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Black Lung Cases Surge in United States

Ray Marcum, left, and Thomas Marcum share fishing stories at Jenny Wiley State Park near Prestonsburg, Ky. Photo by James Crisp/AP Images for The Center for Public Integrity.

Editor’s note: NPR continued its series on black lung Tuesday morning with a closer look at the loopholes in regulation that have contributed to the recent rise in the deadly disease. The NewsHour spoke with NPR’s Howard Berkes on Monday about the series, which was reported in collaboration with The Center for Public Integrity.

PRESTONSBURG, Ky. | Ray Marcum bears the marks of a bygone era of coal mining. At 83, his voice is raspy, his eastern Kentucky accent thick and his forearms leathery. A black pouch of Stoker’s 24C chewing tobacco pokes out of the back pocket of his jeans. “I started chewing in the mines to keep the coal dust out of my mouth,” he says.

Click to enlarge this graphic showing continuous and longwall mining equipment. Graphic by Center For Public Integrity

Plenty of that dust still found its way to his lungs. For the past 30 years, he’s gotten a monthly check to compensate him for the disease that steals his breath — the old bane of miners known as black lung.

In mid-century, when Marcum worked, dust filled the mines, largely uncontrolled. Almost half of miners who worked at least 25 years contracted the disease. Amid strikes throughout the West Virginia coalfields, Congress made a promise in 1969: Mining companies would have to keep dust levels down, and black lung would be virtually eradicated.

Marcum doesn’t have to look far to see that hasn’t happened. Throughout the coalfields of Appalachia, in small community clinics and in government labs, it has become clear: Black lung is back.

A joint investigation by NPR and the Center for Public Integrity (CPI) has found that Marcum is not alone. In fact, incidence of the disease has doubled in the last decade.

NPR’s Howard Berkes discussed the black lung findings on Monday’s PBS NewsHour broadcast.

Cases of the worst stage of the disease have quadrupled since the 1980s in a triangular region of Appalachia stretching from eastern Kentucky through southern West Virginia and into southwestern Virginia.

An analysis of federal data by CPI and NPR also shows that the mining industry and federal regulators have known for more than two decades that coal miners were breathing excessive amounts of the coal mine dust that causes black lung.

NPR and CPI also found that the system for controlling coal mine dust is plagued by weak regulations and inaccurate reporting that sometimes includes fraud.

Many of the newer cases have taken a particularly ugly form. While rates of black lung overall have increased, incidence of the most severe, fast-progressing type has jumped significantly. These cases, moreover, are occurring in younger and younger miners.

Of particular concern are “hot spots” identified in central Appalachia by the National Institute for Occupational Safety and Health, NIOSH, a government research agency.

“I think any reasonable epidemiologist would have to consider this an epidemic,” said Scott Laney, a NIOSH epidemiologist. “All cases of [black lung] are preventable in this day and age, but these cases of [the most severe form] are just astounding … This is a rare disease that should not be occurring.”

Click to enlarge this graphic.

Tune in to the PBS NewsHour Monday evening for Hari Sreenivasan’s discussion with NPR’s Howard Berkes on the scope of the black lung resurgence and the societal factors playing into it.

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