Researchers with the CDC's National Institute for Occupational Safety and Health (NIOSH) report in the current issue of Morbidity and Mortality Weekly Report (Vol. 16, No. 23) on the prevalence of dust diseases of the lungs among U.S. surface coal miners. Based on chest x-rays performed on 2,238 workers who work at surface/strip coal mines in 16 States, 46 of them (about 2 percent) had radiographic evidence of coal workers' pneumoconiosis (CWP). The median age of the workers with CWP was only 56 years; the median years of mining experience was 33 years. Especially troubling is the researchers' finding that 12 of the surface miners who volunteered for the chest x-ray have an advanced form of CWP called progressive massive fibrosis (PMF). It's a condition involving significant scarring of the lungs which prevents adequate oxygen exchange. Individuals with PMF eventually suffer serious respiratory distress, disability and premature death.
We've written previously about the problem of black lung and silicosis among U.S. workers (here, here, here, here, here, here.) This report just adds to the evidence, and provides solid information that surface coal miners develop CWP, too. It comes at a time when some major mining companies are arguing that surface mining jobs are not dusty enough to cause CWP. But this surveillance program found the following: of the 46 miners identified with disease, 37 of them (80%) had never worked in an underground coal mine.
The coal companies' assertions were made last month during the public comment period on proposed changes to the federal Black Lung Benefits Act. The U.S. Department of Labor's Office of Workers' Compensation Programs manages the program, which dates back to 1969, and provides modest compensation to coal miners who are totally disabled by black lung disease, and to their eligible survivors. The proposed changes to the program (77 Federal Register 19456 (March 30, 2012)) were presented pursuant to provisions of the Patient Protection and Affordable Care Act of 2010 (Pub Law 111-148.) One involves a presumption that if a mine worker has a disabling respiratory or pulmonary impairment AND that worker was employed for at least 15 years at a surface mining operation, it is reasonable to presume that the health condition is due to exposure in the dusty environment.
At least two of the country's biggest coal mining companies disagrees. Alpha "Running Right" Natural Resources and CONSOL "Safety Trumps Everything" Energy submitted comments to DOL opposing these proposed changes. In separate, but nearly identical letters prepared by the law firm Jackson Kelly PLLC (here and here) these coal companies misconstrue the 1995 NIOSH "Criteria for a Recommended Standard: Occupational Exposure to Respirable Coal Mine Dust,” (DHHS/NIOSH Pub. No. 95-106.) They erroneously assert that NIOSH
"recognizes that there is no substantial risk for above-ground coal miners, other than those working as drillers, or those who have previously worked underground."
Actually, the section of the NIOSH criteria document addressing surface coal miners reads:
"Studies have shown that U.S. surface coal miners (particularly workers on drill crews) are at risk of developing CWP."
No surprise that the National Mining Association (NMA) jumped on the bandwagon too, claiming that surface miners don't develop pneumoconioses (i.e. dust diseases of the lungs.) In its comments, Mr. Bruce Watzman, NMA's senior VP for regulatory affairs, cherry picks a single paper from 1977 to argue that there is "...almost no incidence of clinical or legal pneumoconiosis in non-smoking surface miners," and also distorts data from CDC NIOSH's surveillance program. Mr. Watzman says:
"More recent studies sponsored by the U.S. Center for Disease Control suggest virtually no incidence of pneumoconiosis in surface mine employees in states where prior underground mining experience is not likely. In studies of more than 4,000 surface miners in Indiana and Illinois, conducted from 1996-2001, only three showed any evidence of pneumoconiosis and none showed evidence of severe disease. [He refers to Table 1 in an April 18, 2003 MMWR. ] ...The incidence reported is statistically irrelevant and most likely shows error or fails to account for prior underground experience."
The trouble is, this paper does not describe a study of "more than 4,000 surface miners in Indiana and Illinois." Table 1 in the paper referred to by the NMA official provides data on 20,647 underground and surface miners in 27 States who volunteered for an chest-xray. The number of surface coal miners in Illinois and Indiana who participated was 572. The "more than 4,000" number comes from a column of data in the table with the heading "average employment" in each State, referring to an estimate of the number of workers employed as underground and surface coal miners. The combined numbers for Illinois and Indiana are an estimated 5,116 workers in underground coal mines, and 4,048 in strip coal mines. The number of surface coal miners screened in those two States was 572, and three cases of CWP were identified by the workers' chest x-rays. There's nothing in that 2003 MMWR to suggest that these cases are "statistically irrelevant" or erroneous.
This June 15, 2012 report in the MMWR on dust-disease prevalence among U.S. surface coal miners is yet another to be published. A chest x-ray surveillance program conducted in 1996 and 1997 involving 1,200 surface coal miners in Pennsylvania was reported in a July 2000 MMWR. In that study, the prevalence of silicosis was nearly 7 percent among all participants, and for about 200 surface miners who participated at one particular mine site, the prevalence was 16 percent. The mean age of all participants with silicosis was only 50.6 years.
But these big coal mine operators---Alpha Natural Resources and CONSOL Energy---argue that surface miners can easily get away from the dust on their job. In their written comments submitted last month to DOL, they wrote:
"Underground coal mining conditions are constant and not dependent upon weather, where in surface work, a rainy or snowy day will keep dust exposure to a minimum."
They forgot to mention a few things that can make a surface mining job more dusty than an underground one. As Steve Sanders a public interest lawyer with the Appalachian Citizens' Law Center wrote in his comments to DOL:
"Surface miners are constantly exposed to dust from the trucks and heavy equipment moving on dirt roads and strip benches, dust from drilling and blasting, and dust from moving, loading and dumping large quantities of earth, rock and coal. Likewise workers at preparation plants and load-out facilities have significant exposure to dust from large quantities of coal being moved, loaded and dumped. ...When one considers the working conditions for surface coal miners, the potential for exposure is actually greater for surface coal miners than for underground miners. Unlike underground mines, surface mining operations do not have ventilation systems drawing clean air to the working section or pulling dust- and fume-laden air away from it. Moreover, because the drilling, blasting, scooping, hauling and transporting process occurs at the site of the freshly extracted coal and rock, surface coal miners simply cannot get away from the dustiest areas."
That's exactly what former surface coal miner John Bud Ritchie, of eastern Kentucky told Laura Ungar of the Louisville Courier-Journal for her June 16, 2012 story "Kentucky surface miners hit hard by black lung":
'Coal mining is really, really dusty. Don’t matter what you do, you’re in the dust,' said Ritchie, who retired in 1995. 'It’s real rough. You can’t hardly keep the dust down on hot days.'
Ungar reports that Mr. Ritchie was diagnosed with CWP in 2008 and doctors removed part of his left lung.
Now, he struggles just to get around. 'You walk and you run out of breath,' he said. 'You ain’t got much breath to do much.'
No matter how much the coal industry tries to convince us they are clean and green, it's the same-old, same-old when it comes to occupational disease: it's not our fault that our employees and retirees can't breathe. Pay no attention to Alpha Natural Resources' corporate propaganda "Running Right, Leading Right, Living Right," or CONSOL Energy's claim that its "ethics and core values" drive its everyday decisions. If the Labor Department says they are responsible for that lung disease, they'll fight those coal miners every step of the way.
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