New silica proposal understates black lung’s toll on coal miners

The gravesite in Danny Smith’s vast and verdant yard is shaded by hulking trees. His parents’ graves are adjacent and marked by a massive headstone. In summer, crickets chirp, birds sing, and leaves rustle in the breeze. It is a peaceful spot for Smith’s final resting place. And it’s ready.

“I honestly never imagined it would get this bad,” Smith, 51, wrote recently in a text message from his home in the coalfields of eastern Kentucky. His breathing is so labored now, he told me, that he wasn’t sure he could get through a phone call. “I have a hard time just walking to the kitchen without losing breath,” he wrote. “I stay so tired and exhausted.”

Smith’s lungs are riddled with fibrotic tissue. When NPR and PBS Frontline last visited in 2018, he tried to mow his lawn, but a fit of heavy hacking forced him to his knees. Coughing violently, he spit out what looked like moist and crusty bits of dark gray paper with black streaks. That’s dead lung tissue, his respiratory therapist told us later.

Smith suffers from progressive massive fibrosis (PMF), an incurable, fatal and advanced stage of black lung disease. It plagues thousands of sick and dying coal miners like him. The likely cause, studies conclude, is exposure to clouds of silica dust while mining coal, and digging through solid rock to get to coal seams and prepare them for mining. Silica, one of the most abundant minerals on earth, is 20 times more toxic than coal dust alone. It wreaks havoc on lung tissue when inhaled repeatedly. 

“As bad as I feel now, and I never thought I would say it,” Smith wrote, “I so wish I had never stepped foot inside a mine.”

Smith worked just 12 years underground and was diagnosed with PMF at 39. Both are shocking numbers because it used to take decades of mining for coal miners much older to get as sick as this.

A crackdown on silica dust. Or is it?

Now, after decades of delay, the federal Mine Safety and Health Administration (MSHA) is finally getting serious about overexposure to silica in the nation’s mines. 

The agency is proposing a silica dust exposure limit twice as tough as it is now. MSHA would also directly regulate excessive silica exposures, something it hasn’t previously done, making citations and fines possible for putting miners at risk. 

“Our current standard as it relates to regulating silica in the nation’s mines…does not adequately protect miners’ health,” Christopher Williamson, the Assistant Secretary of Labor for Mine Safety and Health, acknowledged in an interview.

But there are questions about how effective even these measures will be, beginning with MSHA’s assumptions on potential lives saved and disease avoided.

An investigation by Public Health Watch, Louisville Public Media and Mountain State Spotlight shows that the plan’s purported benefits understate the silica risk to coal miners and the urgent need for immediate action.  The news organizations documented cases of PMF not mentioned in MSHA’s plan or included in the calculation of how many lives the proposed rule could save and how much disease it could prevent. 

The results are staggering: more than 4,000 cases of PMF identified by black lung clinics and the National Institute for Occupational Safety and Health (NIOSH) since 2010; more than 1,500 diagnoses in just the last five years alone.  

Understating the risk potentially weakens MSHA’s case as its proposed rule faces possible challenges from the mining industry.

“The scale of human tragedy is profound,” said Kirsten Almberg, an epidemiologist at the Black Lung Data and Resource Center at the University of Illinois Chicago.  Almberg tracks the occurrence of PMF as reported by federally funded black lung clinics.

Our investigation surveyed both independent and government-supported clinics that test coal miners for black lung disease. We also obtained, through the Freedom of Information Act, unpublished counts of disease from the federally-funded clinics.  

“There’s really no way to quantify…the individual tragedy that happens in each of these cases, with lives cut short, careers cut short, communities reeling and families falling apart,” Almberg said. “It’s just devastating.”

These thousands of cases of disease, suffering and death are not included anywhere in the 168 pages of MSHA’s proposed rule on silica dust exposure. They’re not part of the agency’s prediction of how many lives its new regulation might save (just 63 over 60 years), and how much disease…