black lung

Adelina Lancianese, photos; Alexandra Kanik, illustration.

The central Appalachian coalfields are in the middle of an unprecedented epidemic of severe black lung disease. In a recent issue of the Journal of the American Medical Association federal researchers released the results of a study conducted at just three black lung clinics. The study confirmed 416 cases of the most severe form of black lung disease, Progressive Massive Fibrosis.

According to the authors, it’s the largest number of severe black lung cases ever documented, and one of the worst industrial epidemics in American history.


Michael Sullivan/Getty Images/Science Source

Epidemiologists at the National Institute for Occupational Safety and Health say they’ve identified the largest cluster of advanced black lung disease ever reported, a cluster that was first uncovered by NPR 14 months ago.

In a research letter published Tuesday in the Journal of the American Medical Association, NIOSH confirms 416 cases of progressive massive fibrosis or complicated black lung in three clinics in central Appalachia from 2013 to 2017.

c-span

The Trump administration’s Office of Management and Budget has announced a review of an Obama-era rule that protects coal miners from exposure to the dust that causes black lung disease.

That has some health and safety advocates concerned. The review comes amid a tide of regulatory rollbacks by the Trump administration and at a time that black lung disease is on the rise in Appalachian coal country.


Benny Becker

Federal health researchers are visiting health clinics and medical schools in the Appalachian coalfields to recruit allies in the fight a resurgence of black lung disease. The worst form of the disease may affect as many as 5 percent of experienced working miners in the region, and the researchers fear that rate could be even higher among retired miners. 

Medical students filled an auditorium at the University of Pikeville, Kentucky, to hear the latest on this scourge of coal communities, a disease many think should be history by now.

If we come to your town there’s generally something bad going on there,” said Dr. Scott Laney, an epidemiologist with the National Institute for Occupational Safety and Health, or NIOSH. He was part of a research team that identified a resurgence in the worst form of black lung disease in a study published late last year. 

Howard Berkes/NPR

A bipartisan group of legislators has asked President Donald Trump to make more money available for black lung health clinics as they face an increase in cases of the disease among coal miners.  

More than 20 clinics would benefit from the $3.3 million increase lawmakers are requesting. The clinics provide miners with health screenings, medical care, and assistance in securing black lung benefits.

The lawmakers wrote in a letter to the president and the White House budget director that the level of funding for clinics has been frozen for the past five years.  

Benny Becker | Ohio Valley ReSource

At the age of 38, a coal miner named Mackie Branham Jr. was diagnosed with progressive massive fibrosis, a debilitating and terminal form of an illness that was supposed to be a disease of the past — black lung. But Branham is among many miners afflicted by a resurgence in the disease, and officials are just beginning to realize the scope of the problem. A review of health clinic records shows roughly a thousand such cases, many times more than federal officials had thought existed.

Driving into Pike County, Kentucky, the welcome sign tells you that you’ve entered “America’s Energy Capital.” Sheer rock walls line the highway, evidence of a community that’s extremely skilled at cutting through mountains.