black lung

Jerry Helton

The Appalachian coalfields are in the midst of an epidemic of severe black lung disease. The debilitating and even deadly disease has recently begun to affect miners as young as 30. Dust from coal mines has scarred these miners’ lungs, so little of the air they breathe gets absorbed. In central Appalachia, researchers say, one in every five experienced miners have some form of impairment, and one in every 20 now have the most advanced and disabling form of black lung.

A new study shows that as black lung cases have surged there has also been a dramatic increase in one very expensive and risky surgical treatment — lung transplant. A new set of lungs can make it easier to breathe again, but the surgery introduces a whole new set of medical issues. Most transplant recipients die within 5 years.


Updated at 8 p.m. ET

The federal agency that trains, tests and certifies the physicians who read X-rays and diagnose the deadly coal miners' disease black lung said today it was not consulted by Kentucky lawmakers in the 14 months they considered a new law that mostly limits diagnoses to pulmonologists working for coal companies.

Howard Berkes/NPR

The American College of Radiologists, a professional organization representing radiologists, is asking Kentucky to repeal a new law that changes how coal miners receive benefits for black lung disease.

The law’s changes to Kentucky’s workers’ compensation system removed radiologists from the claims process, even though radiologists are specialists in reading in X-rays and are generally considered to be the most qualified among doctors certified to diagnose black lung disease.

“This is a matter of life and death for many people and politics should be left out of it,” wrote William T. Thorwarth Jr., a radiologist who serves as the organization’s CEO. “We hope that the Kentucky legislature will rescind this new law and work with the medical provider community to save more lives.”

Rural medical clinics that are struggling to respond to an epidemic of a fatal lung disease plaguing coal miners received a 40 percent boost in federal funding with the passage of the omnibus spending bill last week.

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.