Why US coal miners are still developing black lung disease

In Hawk's Nest Redux, Ellen Smith reports that an apalling number of the 29 deceased Upper Big Branch coal miners had black lung disease. The autopsy evidence was reported at the end of one chapter of the investigation report prepared by an independent panel of investigators commissioned by the Governor of West Virginia.* Smith compared the shocking prevalence of lung disease in these men in the year 2010, to the 1930's Hawk's Nest tunnel/Gauley Bridge disaster in which a thousand workers developed acute and progressive lung disease within just a few weeks of work breathing air thick with silica dust. She writes,

Hawk's Nest is considered: "...one of the worst man-made industrial accidents in U.S. history. But as we know, it wasn't an accident. Workers were placed in harm's way for profit. Their health be damned."

Among the deceased Upper Big Branch (UBB) miners, 24 of the 29 had enough lung tissue to be examined by a pathologist, and 71% of these men had evidence of black lung (a.k.a. Coal workers' pneumoconiosis (CWP)). Black lung is a chronic, fibrotic and irreversible respiratory disease caused by inhaling respirable coal mine dust (comprised of coal and rock.) The respirable size particles deposit deep in the lungs and robs miners of their breath and life.

The 17 UBB miners with fibrotic disease (which is not associated in any way with cigarette smoking) ranged in age from 25 to 61 years. Nine of the men---the older ones---had more than 30 years of mining experience (i.e., exposure to respirable dust), but there were also five victims with fibrosis who had less than 10 years of mining experience.

How is it possible in the year 2010, that U.S. coal miners are still developing black lung disease???? It's an occupational illness that is TOTALLY preventable with diligent use of dust control measures including proper ventilation, water sprays and dust collectors.

The simple answer: these men and miners across the country are exposed to levels of respirable coal and silica dust that cause disease, BUT under current worker safety regulations, these hazardous levels are LEGAL. Mine operators have been allowed for decades to expose workers to deadly levels of respirable dust that the public health community predicted would cause respiratory diseases, including coal workers' pneumoconiosis.

More than 15 years ago, the National Institute for Occupational Safety & Health (NIOSH) recommended that the permissible exposure limit for respirable coal dust be reduced from 2.0 mg per cubic meter of air (m3) to 1.0 mg/m3. It was not until last October that the Obama Administration's Labor Department, specifically the Mine Safety and Health Administration (MSHA) took the first step to propose a more protective occupational exposure limit. That rulemaking is ongoing but running up against strong opposition from the mining industry and some members of Congress.

Moreover, most coal miners are not exposed to pure coal dust. Instead, the respirable dust they breathe contains varying concentrations of quartz (crystallline silica) which is substantially more harmful to lung tissue than coal dust. MSHA's (like OSHA's) permissible exposure limit for respirable crystalline silica is woefully out-of-date and not protective of workers' health. Way back in 1974, NIOSH recommended an occupational exposure limit of 0.5 mg/m3 (for up to a 10-hr workday during a 40-hr work week) but neither MSHA nor OSHA have adopted that limit. OSHA stated in December 2010 its plan to propose in April 2011 a more protective exposure limit for crystalline silica. That proposal has been with the White House's Office of Information and Regulatory Affairs since February and appears stuck there. It is also running into strong opposition from business and trade associations. MSHA indicated that it planned to wait for its sister agency OSHA to propose a silica rule, before the mine safety agency did so to protect mine workers. But with the White House's hold-up of OSHA's proposal, perhaps MSHA is rethinking that strategy. [Note to White House: it's a proposal. Let the comment period begin. Don't hold proposed rules hostage.]

As I've said, one part of the answer is that the existing rules are not protective. Another part is that some miners work for employers who break the law. These mine operators expose workers to dust levels that exceed the legal limits. At Upper Big Branch, for example, on six occasions between 2007-2009, federal inspectors measured respirable dust levels that exceeded 2 mg/m3. The exposures ranged from 2.06 to 8.54. If these are the dust levels documented on days when the inspector is present, imagine what workers were exposed to on the other days.

MSHA's respirable dust rules, though outdated, do attempt to provide some additional measure of protection when the air samples reveal more than 5% quartz in the dust. (The 2 mg/m3 exposure limit is reduced by a fraction depending on how much quartz is in the sample.) At Upper Big Branch, for example, the vast majority of the samples had more than 5% quartz:

*In 2009 and early 2010, MSHA collected 14 occupational samples to determine the percentage of quartz in the respirable dust. Samples were collected in March, May, July, December 2009 and March 2010. The % quartz results ranged from 5% to 27.7% The mean and median of the 14 samples was 14% and 9%, respectively.

*In 2008, MSHA inspectors collected 11 occupational samples in March, June, September and December to determine the percentage of quartz in the respirable dust. The % quartz results ranged from 6.8% to 18.8% The mean and median of the 11 samples was 11.2% and 10.8%, respectively.

Quartz is the most common mineral in the earth's crust. When coal miners and other workers cut and drill through it, they create respirable crystalline silica (i.e., quartz). For centuries, exposure to respirable silica has been known to cause respiratory impairment and in more recent years, evidence also indicates it associated with lung cancer and autoimmune disorders.

But MSHA's current regulations are not strigent enough to compel operators to protect miners' lungs from respirable coal and silica dust. At the Upper Big Branch mine between 2007-2009, MSHA issued six citations for violations related to exposing miners to respirable coal dust and silica. All of the violations were classified by the inspectors as "significant and substantial" (i.e., likely to cause serious harm), and four of them remain in limbo (and more than $10,000 in penalties unpaid) because Massey Energy contested them. That's just one coal mine. The same shenanigans goes on at coal mines across the country. Miners' health suffers because of it.

When I look at the comments submitted to MSHA on its proposed rule to address black lung disease, many of them fit into two categories. Coal miners say "YES" to the proposal. Those who already have the disease describe life when you can't catch your breath. They want the new rules in place to protect the younger miners (here, here, here, more here.) Those who oppose the rule say it will cost too much, and MSHA should simply require miners to wear respirators (here, here, more here.)

We know why some coal mine operators would rather pop respirators on the faces of their coal mine workers rather than control the respirable dust at its source with dust collectors, water sprays and ventilation: it's CHEAPER and it shifts the responsibility to the miner. Hey coal miner, if you get lung disease it's your fault. You must not have been wearing your respirator.

I've no doubt that some of these mine operators and their trade associations will be making the pitch for respirators to members of Congress, asking the lawmakers to intervene on their behalf with the Labor Department and the White House. With the Administration, the Republican Members of Congress and businesses all gung ho about "reducing regulatory burdens," and "reasonable regulations," I can see them saying:

"Why not respirators? They're cheaper and easier. That's our idea of a sound, common sense regulation."

When that happens, I surely hope that Administration officials will be bold enough to say:

Come and talk to me about forcing coal miners to wear respirators as a first line of defense against black lung after you, Mr. Congressman, have worn a half-piece respirator for 10 hours per day for five days straight, along with metatarsals boots, a leather belt holding 30 pounds of tools, safety goggles and a hardhat. Then we can talk about asking coal miners to do the same, while they work stooped over in a dark, damp, noisy coal mine.

Until we have lawmakers and policymakers who will do that and more to protect miners' health, we'll still have U.S. workers developing black lung.

Celeste Monforton, DrPH, MPH was a member of the Governor's Independent Investigation Panel examining the Upper Big Branch mine disaster. The team release their report on May 19, 2011.