Despite 'urgency,' Obama black lung rule remains stalled
CHARLESTON, W.Va. -- Top researchers are warning of an increased "sense of urgency" to combat black lung, but the Obama administration is saying little about any progress finalizing a rule it proposed more than 2 1/2 years ago to reduce exposure to the dust that causes the deadly disease.
In a new scientific paper, black lung experts outline the growing evidence that black lung is on the rise among Appalachian coal miners and that dust exposure is linked to a broad variety of respiratory problems, including lung cancer and emphysema.
"Coal miners' lung diseases are not only of historic interest," says the report, published last month in the American Journal of Respiratory and Critical Care Medicine, a respected journal for lung doctors. "They are a concern in the 21st century."
The paper, authored by leading black lung doctors including West Virginia University's Dr. Edward Lee Petsonk, urges physicians treating miners to consider a wider range of lung ailments as part of a class of diseases called "coal mine dust lung disease."
Also, the paper details increasing evidence that modern mining -- sometimes using advanced longwall machines and often targeting ever-thinner seams of coal -- generates huge amounts of dust that, when not properly contained, strangles miners' respiratory systems.
"The cause of the recent resurgence and severe forms of coal mine dust lung disease is likely multi-factorial," the new paper says. "Flaws have been recognized in existing regulations, dust-control practices, and enforcement."
A U.S. Mine Safety and Health Administration rule aimed at dealing with those issues is scheduled to be finalized by June, but the rule has yet to be sent to the White House Office of Management and Budget, where a regulatory review could take many months.
"We have no new information on this rule," MSHA spokeswoman Amy Louviere said last week.
Black lung, or coal workers' pneumoconiosis, is an irreversible and potentially deadly disease caused by exposure to coal dust.
Between 1996 and 2005, nearly 10,000 coal miners nationwide died of black lung, according to the National Institute for Occupational Safety and Health.
West Virginia recorded the second-most black lung deaths of any state, with more than 1,800 during that period, according to NIOSH. That compares to 87 miners killed in on-the-job accidents in that same time, according to federal data.
"In recent years, the country has been riveted by stories of tragic disasters in our nation's coal mines, including the explosions and fires at the Sago and Upper Big Branch mines in West Virginia," the paper said. "Less attention has been paid to the increase in prevalence and severity of the chronic lung disease which results from coal mine dust exposure."
More than 40 years ago, Congress made eliminating black lung a national goal with a law that required mine operators to take steps to limit exposure. The law greatly reduced black lung among the nation's coal miners.
Scientists have found, though, that black lung is on the rise again. Researchers have warned of a doubling of black lung rates since 1997, and of an alarming incidence of the disease among younger miners, whose entire careers took place under the 1969 law's dust limits.
The new paper recounts a host of recent research that shows dust-induced lung disease develops more quickly and progresses much more quickly in coal miners than previously thought, especially among workers in Southern West Virginia and other parts of Appalachia.
Traditionally, physicians have focused on coal workers' silicosis and pneumoconiosis caused by a mixture of dust exposures, but the new paper encourages considering those as part of a spectrum that also includes chronic airway diseases such as emphysema and chronic bronchitis. And, they note data that say some forms of fibrosis not normally linked to coal dust exposure actually show up far more frequently in coal miners and should be considered "coal mine dust lung disease," or CMDLD, so that workplace diseases are accurately counted.
"The sum of the evidence really shows this is a worsening problem, instead of a problem that's getting better," said co-author Dr. Robert Cohen, a medical professor at John Stroger Jr. Hospital of Cook County in Chicago. "When you put it all together, it underscores the need to do something -- better regulations, more stringent regulations, and better enforcement."
In July 2012, a joint investigation by National Public Radio and The Center for Public Integrity reported on the resurgence of black lung and, with additional reporting by The Charleston Gazette, documented widespread cheating by mining companies on dust samples and inaction by federal regulators over the past quarter-century to address the problem.
In October 2010, MSHA proposed new rules as part of what the agency touted as an aggressive plan to end the disease. Among other steps, the MSHA proposal would reduce the legal limit for dust in underground mines from 2.0 milligrams of dust per cubic meter of air to 1.0 milligram of dust per cubic meter of air. A Labor Department advisory commission recommended the change in 1996, and NIOSH has been urging since 1995 that the limit be tightened. Industry officials argue that recent increases in black lung rates are a regional problem and don't require a new nationwide rule.
In August 2012, the federal Government Accountability Office issued a major report that supported MSHA's proposal to toughen coal dust limits to fight a resurgence of black lung. That GAO report's findings ended a block by congressional Republicans on issuance of the final MSHA rule, which was proposed two years ago, in October 2010.
Since the GAO report, though, MSHA has reported no significant actions on its proposed rule. A final version has not been recorded as being filed with the White House Office of Management and Budget, and MSHA officials refuse to say much about the topic.
In a budget document submitted to Congress last month, MSHA said agency officials would "take aggressive action" in the coming year to reduce miners' exposure to coal dust.
MSHA's 103-page budget document noted that the agency's strategy included "enhanced enforcement, education and training, and health outreach." MSHA promised special dust inspections and a review to ensure mine operators are properly monitoring dust levels in work areas.
"[MSHA] will continue to work with mining equipment manufacturers to identify the most effective engineering control measures and promote their use," the MSHA budget document said. "These activities will help ensure the respiratory health of the nation's miners."
A separate section of MSHA's budget on new regulations listed rules on exposure to silica, requiring proximity detection systems, and follow-up to the Upper Big Branch Mine disaster -- but not the agency's proposed rule to tighten coal-dust limits.
Louviere said the coal-dust rule is still high on the agency's agenda, though.
"The respiratory dust rule is on MSHA's regulatory agenda for 2013," she said last month.
Reach Ken Ward Jr. at firstname.lastname@example.org or 304-348-1702.