A graphic on
the Mine Safety and Health Administration website notes that since 1968 there
have been 76,000 deaths from Black Lung disease at a cost of $45 billion in
Federal compensation. Black lung disease, or pneumoconiosis, includes a series
of maladies caused by long-term chronic exposure to coal dust and silica dust,
which scars lung tissue. This black particulate matter can coat the lungs
causing difficulty in breathing and eventually death. The deadliest form or
advanced phase of black lung is a malady called progressive massive fibrosis
(PMF) or complicated black lung. The National Institute Occupational Safety and
Health (NIOSH) announced in February that there have been 416 confirmed cases
of PMF in central Appalachia from 2013 to 2017. Since that study 154 new cases
have been confirmed. That is a huge uptick, and it shows that the disease is
not slowing down as it was thought to be in the 1990s. Out of 50,000 coal
miners still working, 1%, or 1 out of 100 (of that total as some of those w/PMF
may no longer be working) have the worst form of black lung, and presumably, many
more have lesser versions heading toward PMF. That is concerning. Perhaps most
concerning is that 5% of all veteran miners and 10% of those with more than 25
years of mining experience in central Appalachia have PMF which is the highest
level ever recorded. More than 20% of miners in Appalachia have been diagnosed
with some form of the disease. That is rather astounding. Fortunately, since then a lesser percentage of miners have been diagnosed, likely due to regulations of the past. However, as the graph below shows, since around 2011 there has indeed been an uptick in diagnoses.
The new data showing the rising PMF black lung cases suggests two things to some health researchers:
1) it would be considered a serious health crisis if it occurred in other
industries, and 2) the new data show that dust control regulation and/or
enforcement and/or fines have been inadequate.
The Respiratory Dust Rule of 2014
The Coal Mine
Dust Rule was first put into effect in 2014. The Mine, Safety, and Health
Administration (MSHA), a branch of the U.S. Dept. of Labor, explains this
‘respirable dust rule.’ First implemented in August 2014, it required an
initial year of continuous dust sampling in mines and certification every three
years of samplers. This showed that compliance with the planned reductions was
achievable. Phase III took effect in August 2016 and requires lower limits for
coal mine dust in the mines and at air intakes. The limit for dust in the mines
dropped from 2mg/cubic meter to 1.5 mg/cubic meter. The initial proposal was to
drop it to 1 mg/cubic meter as recommended by NIOSH. Negotiations over 3-1/2
years with coal producers and politicians led to the compromise. This was the
first time there was any implementation of a regulation against coal dust for
45 years. The previous law in 1969 made eliminating black lung a national goal.
The rate of contracting the disease did drop in subsequent years as better mining
ventilation systems became standard, water-spraying dust control was widely
implemented, and monitoring was required. The level of black lung was cut by
nearly 60% from the 1970’s to the 1990’s. That was a clear regulatory success
in terms of health outcomes. Then the level flattened and has been back on the
rise in recent years. In studies, a rise was first noted in 2007, a general
rise was noted in 2012, and a bigger rise in 2016.
The MSHA calls the respiratory dust rule “a
historic step forward in the effort to end black lung disease.” NIOSH
researchers stated that “Enhancement and diligent enforcement of the 2014
standards remains critical for reversing these trends” The mining industry
strongly opposed the rule with the National Mining Association and coal
producer Murray Energy filing lawsuits. Murray Energy claimed that MSHA “clearly
seeks to destroy the coal industry and the thousands of jobs that it provides.”
However, the Trump MSHA with former coal executive David Zatezalo now in
charge, seeks to ‘reform’ the rule, first gathering their own data in support
of their presumed idea of reducing required sampling frequency and
“accommodating less costly methods.” He insists they do not seek to roll back
the rule, only to tweak it, although it has been labeled by MSHA as a
‘deregulatory’ action which has raised eyebrows. In April Trump’s MSHA
submitted the draft request for information about the rule titled Regulatory
Reform of Existing Standards and Regulations: Retrospective Study of Respirable
Coal Mine Dust Rule.
Cheating on Sampling and Limiting Benefits to Affected
Miners
In 1998 there
was an expose’ by a Louisville newspaper that found extensive cheating on mine
dust samples by coal producers in Kentucky. A few years ago, there was a case
of admission of guilt in cheating on water samples taken for coal companies in
West Virginia. These and other cases show that there is a need for regulatory
enforcement. The same paper reported in 2007 on the initial resurgence of black
lung. More recently, there have been several indictments for people from a few
mines in Western Kentucky where some whistleblower miners told of routine
manipulation of dust samples at the threat of harassment and/or job loss. This
was at two Armstrong Coal mines between 2014 and 2017, Armstrong Coal has since
gone bankrupt. Those charged include a section foreman, a safety director, and
a superintendent. Armstrong Coal is named as an "unindicted
co-conspirator." One might speculate that there was some 'pushback'
against the new federal rule at least at those mines. Of course, when one
company or group in a company conspires to avoid implementing compliance to a
regulation and gets caught, then it makes all those who do comply look bad as
well in a sense. In the case of the very well-known dangers of black lung, cheating
seems particularly devious. The Ohio Valley Resource article referenced below
is a good summary of the cases.
Other expose's
have shown doctors retained by coal companies had sought to limit black lung
benefits to miners and even now there are severe limits in choosing doctors in
Kentucky. The requirement is for the disease to be diagnosed only by a small
group of certified pulmonologists, lung specialists, rather than radiologists.
Radiologists say they are perfectly qualified to diagnose the malady. This
means that it could take over a year for people to even be seen by lung
specialists. Since early detection is key to mitigating the effects of black
lung, this is a delay that certainly could negatively affect health outcomes.
All the data
suggest that black lung can be significantly reduced – simply by adequate
regulation, enforcement, and corporate accountability through fines and
inspections. Regardless of the economics of coal producers, at 76,000 dead,
over 10,000 ill, and $45 billion and counting - this is a no-brainer.
Update: Dec. 19, 2018: “Slope Mining”
and the Silica Dust it Produces is Probably the Main Culprit in Recent Upticks
of Black Lung and Silicosis Among Coal Miners
According to a
news segment by NPR which was included in a Frontline/NPR TV special, there is
some additional very interesting info. In recent years as coal seams are mined
out, there has been more cutting through non-coal rock, rock containing high
amounts of silica dust. Silica dust is strongly suspected of being much more
damaging to the lungs than just coal dust. The Obama-era regs sought to address
silica dust by addressing overall dust rates, which would be an improvement but
not a drastic one for overall exposure to black lung-causing dust. The miners
interviewed noted that this “cutting rock,” also known as “slope mining,” has
definitely increased and so too has the silica dust to which they were exposed.
Trump’s MSHA chief publicly acknowledged that silica dust is suspected to be
the culprit in increased black lung but also has privately said in
contradiction that the link is not yet proven. The silica dust is regulated by
other regulatory agencies, particularly OSHA. Other industries regulate silica
dust via OSHA, but the mines have kept the MSHA regs. A big factor that may
miss the increased exposure is that sampling rates are probably inadequate.
Even though mines now use third parties to do the sampling the rates of
sampling are likely inadequate. The miners that operate the mining machines
cutting rock also say that the dust is so heavy that it clogs up dust masks
making it hard to breathe and some mines don’t even require dust masks. Mine
vents may be seen by the mine operators to be enough to mitigate the problem,
but this is fairly obviously not the case. The latest increases in black lung, PMF,
and silicosis (another disease that causes death and debilitation) are likely
due mainly to silica dust has been accurately described as a regulatory
failure. Basically, with the increase in slope mining and the subsequent
production of silica dust, “putting miners back to work” basically means
hastening their suffering and death.
It is perhaps
ironic that Murray Energy CEO Robert Murray, who started out as a miner and mining
engineer, died of black lung. Murray also spent a lot of time fighting against
regulations for the coal industry, including regulations meant to address black
lung. However, he did live to be 80 years of age. Many others did not and will not live that
long. According to a 2018 article in Med Page Today the CDC determined that:
“The overall number of coal workers dying of black lung
disease, known medically as coal-workers' pneumoconiosis (CWP), decreased
steadily from 1999 to 2016 -- a high of 409 workers in 1999 to a low of 112 in
2016.”
“But during this period, the mean years of potential life
lost to life expectancy increased by 55.6%, from 8.1 years of life lost to 12.6
years per decedent. This increase was mostly observed in the years 2003 to 2016.”
“The researchers noted that the decline in the
age-adjusted CWP death rate might be explained, in part, by the decline in
employment in the mining industry.”
As the caption
from the picture below shows, other actions within a mine, such as roof bolting
can increase exposure to silica dust.
Addressing Black Lung and Silicosis Going Forward,
Particularly the Dangers of Silica
An audit by the
U.S. Dept. of Labor’s Office of the Inspector General, published in November
2020 made some conclusions that confirmed the dangers of silica dust, the inadequacies
of silica exposure limits, enforcement of those limits, and sampling protocols.
The specific conclusions are as follows:
MSHA's silica exposure limit is out of date.
A significant body of evidence shows that lowering the silica limit would be a
major factor in preventing coal workers’ deaths and illnesses caused by silica
exposure. Even though MSHA has known its silica limit did not align with
current scientific recommended limits, it continued to maintain essentially the
same silica limit established in the 1960s. As a result, workers in coal mines
with silica levels above recommended limits continue to be at risk of
developing life-threatening health problems.
MSHA cannot issue fines for excess silica exposures
alone. Instead, MSHA’s exposure limit for silica is tied to its
exposure limit for respirable coal mine dust. Thus, violating MSHA’s silica
limit alone but not its coal dust limit, does not result in a citation or fine
to deter future violations. A separate standard for silica would allow MSHA to
issue citations and monetary penalties for violating its silica limit to better
protect miners from this toxic mineral.
MSHA's silica sampling protocols may be too infrequent
to be sufficiently protective. Since MSHA is required by the MINE
Act to inspect underground coal mines quarterly and surface mines semiannually,
MSHA only sampled mines for silica levels during these periodic inspections.
However, silica levels fluctuate frequently. Changes in geology and movement of
personnel within mines mean that miners’ exposure to silica may change on a
daily, if not hourly basis.
The audit also made the following recommendations based on
those conclusions:
1. Adopt a lower legal exposure limit for silica in coal
mines based on recent scientific evidence.
2. Establish a separate standard for silica that allows
MSHA to issue a citation and monetary penalty when violations of its silica
exposure limit occur.
3. Enhance its sampling program to increase the frequency
of inspector samples where needed (e.g., by implementing a risk-based approach
Research
conducted by the University of Illinois Chicago School of Public Health led to
the publishing of the first new pathology standards for black lung disease in
over 50 years in December 2023. They concluded, as expected, that excessive
exposure to silica dust was the culprit. Unfortunately, they also concluded
that compared to the black lung disease of the past which took longer to
develop, the effects of silica dust progress much more rapidly. These days
there are cases that develop within five or six years or less, compared to the
decades it took to develop black lung in the past. The bottom line and the main
problem, they concluded, is that MSHA regulations allow miners to inhale twice
as much silica as do OSHA regulations. The study compared PMF based on three
types: “coal-type, mixed-type and silica-type based on the microscopic
characteristics of the lung nodules.” What they found was that the coal-type
and the mixed-type were declining but the silica-type was increasing.
Additional research has confirmed this. The evidence is now quite clear that silica-based
PMF with a much faster rate of progression is overtaking coal-based PMF and new
regulations should be adopted and enforced as soon as possible to account for
that so miners will be protected.
A new rule is
currently under consideration to bring MSHA standards up to OSHA standards. Hearings
regarding the new rule, known currently as Lowering Miners' Exposure to
Respirable Crystalline Silica and Improving Respiratory Protection were held
in August 2023. Again, this is a no-brainer. In reality, the horrible effects
of silica dust have been known for many decades, perhaps over a century. People
working with metal, nonmetal, stone, sand, and gravel are also exposed to high
levels of silica dust and die from silicosis, and the new rule under
consideration should help them as well. In fact, this rule is perhaps 50-100 years
behind when it should have been implemented. NIOSH reported that some miners in
West Virginia have more severe forms of black lung in their 30’s and 40’s. This
is no doubt likely due to silica dust. NIOSH recommended cutting allowable
limits of silica dust back in 1974, 50 years ago, but lobbying from the coal
industry prevented it. One of the University of Chicago researchers noted that “he
thinks masking against dust is the least effective means of protection, and it
can cause communication problems in the workplace. Preventing dust from being
in the atmosphere, whether by watering it down or through better ventilation,
is safer.”
Fortunately, MSHA
has stepped up enforcement with its Silica Enforcement Initiative. The
initiative has four components: inspections, sampling, compliance assistance,
and miners’ rights. This includes more spot inspections at coal and non-metals
mines, more reviews of ventilation and roof control plans, more overall
sampling, more sampling in overburden removal, shaft construction, slope
construction, extended cuts, cross cuts, and educating miners of their rights.
The graphic below shows some sampling data for respirable crystalline silica from different industries:
Source: Respirable Crystalline Silica: Notice of Proposed Rulemaking. Mine Safety and Health Administration. 2023. Respirable Crystalline Silica | Mine Safety and Health Administration (MSHA)
In conclusion, it
should be said that inadequacies in the laws, particularly laws relating to
exposure to silica dust in the mining industry are very clear and abhorrent examples
of an occupational health failure that could have and should have been
addressed many years ago. The ruining of lives in the past can’t be changed but
prevention of these harms in the future can be changed. There should be no more
delays.
References:
Trump
Wants to Weaken Coal Miner Protections as Black Lung Makes a Comeback – by Mark
Hand in ThinkProgress, July 20, 2018. Trump
wants to weaken coal miner protections as black lung disease makes a comeback –
ThinkProgress
Black
Lung Rate Hits 25-Year High In Appalachian Coal Mining States – by Howard
Berkes, in NPR.org, July 19, 2018. Black
Lung Rate Hits 25-Year High In Appalachian Coal Mining States : NPR
Respirable
Dust Rule: A Historic Step Forward in the Effort to End Black Lung Disease – by
U.S. Dept. of Labor – Mine Safety and Health Administration (MSHA) (website) –
2014-2017. Respirable
Dust Rule: A Historic Step Forward in the Effort to End Black Lung Disease |
Mine Safety and Health Administration (MSHA)
Black
Lung Study Finds Biggest Cluster Ever of Fatal Coal Miners' Disease – by Howard
Berkes & Adelina Lancianese, in NPR (All Things Considered) – Feb. 6. 2018.
Black
Lung Study Finds Biggest Cluster Ever Of Fatal Coal Miners' Disease : NPR
A
Scourge for Coal Miners Stages a Brutal Comeback – by Ken Ward Jr. – in Yale
Environment 360, Nov. 11, 2014.
Federal
Prosecutor Charges Coal Company with Faking Dust Samples Amid Black Lung Surge
- by Jeff Young and Becca Schimmel, in Ohio Valley Resource, July 11, 2018. Federal
Prosecutor Charges Coal Company With Faking Dust Samples Amid Black Lung Surge
(lpm.org)
MSHA Needs
to Improve Efforts to Protect Coal Miners from Respirable Crystalline Silica. U.S.
Department of Labor: Office of Inspector General. November 12, 2020. https://www.oig.dol.gov/public/reports/oa/2021/05-21-001-06-001.pdf
Unearthing
pathology of recent rise in black lung disease. Rob Mitchum. University of
Illinois Chicago School of Public Health. UIC Today. December 6, 2023. Unearthing
pathology of recent rise in black lung disease | UIC today
CDC:
Coal Workers With Black Lung Disease Are Dying Earlier. Salynn Boyles. Med Page
Today. August 3, 2018. CDC:
Coal Workers With Black Lung Disease Are Dying Earlier | MedPage Today
Not
your grandfather's black lung: Federal rule seeks to save coal miners from
silica dust. Eduardo Cuevas. USA Today. September 25, 2023. Silica
dust can be deadly for coal miners. This new rule hopes to help (usatoday.com)
Silica
Enforcement Initiative. Mine Safety and Health Administration. Silica
Enforcement Initiative | Mine Safety and Health Administration (MSHA)
Respirable
Crystalline Silica: Notice of Proposed Rulemaking. Mine Safety and Health
Administration. 2023. Respirable
Crystalline Silica | Mine Safety and Health Administration (MSHA)
Lowering
Miners' Exposure to Respirable Crystalline Silica and Improving Respiratory
Protection: A Proposed Rule by the Mine Safety and Health Administration on
07/13/2023. Federal Register. Federal
Register :: Lowering Miners' Exposure to Respirable Crystalline Silica and
Improving Respiratory Protection
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