NIOSH: black lung affects 1 in 3 veteran Appalachia miners

A National Institute for Occupational Safety and Health study published this month found that one out of three coal miners in Appalachia with more than 25 years in the industry has black lung disease.

Black lung disease, or coal workers' pneumoconiosis, is caused by repeated inhalation of coal dust, which scars the lungs and makes breathing difficult. There is no treatment to reverse the damage, and complications can eventually be fatal when too little oxygen reaches the bloodstream.

Appalachia, a major US mining region that includes all of West Virginia and parts of a dozen other states, has about 30,000 coal miners. NIOSH epidemiologist Scott Laney, a co-author of the study, said the prevalence rate is the worst he has seen since the 1970s.

Laney said rising exposure to silica helps explain why more miners are becoming sick faster and more seriously. Silica, which can be released when miners bore deeper into rock after easier-to-reach coal has been extracted, is described as 20 times more toxic than coal.

The Mine Safety and Health Administration adopted a rule in 2024 lowering the silica exposure limit to a level scientists believe is safer. Mining associations sued, arguing that the compliance standards were too stringent. A federal appeals court suspended the rule, which has not been implemented and has been shelved indefinitely.

The National Mining Association said it supports a lower permissible silica exposure limit but disagrees with MSHA's approach. Association spokeswoman Ashley Burke said new black lung cases do not reflect current mining conditions because symptoms can take time to appear, and said dust levels have fallen over the past two decades.

The Appalachian Citizens' Law Center, a group that advocates for miners, found that one out of five mines tested by MSHA in 2025 had dangerous levels of silica dust. In about 10 mines, the level was twice as high as the limit proposed in the unimplemented MSHA rule.