. At Smithsonian magazine, Maya Wei-Haas cites Anita Wolfe, the program coordinator of NIOSH’s coal workers health surveillance, as saying some miners wait until retirement to be examined, even though they are entitled to free x-ray exams every five years:
“Some miners just flat out don’t want to know if they’re sick or not … they’re going to continue to work. That’s their livelihood,” she says. She estimates current participation in screening programs is about 40 percent overall, but in states like Kentucky, it’s as low as 17 percent.
Second, miners aren’t always made aware of the risks. This is particularly common among surface miners, who weren’t considered at risk for black lung until recently. In one of NIOSH’s outreach trips to Oklahoma, Texas and Louisiana, Wolfe was surprised at how little the miners knew about the disease. “When you talk to those miners about black lung, they look at you like you’re speaking a foreign language,” she said in a 2015 presentation.
UNDERESTIMATING BLACK LUNG
Howard Berkes at NPR conducted a comprehensive investigation of the matter in 2012. And a team of NPR reporters recently found that the number of black lung cases are 10 times higher than what federal authorities have been reporting and at least double the number of cases at their low point at the end of the 1990s. Fourteen months ago the team uncovered the largest cluster of advanced black lung disease ever reported, 416 cases at just three Appalachian clinics.
The finding was confirmed this month in a research letter published in the peer-reviewed Journal of the American Medical Association. "This is the largest cluster of progressive massive fibrosis ever reported in the scientific literature," said Scott Laney, an epidemiologist at the National Institute of Occupational Safety and Health who was involved in the study.
What’s causing this surge? Experts speculate it’s a combination of miners working longer hours, production being much higher than when the Coal Act was enacted, coal being mined from thinner seams intercut with quartz whose tiny particles cause their own nasty lung disease—silicosis, the fact that continuous mining machines pulverize the coal and rock into particles small enough to pass through face-mask filters, and the dwindling power of unions. For instance, in the remaining coal operations in Eastern Kentucky today, once the scene of long and bloody battles between unionized miners and mine owners, there isn’t today a single union contract. That makes miners reluctant to report health and safety violations for fear of losing their jobs.
President Obama appointed Joseph Main to run MSHA in 2009. A former safety inspector, administrative assistant, and deputy director in the United Mine Worker of America's Safety Division, Main advocated stricter safety rules, tougher enforcement, and reduced dust levels. And on his watch, MSHA moved to reduce the allowable levels of dust from 2 milligrams per cubic meter of air to 1.5 milligrams. The new dust rule was finalized four years ago, and its third and final phase came into effect in late 2016.
However, Main was replaced last year by David Zatezalo, a former mining company executive who last fall filed for a retrospective review of the dust rule. At a congressional hearing he said the MSHA review of the rule was not specifically a move toward a roll-back. But the agency’s filing labeled the review “derogatory,” which does nothing to calm fears the rule weakened or eliminated. Moreover, the industry’s complaints that the rules is too “burdensome” and doesn’t accomplish anything sounds a good deal like Zatezalo’s boss.
Not to mention Zatezalo himself. He was at the head of Rhino Resources when the company came under fire from MSHA for two “pattern of violation” notices in 2010 and 2011. Ultimately, Rhino racked up $2.1 million in fines for 160 workplace safety or health violations starting in 2005. At his confirmation hearing last year, Democratic Washington Sen. Patty Murray said: “It is so critical, absolutely critical, that the MSHA administrator is committed to standing up for our miners. But instead of nominating an advocate for workers’ health and safety, President Trump nominated one of the industry’s worst offenders.”
Fox + Henhouse = Standad Republican approach to regulation.
COAL MADE LIVES COMFORTABLE AND MISERABLE
While it provided a key fuel for the industrial revolution, coal also has brought with it disaster, disease, and death around the world.
In 20th-century America alone, more than 100,000 coal miners died in accidents from methane and coal-dust explosions, gas poisonings, cave-ins, suffocation, and lethal interactions with machinery.
Over time, the number of accidents, especially fatal ones, have dwindled thanks in great part to union pressure. During the early 1900s, the nation was witness to an average of 1,500 coal-mining deaths a year from accidents, with the worst being 1907, when more than 3,200 miners were killed, 358 of them in a single accident at Monongah, West Virginia.
Since 1985, however, every year has seen fewer than 100 coal miner deaths from accidents. In 2016, for the first time in the more than a century that complete records have been kept, only eight workers died in coal-mining accidents. Over the past half-century, from 1968-2017, U.S. coal-mining deaths from accidents have totaled 3,936.
But in that same period, 20 times as many coal miners have died from the ravages of black lung, 76,000 from 1968 to 2014, with about 1,000 more dying each year since then.
One of them was my grandfather, who died in 1978. He had only spent 12 years underground, starting at age 14, and then 20 years as an organizer for the United Mine Workers. By the time he was in his mid-50s, the first impacts of the disease had become obvious. By his early 60’s he was completely disabled and could scarcely walk across a room with stopping to gulp for air. I was his caregiver for the final horrible few months and was at his side when he gasped his last painful breath.
Eight years before then, he had been one of the early applicants for compensation under the Federal Coal Mine Health and Safety Act of 1969 known widely as simply the Coal Act. It was a broad piece of legislation, passed by Congress at a time the UMW still had a bit of clout nationally. Included in it was a provision for compensating coal miners with black lung. Based on the number of dependents, a miner approved for compensation received from $136-$272 a month—around $950-$1,950 in 2018 dollars. After seven years of battling for his compensation, my grandfather got his first check five months before he died. That was 40 years ago. Current payouts run from $660 to $1,320 a month.
Since the program began, the federal government has paid out more than $45 billion to afflicted miners. But even today, miners often have to engage years-long battles, just as my grandfather did, to get approved to receive those checks.
Fifty years ago unions still had some political clout, and the UMW was a big part of persuading Congress to pass the Coal Act. But it took a bloody long time to get there.
In his 1991 peer-reviewed study, Alan Derickson noted that the UMW first brought up the matter of “miners’ asthma” at the hearings of the US Anthracite Coal Strike Commission of 1902-3. And in 1915, the union began pushing to get afflicted miners compensated:
Throughout the 1950s and 1960s, the union's Welfare and Retirement Fund disseminated information on advances in understanding chronic pulmonary diseases of mining. In particular, the miners' fund promoted the British conceptualization of a distinctive coal workers' pneumoconiosis. At the same time, the staff of the union health plan pressed the US Public Health Service and the Pennsylvania Department of Health to investigate the prevalence of occupational respiratory diseases among bituminous miners. Taken together, these endeavors contributed significantly to growing recognition of the severity and extent of this important public health problem and thus helped lay the foundation for the Federal Coal Mine Health and Safety Act of 1969.
According to a 2011 study conducted by Alison D. Morantz:
...unionization predicts a substantial and statistically significant decline in traumatic injuries and fatalities, the two safety measures that are the least prone to reporting bias. These results are especially pronounced among larger mines. Overall, unionization is associated with a 14 to 32% drop in traumatic injuries and a 29 to 83% drop in fatalities. Yet unionization also predicts higher total and nontraumatic injuries, suggesting that injury reporting practices differ between union and nonunion mines.
Coal unions, however, are barely hanging on by their fingernails these days, and their crumbling membership began long before the closure of scores of coal operations over the past decade. Union membership among coal miners fell from 14 percent in 1997 to just 6 percent in 2016. There have been no unionized mines in Kentucky since 2015.
The Trump regime likes to euphemize its evisceration of health, safety, and environmental rules as “streamlining.” Companies like to claim that more restrictive rules will only cost them more money without benefiting workers. The dust rule isn’t doing any good, they say. In other words, the typical corporate whine. But it’s far too soon to determine whether the rule is having the desired impact.
We don’t yet know the full extent of the black lung epidemic. But given that it is disabling and killing hundreds of miners a year, now is clearly not the time to propose a weaker rule to control the dust that is causing the carnage. Someday soon, if we can install wiser policy-makers in office, burning coal will go the way of burning whale oil. But as long as men and women continue to dig coal, underground or in strip mines, they need to be protected from accidents and the ravages of this terrible disease. Streamlining the respirable dust rule would pave the path to the black lung graveyard.