OAK HILL, W.Va. \u2014 Each day at New River Health in Oak Hill, Lisa Emery finds disheartening signs of what she describes as a slow-motion repeat of the Hawks Nest Tunnel disaster.<\/p>\n
Emery is director of New River\u2019s Breathing Center and chair of the National Coalition of Black Lung and Respiratory Disease Clinics<\/a>.<\/p>\n The disaster she\u2019s reminded of started in 1930, when construction began<\/a> on a 3-mile tunnel through Gauley Mountain in West Virginia. Over the course of 18 months, some 3,000 miners, most of them Black, spent long hours drilling through sandstone, engulfed in a cloud of its toxic byproduct, silica dust. More than 750 men died from that exposure.<\/p>\n The risk still exists, and advocates for workers say the government should do more to rein it in.<\/p>\n In April of last year, the Trump administration paused the enforcement of a rule designed to help protect coal miners from an aggressive form of coal workers\u2019 pneumoconiosis, commonly known as black lung disease, the primary cause of which is exposure to silica dust.<\/p>\n (Other occupations at high risk of exposure to silica dust<\/a> include construction, countertop fabrication<\/a>, and oil and gas work. The new rule would reduce the permissible limit of exposure in coal mining to the existing level in other industries.)<\/p>\n This April, the Labor Department\u2019s Mine Safety and Health Administration announced an indefinite delay in enforcement of the rule.<\/p>\n Gary Hairston sits on New River Health\u2019s board. For decades, Hairston, a retired coal miner and president of the national Black Lung Association<\/a>, has been an advocate for miners struggling with the debilitating effects of black lung, including extreme fatigue, an incessant cough, and a sensation of drowning. He regularly lobbies legislators for improved working conditions and black lung benefits. His entreaties, he said, seem to fall on deaf ears. He rarely gets an audience with the legislators themselves.<\/p>\n \u201cI\u2019d just like them to look me in the face,\u201d Hairston said.<\/p>\n Gary Hairston, president of the Black Lung Association, says his lobbying of legislators for improved working conditions and black lung benefits for coal miners seems to fall on deaf ears. (Taylor Sisk for KFF Health News)<\/p>\n Evidence from just-released research underscores the urgency of his appeals for a safer work environment.<\/p>\n In August, the National Institute for Occupational Safety and Health, an agency within the federal Centers for Disease Control and Prevention, released a report<\/a> on the results of testing conducted over the past five years on miners in central Appalachia \u2014 eastern Kentucky, southwestern Virginia, and West Virginia \u2014 with 25 or more years underground. Almost 1 in 3 tested positive for black lung disease, the highest rate in nearly 50 years.<\/p>\n The rate in 2018, the last time the agency reported results, was 1 in 5. The lowest reported rate, in 1999, was less than 1 in 10.<\/p>\n \u201cWe knew this would happen,\u201d said Sam Petsonk, a West Virginia attorney who has represented thousands of miners in the region. \u201cIt\u2019s surprising to me that they only found one in three.\u201d<\/p>\n Silica Dangers<\/strong><\/p>\n Exposure to silica has increased as more-accessible coal seams are depleted, requiring mining operations to probe deeper, often through sandstone. The stone breaks into sharp particles that are 100 times smaller<\/a> than a grain of sand and, according to National Institute for Occupational Safety and Health research, are some 20 times more toxic<\/a> than coal dust. Trapped in lung tissue, those particles can cause a debilitating, sometimes fatal condition.<\/p>\n Kenny Thompson, a retired West Virginia miner who now lives in Richmond, Kentucky, was employed in the mines for 22 years. He would sometimes cut into four feet of sandstone to reach a coal seam.<\/p>\n \u201cYou ate a lot of dust,\u201d Thompson recalled. It induced nausea. It took a toll.<\/p>\n In October 2025, he had his left lung removed. Post-surgery, he was in a coma for three months; he flatlined three times, he said. \u201cThey were about to really give up on me.\u201d<\/p>\n He had to relearn to walk and to talk. Trekking to the mailbox still leaves him winded, lightheaded, and blurry-eyed.<\/p>\n The new silica rule would cut the allowable level of silica dust in half, thereby meeting the standard of other industries. Miner advocates laud the fact that it would require operators to deploy engineering controls, such as improved ventilation systems and water sprays.<\/p>\n But the National Mining Association and other industry trade groups argue that reaching and maintaining compliance would also require supplementing those controls with workforce measures, such as requiring personal protection equipment and rotating miners from particularly dusty areas. Many miners, and their advocates, say such measures are impractical \u2014 because respirators can impede breathing, can limit vision, and often malfunction, and because smaller mines don\u2019t have enough workers to support rotating schedules.<\/p>\n In April 2025, the 8th U.S. Circuit Court of Appeals granted an emergency stay of the rule to give operators more time to comply.<\/p>\n In May of this year, the Labor Department sent the White House Office of Management and Budget a request to gather information<\/a> on the proposed rule. And in July, the department\u2019s regulatory agenda included a new notice of proposed rulemaking<\/a>, indicating its intent to amend the rule.<\/p>\n The department\u2019s Mine Safety and Health Administration \u201crecognizes it has a clear duty under the law to impose stricter silica standards,\u201d said Petsonk, the attorney representing coal miners. \u201cThey\u2019re failing to provide that measure of protection to American coal miners, so they\u2019re going through bureaucratic motions to make it seem like they\u2019re doing something, when, in fact, they\u2019re just perpetuating an illegal and lethal status quo.\u201d<\/p>\n The Labor Department declined to comment on ongoing rulemaking or litigation.<\/p>\n \u201cWe knew this would happen,\u201d West Virginia attorney Sam Petsonk says of a recently released report showing that the black lung rate for coal miners in central Appalachia is at a nearly 50-year high. (Taylor Sisk for KFF Health News)<\/p>\n \u2018It\u2019s On the Books\u2019<\/strong><\/p>\n The rule is, in fact, in effect, said Chris Williamson, head of the Mine Safety and Health Administration in the Biden administration \u2014 it\u2019s just not being enforced. He and his team filed a legal brief in the closing days of the administration defending the rule.<\/p>\n \u201cIt\u2019s on the books,\u201d Williamson said, adding that the Mine Safety and Health Act<\/a> prohibits weakening existing protections for miners. \u201cI\u2019m just genuinely curious,\u201d he said. \u201cI want to know how they can address the issues that the industry\u2019s raised without weakening protections for miners.\u201d<\/p>\n Meanwhile, younger miners, with a decade or less in the mines, are being diagnosed with advanced stages of black lung. New River Health\u2019s Emery said the youngest person her clinic had diagnosed with complicated black lung<\/a> was 30. He\u2019d worked underground for 10 years.<\/p>\n This is no longer just your \u201cpapaw\u2019s disease,\u201d she said. \u201cIt\u2019s your husband\u2019s disease. It\u2019s your son\u2019s disease.\u201d (More than 90% of coal miners are men.)<\/p>\n With families to support, Emery said, \u201cwhat do these guys do when they\u2019re disabled in their 30s?\u201d<\/p>\n Lisa Emery is director of the New River Health Breathing Center in West Virginia and chair of the National Coalition of Black Lung and Respiratory Disease Clinics. She says the youngest person her clinic has diagnosed with complicated black lung was 30. (Taylor Sisk for KFF Health News)<\/p>\n She told of a man who sat in her office with his wife, describing his symptoms. As he spoke, he began to cry. His wife was taken aback. \u201c\u2018I didn\u2019t know it was that bad,\u2019\u201d Emery recalled her saying. \u201cAnd he said: \u2018That\u2019s why I haven\u2019t fixed the deck. I haven\u2019t fixed the deck because I can\u2019t breathe, and I\u2019m just so tired.\u2019\u201d<\/p>\n Thompson can relate. \u201cFor 22 years, you\u2019re used to getting up, putting your boots on every day, and going to work,\u201d he said. \u201cI\u2019d been in great health shape and 160 pounds. And here I am now, I don\u2019t work at all and I\u2019m 115 pounds.\u201d<\/p>\n Still, he recognizes what the job afforded.<\/p>\n \u201cYou know, it put my girls through college,\u201d he said. \u201cAnd to me, as a dad, that was the best reward that I can give them, to move forward in life, to be successful at what they chose to be and not work like a dog like I had to.\u201d<\/p>\n President Donald Trump said in an April 2025 executive order<\/a>: \u201cOur Nation\u2019s beautiful clean coal resources will be critical to meeting the rise in electricity demand due to the resurgence of domestic manufacturing and the construction of artificial intelligence data processing centers.\u201d<\/p>\n Six months later, the Energy Department announced a $625 million investment<\/a> to \u201cexpand and reinvigorate America\u2019s coal industry.\u201d<\/p>\n Should the administration announce a weaker rule, it would be \u201can unconscionable crime against American coal miners,\u201d Petsonk said. \u201cBut I fear that\u2019s going to happen.\u201d<\/p>\n In June, Hairston spoke at a reception for a photo exhibit titled \u201cEntirely Preventable: The Toxic Legacy of Silica Dust From Hawks Nest to Black Lung<\/a>.\u201d<\/p>\n \u201cIt seems like coal miners, we\u2019re just a number,\u201d he said. \u201cJust a number.\u201d<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":" OAK HILL, W.Va. \u2014 Each day at New River Health in Oak Hill, Lisa Emery finds disheartening signs of what she describes as a slow-motion repeat of the Hawks Nest Tunnel disaster. Emery is director of New River\u2019s Breathing Center and chair of the National Coalition of Black Lung and Respiratory Disease Clinics. The disaster…<\/p>\n","protected":false},"author":0,"featured_media":15695,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-15694","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15694"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15694"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15694\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/15695"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15694"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}