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This story is part of an investigation into how federal regulators and the mining industry are failing to protect coal miners from the excessive toxic coal mine dust that causes black lung.
The concern about black lung isn't just focused on coal miners working underground. A new study by the National Institute for Occupational Safety and Health (NIOSH) documents severe cases of the disease among surface coal miners, too.
The study, the first of its kind in a decade, used chest X-rays and breathing tests gathered by a mobile surveillance van, which examined coal miners in 16 states from Pennsylvania to Utah.
"You expect to see less disease among surface miners because you would think they are out in the open air and probably not breathing in as much dust than if they were in a confined space," says Cara Halldin, who coordinated the study for the Epidemic Intelligence Service at the Centers for Disease Control.
Of the miners tested:
- 2,257 worked more than a year at a surface coal mine.
- 46 (2 percent) were diagnosed with coal workers' pneumoconiosis (black lung). All but nine of those miners never worked underground.
- A dozen had progressive massive fibrosis, the advanced stage of the disease.
The last black lung study of surface coal miners in 2002 involved about 10,500 miners and found an illness rate of fewer than 2 percent. The rate of advanced disease was only 0.1 percent. Yet the current study found five times that rate.
"We do see less disease [than among underground miners]," Halldin says, "but we see more severe disease among younger miners."
The most surprising finding involved those miners who never worked underground.
"We identified coal workers' pneumoconiosis and severe pneumoconiosis in surface miners who reported no years of underground mining in their tenure," Halldin says.
Dust 'Comes Up Through The Floorboards'
Most of those with black lung are from the same region in Appalachia where the increase in the disease in underground miners is most pronounced. That suggests that a possible cause may be exposure to silica. Surface mines in the region include coal seams laced with silica-laden rock.
"These findings suggest that current federal permissible dust exposure limits might be insufficient to protect against disease or are not being adequately controlled to prevent excess dust exposure," the study says.
Miners who have worked on the surface describe clouds of dust around mining and drilling machines, around coal trucks and along mine roadways.
"You breathe a lot of dust when you drive a coal truck, even inside," says Jim Harper, who hauled coal for three years before his retirement in 2010. Harper suspects he may have black lung and was tested recently at a clinic in Beckley, W.Va.
Coal dust "comes up through the floorboards and ... through the windows," he says.
'We Know We're Getting Black Lung, Too'
At the Upper Kanawha clinic in Cedar Grove, W.Va., Debbie Wills, a black lung program director, worries that more surface miners have black lung but don't yet know it.
"Most of the surface miners were not coming in for testing because they didn't think they could get the disease," Wills says. "They thought it was only underground coal miners."
X-rays can pick up early indications of the disease. A formal positive diagnosis gives underground miners the right, guaranteed by federal law, to be transferred to less dusty jobs without a reduction in pay.
The NIOSH surveillance van has focused on underground miners because that's its legal mandate, says Anita Wolfe, who coordinates the NIOSH Coal Workers Health Surveillance Program. She says surface coal miners insisted they were also at risk so the program has targeted them for testing, too.
Wolfe says they told her, " 'We're drilling rock. We are shooting rock. We are breathing the dust. We know we are getting black lung, too.' "