Resurgence of Black Lung Disease Amid Delayed Silica Rule in Appalachia

Coal miners in Pennsylvania and surrounding Appalachian counties are experiencing a sharp rise in progressive massive fibrosis, the most severe black-lung disease, driven by inhalation of crystalline silica released when mining thinner coal seams. Lungs at Work reports rising cases.

Trump Killing Off More of His Base by Blocking Regs That Would Check Resurging Black Lung DiseaseMother Jones

The 1969 Coal Mine Health and Safety Act, enacted after a West Virginia disaster, cut black-lung rates dramatically; by the early 2000s the disease was considered nearly eradicated. Coal production has fallen over 50 percent since 2008, yet Pennsylvania still reports 5,000 mining jobs generating $2.2 billion annually.

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NIOSH estimates one in ten miners with >=25 years underground now has black lung; deaths fell 1999-2018 but rose again 2020-2023. 40,000 coal workers remain nationwide. The 2024 MSHA rule would lower the silica limit to 50 µg/m³, slated for April 2025 enforcement, but implementation has been stalled.

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President Donald Trump signed an executive order declaring coal essential to security and DOE allocated $625 million to coal projects. MSHA’s workforce has been cut by 50 percent, with a 7 percent AFGE buyout and rescinded inspector offers, weakening enforcement capacity.

Trump Killing Off More of His Base by Blocking Regs That Would Check Resurging Black Lung Disease

United Mine Workers of America communications director Erin Bates argued that the administration’s failure to adopt a silica rule shows concern for miner safety. National Mining Association and National Stone, Sand & Gravel Association have sued to block the rule, claiming respirators should suffice for compliance.

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Justin Smarsh, a 42-year-old roof bolter from Cherry Tree, Pennsylvania, developed progressive massive fibrosis after eight years underground. He describes constant breathlessness and says his family feels the industry cares only about extracting, not protecting workers.

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Experts warn that black-lung prevalence may be underreported because miners fear retaliation for seeking diagnosis, creating uncertainty about the true number of cases. The Appalachian Citizens’ Law Center notes miners avoid testing.

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• “Most people think coal mining is a thing of the past,” — Deanna Istik, CEO, Lungs at Work

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• “Respirators are really the last line of defense,” — Deanna Istik, CEO, Lungs at Work

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• “If the Trump administration actually cared about protecting coal miners from black lung, we’d have a strong silica rule in place.” — Erin Bates, communications director, United Mine Workers of America

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• “All they’re worried about is ‘you better have that black gold,’” — Justin Smarsh, coal miner

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Legal challenges, including an emergency stay by the 8th U.S. Circuit Court of Appeals, keep the 2024 silica rule in limbo; MSHA has postponed enforcement indefinitely, and the appeal remains pending. Stakeholders expect continued litigation, congressional oversight, and health monitoring of miners.

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