Black Lung cases surge in Coal Mines

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http://www.npr.org/2012/07/09/155978300 ... ases-surge

As Mine Protections Fail, Black Lung Cases Surge

by Howard Berkes
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Coal miners are tested for black lung at a clinic in West Virginia.
Enlarge David Deal for NPR

Coal miners are tested for black lung at a clinic in West Virginia.
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July 9, 2012

Part one of a two-part series.

It wasn't supposed to happen to coal miners in Mark McCowan's generation. It wasn't supposed to strike so early and so hard. At age 47 and just seven years after his first diagnosis, McCowan shouldn't have a chest X-ray that looks this bad.
Graphic
A lung from a coal miner with advanced coal workers' pneumoconiosis, or black lung.

What Is Black Lung?

"I'm seeing more definition in the mass," McCowan says, pausing for deep breaths as he holds the X-ray film up to the light of his living room window in Pounding Mill, Va.

"The mass is larger and more defined in the right upper lobe," he continues, clinically describing the solid streak that shows up white on the X-ray of his lungs. "If you know white is bad and black is good, I'm in a lot of trouble."

McCowan went from a clean X-ray at age 35 to progressive massive fibrosis — an advanced stage of coal workers' pneumoconiosis, or black lung — in just five years.

"You go from being normal to where ... one day you try to do something you used to do, and you can't do it and you're just heaving to catch your breath," McCowan says. "And you say this is crazy. It can't be this bad. And then you realize a couple months down the road that it can be. And you realize a year down the road after that that you ain't seen nothing yet."

An 'Epidemic' Among Miners
The Resurgence Of Black Lung By Tenure
Percent of evaluated mine workers with the most severe stage of 'black lung,' by years of mining

Source: Coal Workers' Health Surveillance Program (CWHSP), NIOSH

Credit: Alyson Hurt / NPR

A joint investigation by NPR and the Center for Public Integrity (CPI) has found that McCowan is not alone. Incidence of the disease that steals the breath of coal miners doubled in the last decade, according to data analyzed by epidemiologist Scott Laney at the National Institute for Occupational Safety and Health (NIOSH).
Black Lung District By District
Percent of evaluated mine workers with any stage of 'black lung,' by years of mining

Source: Coal Workers' Health Surveillance Program, NIOSH

Credit: Alyson Hurt / NPR

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.

The Appalachia region between eastern Kentucky, southern West Virginia and southwestern Virgina has seen a dramatic return of black lung.
Mining Districts Most Affected

Black lung experts and mine safety advocates have warned of the resurgence of the disease since 1995. New reporting by CPI and NPR reveals the extent to which federal regulators and the mining industry failed to protect coal miners in the intervening years.

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

"This is clearly a public health epidemic," Laney says. "This is a rare disease that should not be occurring. It's occurring at a high proportion of individuals who are being exposed."

Especially shocking to Laney and others focused on black lung is the grip the disease has on younger miners and its rapid evolution to progressive massive fibrosis, or complicated black lung.

At the Upper Kanawha clinic in Cedar Grove, W.Va., the black lung caseload doubled in the last 10 years, according to program coordinator Debbie Wills, and began to include younger miners in their 40s and more serious disease.
Patty and Gary Quarles lost their son, Gary Wayne Quarles, in the explosion at Upper Big Branch mine. Their son's post-mortem diagnosis indicated he had black lung, a puzzling finding since he was only 33.
Enlarge David Deal for NPR

Patty and Gary Quarles lost their son, Gary Wayne Quarles, in the explosion at Upper Big Branch mine. Their son's post-mortem diagnosis indicated he had black lung, a puzzling finding since he was only 33.

"The first 10 years or so that I worked here I had four patients with complicated black lung," says Wills, who has worked at the clinic since 1989. "We knew them all intimately because there were so few of them. Now we have at least 50 diagnosed with complicated black lung."

The autopsies of the 29 victims of the 2010 explosion at what was then Massey Energy's Upper Big Branch mine also show an escalation of cases. Twenty-four of the victims had sufficient lung tissue for testing, and of those, 71 percent had the nodules and lesions on their lungs that signify the disease.

That's a rate 10 times the average for southern West Virginia, says Davitt McAteer, a former federal mine safety chief who led an independent investigation of the explosion, in Raleigh County, W. Va., and reviewed the autopsies.

"What was shocking was the number of miners who showed evidence of black lung," McAteer says, "particularly among younger miners ... and miners who you would not have expected to have black lung."

That includes some victims who spent fewer than 10 years underground and at least two who were only in their 20s.

"It's unbelievable," says Gary Quarles, whose son Gary Wayne Quarles was 33 when he died at Upper Big Branch. His autopsy showed signs of black lung. "Being in the mines for 13 to 15 years and already considered having black lung ... that's uncalled for."

Quarles, who is 55 and spent twice as many years underground, says his chest X-rays are negative for the disease.

Federal Law Aims To Curb Black Lung

The Federal Coal Mine Health and Safety Act of 1969 was supposed to sharply cut exposure to coal mine dust. The act set a standard for coal dust exposure (2 milligrams per cubic meter of air), which was as little as 1/4 of the concentrations miners breathed at the time.

The act's passage followed a 23-day unauthorized and rowdy strike in which 40,000 West Virginia coal miners demanded government efforts to prevent the disease and to compensate victims.
Historic Photos

Images from 1974 document the efforts to reduce black lung among coal miners.

East Gulf, one of the largest mining companies in the area of Rhodell and Beckley, W.Va., in 1974.
Jack Corn/US National Archives
A miner at the black lung laboratory in the Appalachian Regional Hospital in Beckley, W.Va., has his lung capacity tested. Blood samples were also taken and his heartbeat was monitored while walking on a treadmill. These and other tests were used to determine if miners had coal dust particles in their lungs.
Jack Corn/US National Archives
Miners who were turned away by other doctors often went to Donald Rasmussen, a pulmonologist, to learn whether they might have the disease.
Jack Corn/US National Archives
Miners undergo tests in the black lung laboratory at the Appalachian Regional Hospital.
Jack Corn/US National Archives
Miners waiting for their examination. After years of decline in black lung there has been a sudden surge in diagnosis, especially among younger miners.
Jack Corn/US National Archives
Men wait for the Beckley Black Lung Association meeting to begin. A fight for safer regulations dramatically decreased the hazards of mining.
Jack Corn/US National Archives

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By the end of the year, tough dust exposure limits were in place. Miners were offered free diagnostic chest X-rays every five years, and federal compensation became available.

The X-rays showed 4 in 10 miners tested had black lung. The disease killed 1,800 miners in a single year. But diagnoses soon plunged more than 90 percent, according to NIOSH data.

"They anticipated that no one would develop progressive massive fibrosis," says 84-year-old Donald Rasmussen, a pulmonologist in Beckley, W.Va., who says he's tested 40,000 coal miners in the last 50 years.

"In 1969, I publicly proclaimed that the disease would go away before we learned all about it," he adds. "And I was dead wrong."

Rasmussen first started charting an increase in serious black lung cases about 15 years ago.

"We began to see the appearance of younger miners who had worked in the mines only since the dust suppression following the '69 act that were showing up with complicated pneumoconiosis or progressive massive fibrosis," he says.

Since 1970, NIOSH epidemiologists documented test results for 43 percent of the nation's coal miners. In 1995, the tests began to indicate more and more black long, rapid disease progression and the unexpected occurrence among relatively young miners.

"From the patterns and from the severity, from the prevalence of the disease, this must be a situation in which the dust in many, many mines is simply not adequately controlled," says Edward Petsonk, a pulmonologist at West Virginia University and a consultant for NIOSH. "There's nothing else that could possibly cause this."

Increased Dust Exposure

The new era of coal dust controls was followed by more dust exposure for miners, according to federal data obtained by CPI and NPR. The average workweek for coal miners grew 11 hours in the last 30 years, adding about 600 hours of exposure each year.
More On Black Lung
Coal miner Lee Hipshire in 1976, shortly after emerging from a mine in Logan County, W. Va. at the end of his shift. At age 36, he had worked 26 years underground. A few years later, Lee took early retirement because of pneumoconiosis, or black lung disease. He died at 57.
The Picture Show

Documenting 'Dirty' Jobs: Miners At Work

Surface Coal Miners At Risk For Black Lung

Why Respirators Are Not A Solution

"By the time I was 40 years old, I mined more coal than most miners [had] seen in a lifetime," says McCowan.

Production pressure grew with greater demand for coal and higher prices. By 2000, coal production had jumped fivefold from the 1970s. In 2010, it was still triple what it was when the new coal dust limits took effect.

"You can't be exposed to the kind of tonnage that I was and not get black lung disease," McCowan says.

Actually, Petsonk and Rasmussen say, some miners are more susceptible to black lung than others. They can't explain why, but they do say that smoking enhances susceptibility. Still, neither McCowan nor Gary Wayne Quarles was a smoker.

Mining machines also became more powerful and efficient, cutting through coal seams laced with silica-bearing quartz and sandstone, especially in Virginia, West Virginia and Kentucky.

"In the process, they release more silicon dioxide, and the increase in silica is more toxic than just the coal dust itself," Rasmussen says.

Federal records obtained by CPI and NPR under the Freedom of Information Act show thousands of coal miners were exposed to excessive levels of silica in each of the last 25 years. Since 1987, coal mining companies and government inspectors turned in more than 113,000 valid mine dust samples. Roughly 52 percent of those samples exceeded federal standards. In 1998 alone, about 65 percent of the valid silica samples violated the standard.
Donald Rasmussen, 84, is a pulmonologist in Beckley, W.Va. He figures he's tested 40,000 coal miners in the last 50 years.
Enlarge David Deal for NPR

Donald Rasmussen, 84, is a pulmonologist in Beckley, W.Va. He figures he's tested 40,000 coal miners in the last 50 years.

Silica exposure prompts a call for something that might seem unexpected from the National Mining Association (NMA): more regulation. The industry group wants a crackdown focused specifically on silica in the Appalachian region where black lung is resurgent.

"These people are being exposed [to] three to four times the silica exposures for periods over 20 years. [They have] a chest full of silica and nothing's been done about it," says Bob Glenn, a black lung consultant for NMA.

Excess silica forces mining companies to meet a lower standard for coal dust. The idea is that less exposure to coal dust means less exposure to silica. The federal Mine Safety and Health Administration (MSHA) proposes toughening the coal dust standard by slashing exposure limits in half (to 1 milligram per cubic meter of air).

Mine Dust Standards Vs. Protection

Coal dust measurements taken by MSHA and the industry show that coal mines already meet the lower standard and have for years. But the industry still opposes the new standard because it would broadly apply to coal dust and to all mines everywhere.

In a companion story to the NPR/CPI investigation, veteran coal industry reporter Ken Ward Jr. of The Charleston Gazette reviews 40 years of attempts to strengthen protection for miners.
Mark McCowan, 47, was diagnosed with the worst stage of black lung only five years after an X-ray showed he had no sign of the disease.
Enlarge David Deal for NPR

Mark McCowan, 47, was diagnosed with the worst stage of black lung only five years after an X-ray showed he had no sign of the disease.

Ward quotes former MSHA official Celeste Monforton, a worker safety advocate now at George Washington University: "We can't get a regulation out to save our souls." And, as Ward reports, "miners are left with the same system that experts have agreed hasn't worked for decades."

Since 1970, when mine dust controls began, black lung contributed to the deaths of more than 70,000 miners. The federal government and the industry spent $45 billion compensating the victims, including McCowan, and their families.

"Now it feels like I've got a heavy wet sack on each lung," McCowan says, between long, deep breaths. "Breathing has become a conscious effort. ... It seems like I give up a little bit of my world each day, that it gets smaller and smaller."

Simple tasks become enormous challenges — "a Mount Everest every day," he calls it — including holding his 2-year-old grandson.

"I say, 'Little buddy, I got to put you down for a few minutes,'" McCowan says with a deep sigh. "And he's learned to run a little bit. He'll say, 'Run, paw-paw, run.' He wants me to chase him. And I can't."

NPR's Sandra Bartlett and Chris Hamby of the Center for Public Integrity contributed reporting for this story. Research by NPR's Barbara Van Woerkom; editing by NPR's Andrea de Leon and Alicia Cypress.

Listened to this story on NPR today. I was rather aghast at this.

[LadyTevar]

I will point out that this coincides with various loosening of Mining Regulations, as well as a sharp rise in Non-Union Mines. It's harder to complain that a mine is unsafe when there's no Union to protect you and your job. A related article in the local paper accuses various mines of 'cheating' on coal dust regulations.

We're reverting to the Bad Old Times. Next thing you know you'll have another "Dead Town" like Gauley Bridge (WV) after the Hawks' Nest Disaster.

[Sea Skimmer]

Well, easy solution is blow up the mountains, remove coal from air conditioned power shovel cab.

Though we might not even need that, because while coal demand was surging in the 1990s and early 2000s, its now crashing for the last four years, and will keep crashing for as long as fracking for natural gas works out. This however is likely to only increase industry pressure not to change regulations.

[Ritterin Sophia]

Well, easy solution is blow up the mountains, remove coal from air conditioned power shovel cab.

I hope that's sarcasm.

[Zaune]

So... Do your laws on corporate personhood include the ability to try one for whatever the nearest US equivalent is to Manslaughter By Gross Negligence?

[Highlord Laan]

I will point out that this coincides with various loosening of Mining Regulations, as well as a sharp rise in Non-Union Mines. It's harder to complain that a mine is unsafe when there's no Union to protect you and your job. A related article in the local paper accuses various mines of 'cheating' on coal dust regulations.

We're reverting to the Bad Old Times. Next thing you know you'll have another "Dead Town" like Gauley Bridge (WV) after the Hawks' Nest Disaster.

REGULATUNS R SOSHULSIST U COMMIE!

Really, I'm not surprised at this at all, and that's depressing. I know how I hope it ends up, but I'd probably get a warning for posting it. But yes, it will only get far, far worse from here. But there's a silver lining. At least most of the US is willing to let themselves be told it's what they want.

So... Do your laws on corporate personhood include the ability to try one for whatever the nearest US equivalent is to Manslaughter By Gross Negligence?

Hold corporations accountable? In the US? In some form that would actually matter? Thats some stand up worthy comedy there.

[Highlord Laan]

Doublepost.

[Darth Wong]

So... Do your laws on corporate personhood include the ability to try one for whatever the nearest US equivalent is to Manslaughter By Gross Negligence?

No, but there's corporate liability for negligent conduct. Of course, the right-wing is trying to "fix" that with "tort reform", so that avenue might be closed.

[Darth Wong]

Well, easy solution is blow up the mountains, remove coal from air conditioned power shovel cab.

I hope that's sarcasm.

It is easy; it's just not good for the regional environment.

[Broomstick]

This is yet another example of how a "safe" energy source like coal kills far more people than a "dangerous" energy source like nuclear.

I can't help but think that for many this is acceptable because those sickened and killed are poor white trash hillbillies or black people, whereas radiation might migrate on wind or water and affect them.

Most people have no clue how people are maimed and killed for their lifestyle because they don't see those people, they live far away from them and thus it's easy not to care or to regard them as lesser people that don't matter.

[Alyrium Denryle]

Well, easy solution is blow up the mountains, remove coal from air conditioned power shovel cab.

I am going to give you one opportunity to show that my forbearance is not misplaced SeaSkimmer. I am going to assume your statement is sarcasm, because mountaintop removal is not a solution for the following reasons

1) tap water contaminated with lead, arsenic, barium and manganese in dangerous concentrations... in Charleston. The state fucking capitol. Not some hick town on well water. Fucking Charleston.
2) Massive biodiversity loss
3) Air contamination. What? You think blowing up a mountain wont force everyone down wind to breath that shit?
4) Coal fired plants themselves expel things like Selenium which then proceeds to fall downwind, with toxic side effects.

These issues are not tied strictly to mountaintop removal, but coal mining in general.... but mountaintop removal is particularly bad.

But of course, state regulations are ignored by the regulators... because what coal companies do is actually illegal under state law. The federal government also ignores flagrant violations of the Clean Water Act. Why? A combination of staggering corruption, and governments that keep their regulatory agencies chronically underfunded for ideological reasons and more corruption (this is 'Murica. We dont do corruption by halves), and regulatory fines that do not exceed the savings made by illegal dumping, pollution, or even for that matter, federal occupational health standards.

[LadyTevar]

Gods folks, couldn't you smell Skimmer's sarcasm? *rolls eyes*

In related news one 'local' coal company is declaring Chapter 11 Bankruptcy.

Patriot says weak economic conditions in the U.S. and overseas also hurt its business, and environmental regulations have driven its costs higher. Patriot said it responded to weakening sales in the U.S. by reducing production and selling more coal overseas, but it continued to struggle with falling prices for thermal coal used for generating electricity and with rising costs.

Patriot also says several customers canceled their contracts.

The company idled several mines this year and eliminated about 1,000 jobs. CEO Richard Whiting left the company in late May amid concerns that Patriot might run short on cash.

I wonder how big a Golden Parachute Whiting left with. *snarl*