Miners Keep Dying Despite Federal Laws

Link to Special Report:  http://www.courier-journal.com/cjextra/blacklung/index.html

POUNDING MILL, Va. — Mark McCowan knew he had inhaled a lot of coal dust during 20 years of operating heavy equipment in underground mines in southwest Virginia.

But at 40 years old, he had no symptoms of disease, and a chest X-ray taken eight years earlier had shown nothing amiss.

Plus, a federal law enacted to eliminate coal workers' pneumoconiosis — black lung — had been in effect for more than 35 years.

Yet, after McCowan followed a friend's example and got a second chest X-ray in April 2005, he found he was another example that the nation's commitment to eliminating black lung has been imperfectly fulfilled.

The 1969 law set the level of coal-mine dust that miners can breathe during an eight-hour shift at 2 milligrams per cubic meter of air. But 38 years later, they're still dying — more than 20,000 nationwide since 1990.

Black lung death rates in Kentucky rose 38 percent in the six years ending in 2004, even as they dropped in other major coal-mining states.

And there are signs that the deaths will continue. Among Kentucky miners getting chest X-rays last year, the number of black lung cases was three to five times higher than expected.

For years, federal officials have talked about eliminating black lung, but there have been obstacles. For example, a federal advisory committee's key recommendations on how to stamp out the disease still haven't been implemented almost a decade after they were issued — partly because of a change in focus when President Bush took office, some say. Also, some researchers say the operators of small mines common in Eastern Kentucky may not have the resources or the will to bring dust down to levels that won't sicken workers.

Fifteen years after the federal law went into effect, McCowan began working in the mines, so he never should have been exposed to dust levels sufficient to scar his lungs, end his career and perhaps consign him to a premature death.

Now 43 and with two grown sons, McCowan is plagued by shortness of breath and fatigue.

He has settled his disability-benefits case with Virginia, but a federal claim has been denied and he is appealing. And while his wife works as a secretary, McCowan languishes at home.

Inactivity isn't something he is used to. He says he worked hard in the mines, but that his labor came at a high price.

"The record production I give 'em has shortened my life on this earth. Legislation was enacted to try to protect us (but) we're dyin'. Thirty-eight years is too long."

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The federal law's overall impact has been substantial. The percentage of coal miners with black lung has declined dramatically since the 1970s, from 33 percent to 5 percent or less.

But the deaths continue, and in addition to the human toll, more than $40 billion in federal black-lung benefits has been paid out since 1970, financed by an excise tax on coal and with the cost presumably passed along to consumers.

And Kentucky pays an estimated $77 million annually in state benefits to about 10,000 disabled miners or their surviving dependents. Those benefits are funded by assessments on workers' compensation insurance premiums paid by coal companies.

Recent analysis by the National Institute for Occupational Safety and Health of miners' chest X-rays has renewed concern that any are still getting sick from breathing coal dust.

NIOSH sent its van into nine Eastern Kentucky and southwest Virginia counties last spring and summer, offering free chest X-rays to miners.

Although only about 13 percent of the estimated workforce responded — 633 in Virginia and 340 in Kentucky, the results showed that from two to five times as many miners as expected had black lung, 91 in all, including 43 with severe cases.

Because the sample was relatively small, the incidence of miners found to have black lung could have been inflated if those who knew or thought they were ill were more likely to get X-rayed. McCowan, for example, had an X-ray when the NIOSH van came to Tazewell County, Va., even though he'd been already been diagnosed.

Still, the fact that even a few cases of severe black lung were identified, especially in relatively young miners, heightened the sense of urgency for health professionals seeking to eradicate it.

"We are finding people for whom things went terribly wrong," said Dr. David Weissman, director of the division of respiratory disease studies for NIOSH in Morgantown, W.Va."And that makes us think there are others for whom things went terribly wrong. ... That's not something that should be happening in 2007."

Dr. John Dement, a Duke University occupational medicine professor, said: "Isn't it sad that we're still talking about this? We know a lot about the disease. It's a matter of having the will to do what's needed."