Black Lung: Enough Study, More Action

Every few months like clockwork, news stories have been appearing to report a rise in incidence rates for coal workers' pneumoconiosis (CWP).  The format goes something like this: 

• Headline: Black lung on the rise!
• Lead: NIOSH reports sharp increase in black lung cases
• Body: How can this be?  It's so perplexing.

You'd think they're talking about a never-seen-before viral disease.  Instead, it's all about CWP, a disease that is 100% preventable, yet it's being treated as if it is a mystery that can't be solved. 

This time, the story appeared in the Beckley, WV Register-Herald which reported on a public briefing by a NIOSH researcher for the WV House Select Committee on Mine Safety.  NIOSH's Lee Petsonk, MD provided the state lawmakers with preliminary results of a special chest X-ray screening program conducted in selected WV counties.  According to the news account, among the miners screen in Raleigh and Mercer counties, the incidence of pneumoconiosos was twice the national average.  The articles continues:

"What is even more puzzling is that miners are contracting deadly black lung at a younger age, meaning workers who start a career in the industry at 18 show evidence of it in their 30's, the physican told the panel.  Research performed in eastern Kentucky and western Virginia revealed almost identical results he said."

What's troubling about this newspaper account and the ones before it,* is the suggestion that these cases are a big surprise and that there is some mystery about why they are occurring.  The reasons mentioned in this story included:

• low coal seams in certain mines, which put miners in closer proximity to the dust;
• longer work days for miners; and
• higher percentage of crystalline silica in the coal dust.

Indeed, all of these things can contribute to a miners' overall exposure to coal dust, but it looks like a reminder is in order--the reason that miners develop CWP is EXPOSURE to respirable coal dust.

After the NIOSH presentation, the WV House Select Committee passed:

"a resolution seeking a full report on the disorder and possible solutions for the January interim [session]."

Rather than study the issue any further, the Committee can save a lot of time by simply reviewing the 1996 report of the Secretary of Labor's Advisory Committee on the Elimination of Pneumoconiosis Among Coal Mine Workers.  It contained 20 major recommendations including:

• separate exposure limits for coal dust and silica dust;
• verification of respirable dust plan based on actual coal production;
• a refined sampling protocols for extended work-shifts;
• the use continuous dust monitoring; and
• miners' participation in dust monitoring.

Futhermore, it has been more than 12 years since NIOSH recommended that the permissible exposure limit for coal mine dust should be cut in half (i.e., from 2.0 mg/m3 to 1.0 mg/m3.)  The agency's risk assessment provided substantial epidemiological evidence that the current 2.0 mg/m3 work-shift exposure limit is not protective.  In fact, at the current limit over a working life-time, about 15% of miners will develop CWP.  So, should we really be surprised that this is exactly what's happening?

After the Sago disaster, we saw how quickly the WV legislators responded with safety improvements like emergency communication systems and refuge chambers.  WV Delegate Mike Caputo and his colleagues on the Committee on Mine Safety should repeat this example by adopting a 1.0 mg/m3 coal dust limit to protect miners' health.  If West Virginia waits for federal MSHA to act, their own mountaineer-miners will suffer.