How A Reporter’s Investigation Of Appalachia’s Black Lung Epidemic Pushed

This story originally aired in the Oct. 8, 2023 episode of Inside Appalachia.

The coal-producing regions of central Appalachia are at the center of an epidemic of advanced black lung cases among coal miners. New reporting by a retired NPR reporter has shown how federal officials underestimated the sheer number of cases across West Virginia, eastern Kentucky and southwestern Virginia, and now regulators seem to be responding.

Miners are suffering from an advanced version of black lung disease known as progressive massive fibrosis.

It’s the result of digging at increasingly thin coal seams. That means they’re also cutting into quartz, which creates silica dust.

Advanced black lung results from breathing in that blend of silica and coal dust. 

Retired NPR reporter Howard Berkes has been covering this story for years.

He worked with NPR and the PBS series Frontline, and spent more than a year investigating fears that federal regulators and mining companies were failing to protect coal miners from toxic dust.

He and his team obtained documents and data showing federal mine safety officials had evidence of the danger dating back more than 20 years, but never addressed it.

In 2018, Berkes reported that more than 2,000 miners were dying of illness related to that toxic dust. Since that story aired, at least four of the miners in it who appeared have died, and at least two have received double-lung transplants. Danny Smith, who was prominently featured, is being assessed for a double-lung transplant.

Lately, the metallurgical coal industry has been ramping up production to meet global demand, and experts predict even more advanced black lung cases will appear. After years of inaction, though, federal officials are addressing the issue.

Over the summer, the Mine Safety and Health Administration proposed a rule intended to protect coal miners from exposure to silica dust. By the time the agency closed the public comment period in September, the draft rule had attracted more than 5,000 comments. 

Now, Berkes is part of a new investigation into advanced black lung cases that was co-published by Public Health Watch, Louisville Public Media and Mountain State Spotlight. Inside Appalachia Host Mason Adams spoke with Berkes about what his team found.

The transcript below has been lightly edited for clarity.

Adams: So your work in the past, your investigations have in the past have seemed to have resulted in some action. Now MSHA has proposed some new regulations for monitoring silica dust.

Berkes: Yeah, MSHA has taken two very significant steps in this proposed rule. One is to make the exposure limit for silica dust twice as tough as it has been. That was recommended by the National Institute for Occupational Safety and Health back in 1974, and it was recommended again by the Labor Department’s own mine dust advisory committee in 1996.

It’s taken all these years for MSHA to finally adopt what has been long recommended, this tougher limit to exposure to silica dust. That’s a major, major improvement. The second thing that they did is that they decided to regulate overexposure to silica dust directly. In the past, they applied a complicated formula: If a mining company had too much silica dust, then the mining company had to lower the amount of overall mine dust, coal dust and silica dust in the air. That was supposed to bring down the silica dust exposure to an acceptable level. But it’s not a one-to-one relationship.

What we found in our previous investigation was 9,000 overexposures to silica dust, even after the mining companies responded to the regulation that was in effect at the time. So now MSHA is directly regulating silica dust. There can be citations and fines associated with exceeding the silica dust level, that has never happened in the past. So those are two very promising elements of this proposed rule.