The scourge of black lung: Still a terrible problem we’re not doing enough to stop.

The federal Black Lung Program was enacted in 1969, just prior to the death of my grandfather, a Kentucky coal miner, from the disease. Black lung, also known as “Coal Workers’ Pneumoconiosis,” is an all-too-common occupational disease suffered by coal miners. Black lung is caused primarily by coal dust and respirable crystalline silica, a substance invisible to the naked eye, and even deadlier than coal dust.

Over half a century after the program’s launch, the black lung problem is worsening. Younger coal miners have been stricken in recent years with a disease assumed to afflict older workers after many years of exposure. About 16% of coal miners in the U.S. will ultimately contract the disease.

Once the potentially deadly dusts enter a miner’s lungs, they do not leave. They sit dormant – and hard to diagnose. Continued exposure to the dusts may lead to formation of scar tissue that replaces healthy lung tissue. Low blood oxygen levels may set in, taxing the heart and brain as scar tissue slowly degrades the miner’s lungs. Finally, the miner simply loses the lung capacity to breathe. The bitter end.

In light of these horrors, you would think that everything possible would be done to prevent black lung, and that when workers do contract it, all available resources would be deployed to compensate for the ensuing disability.

The situation is not that simple. Despite enactment of more stringent dust exposure standards, the rate of black lung cases has steadily risen in the past 20 years. Moreover, benefits payments to sick miners have fallen even as the overall cost of the program has risen. The black lung excise tax rate, which funds benefits and health care for stricken miners, was slashed by more than half at the end of 2021. To fix the problem Bobby Scott (VA-03) and Alma Adams (NC-12), introduced the Black Lung Benefits Disability Trust Fund Solvency Act of 2022 (H.R. 6462). The bill would “ensure the solvency of the fund that provides health care and benefits for disabled coal miners suffering from black lung disease.”

In a recent spotlight, Boston University public health professor Les Boden suggests that increased prevalence of black lung despite more stringent regulations may be due in part to the fact that “in recent years, underground mines have been mining coal faster and drawing it from increasingly thinner seams. As a result, ever more powerful mining machines have been cutting into rock with a high silica content, generating even more dust.” He also suggests that miners have been working longer hours, thereby increasing their exposure to coal-mine dust.

Other explanations for increasing prevalence and decreasing benefits are even less benign. Professor Boden notes that coal mine operators may be providing the Mine Safety and Health Administration, which monitors coal mine dust, with non-representative air samples from their mines, skewing air quality monitoring. S.2205 would require the Department of Labor to “use data from continuous personal dust monitors to determine whether to make changes to respirable dust concentration standards, controls, and measurements.” The bill’s findings contend that certain medical experts retained by coal operators have “systematically misclassified chest radiographs while employed by coal operators or their law firms for the purpose of opposing claims.”S.2205 seeks to make the claims process fairer, ensuring that sick miners, or survivors of deceased miners, who are legally barred from pursuing lawsuits, do not have their benefits whittled down further by unfair federal claims processes.

Low benefits and increasing exposure to lethal dusts are outrage enough. While the growing costs of operating the system will require much investigation, we owe our coal miners so much more than basic fairness. But that would be a good start. S.2205 at least seeks to put black lung back on the national radar as it once was in 1969; too late for my grandfather.

Michael C. Duff is Professor of Law at the Saint Louis University School of Law and the grandson of a Harlan County, Kentucky coal miner who died from black lung.