More than 20 years ago I became certified to perform Department of Labor (DOL) exams for the coal miners in the surrounding counties. I continue to supply these services today.  The local Black Lung Clinic saw a marked decline in the number of patients with Coal Workers’ lung disease between the 1970’s to the mid 1990’s.  This decline in black lung disease was briefly viewed as a public health triumph.  However, there has been a strong and ongoing resurgence of the potentially deadly fibrotic interstitial lung disease associated with coal dust exposure since the 2000’s.  Of great concern is the resurgence of complicated Black Lung (progressive massive fibrosis [PMF]) which is completely disabling and leads to premature death.

    Since the mid 2000’s National Institute of Occupational Safety and Health (NIOSH) has observed the following: increased prevalence and severity of Black  Lung nationwide, and specifically in Central Appalachia (Kentucky, Virginia, West Virginia and parts of Pennsylvania;  increases in the frequency of lung transplants for Black Lung disease; increased number of miners with PMF filing for federal black lung compensation; premature mortality in miners diagnosed with Black Lung disease, and underutilization of programs designed to reduce the exposure of miners with disease.

    Many miners who have been worked up for years for other types of lung disease other than Black Lung have eventually learned that they had dust-induced lung disease attributable to their work.  Mortality data also suggests that coal dust related lung disease is under-reported as a cause of death for many miners.