Black lung disease is on the rise in West Virginia, but those with intimate knowledge of its effects say there are steps that miners and their families can take to ensure adequate care and support even before symptoms develop.
From their home in Oak Hill, Joe and Nancy Massie field calls from miners all over the country who need help and advice about the disease.
“There’s hardly ever a day that goes by that someone doesn’t call to ask a question,” says Nancy.
The Massies are volunteers with the National Black Lung Association, where Joe serves as president. Both of their fathers developed black lung in the days before federal legislation legitimized the disease and established compensation for its victims.
“When you grow up with parents that are coal miners and see the struggles they had, it’s something you never forget,” says Nancy, who focuses much of her work on helping miners’ widows file for federal black lung benefits. Joe’s mother, 105, still draws them.
Joe, 75, was diagnosed with the disease in 1993 after 30 years as an underground miner.
“In 1969, when they passed the law, there wasn’t supposed to be any black lung anymore. But now there’s more than there ever was,” says Joe.
Black lung diagnoses doubled in the last decade, and advanced cases have quadrupled since the 1980s, according to a recent joint investigation by the Center for Public Integrity and National Public Radio. Seventy percent of the miners who died in the Upper Big Branch mine explosion and were tested for black lung showed some signs of the disease.
Nancy is especially worried about younger miners who she said don’t often take the time to visit a doctor and establish a baseline medical history. She said they don’t think it can happen to them.
“I hate to tell them that it can and it will happen.”
These days, doctors are seeing younger miners developing black lung, which has killed approximately 70,000 in all since 1970. That means it’s even more important for workers to take steps now to prevent future suffering, say the Massies.
Whether because of demanding work schedules or fear of losing their job, most miners don’t go to a doctor for black lung screenings, according to the staff of New River Breathing Center (NRBC) in Scarbro. But they should.
“If you’re a coal miner, you need to be tested. You should start from the get-go,” said Susie Criss, the center’s director.
“If you are around dust and you want to be with your family for years to come, keep track of what your lungs are doing. You don’t want to find out when it’s too late.”
It’s important to establish lung function prior to any impairment.
“It also gives us the opportunity to ... delay any type of black lung disease they get by educating them about prevention,” Criss said.
After an initial exam, NRBC recommends miners get breathing tests every two to three years for as long as they are exposed, or if they notice a big change in their breathing.
“If they’ve always been able to walk up that hill to get to their hunting spot and all of a sudden they need to stop two or three times, they need to be more aware of where their lung function is,” said Criss.
Miners who are especially susceptible to developing black lung include those working on the face or in tipples, continuous miner operators and any kind of drillers, including roof bolters.
Surface miners working around dust are not immune.
Neither are younger miners. The youngest patients with complicated black lung at the NRBC are in their late 30s and early 40s.
Criss and her staff talk to miners about their jobs and encourage those in high dust areas to wear respirators and try to stay out of direct dust as much as possible.
If black lung is identified, the staff works with the National Institute for Occupational Health and Safety (NIOSH) to get the patient “Part 90” status, which means the patient has the option to move to a less dusty job.
The New River Breathing Center, one of eight black lung clinics in West Virginia, is a kind of “one-stop shop” for coping with the disease. About 500 miners are treated annually and they have established close relationships with patients over the years. Most of the staff members have family in the mining industry.
Not only do they test for black lung, they also help miners file for compensation, which involves wading through a lot of paperwork.
Tony Canada, a benefits counselor for NRBC, helps miners figure out what to do once they have been diagnosed.
“A lot of times we’ll sit down and throw all the options on the table that are available, whether it’s disability, a miner’s pension, Social Security, federal or state black lung benefits,” says Canada.
It can take as many as 20 years of legal appeals by coal companies to establish federal benefits. In the meantime, some miners feel they must keep working to maintain medical insurance and support their families.
“You lay everything out on the table and try to help guide them on a pathway that can financially sustain them until they get in a situation (where they obtain federal benefits),” says Canada.
Establishing a continuous medical history with a family physician — especially one who specializes in black lung — can be crucial for supporting a federal black lung claim down the road, the NRBC staff says.
“Being able to document over time that your breathing got worse affects your federal claim a lot,” says Criss. “It’s very supportive.”
If approved, a husband and wife can expect to receive $938 per month in federal benefits, plus medical coverage for black lung-related treatment and medication.
Research into why black lung diagnoses are increasing is ongoing, but there are many possibilities. The industry, for one, has changed since Joe Massie’s day.
“They are running more coal with fewer men. When I worked, you worked about eight hours and that was it. Most of them now work 12 hours, six or seven days a week,” says Joe.
Longer work hours give the body less time to recuperate from dust exposure.
Smaller coal seams with more rock mixed in mean miners are breathing more silica.
The Massies say that a decrease in union jobs also contributes.
“In my days, if you seen something unsafe, you could refuse to do it and there was nothing they could do about it,” said Joe. “Nowadays, if you refuse, you hit the road and somebody else will be in your place tomorrow.”
Some miners still fear there will be consequences for getting screened, he says. Criss has heard of miners waiting in their cars until it gets dark before entering a NIOSH mobile testing unit.
But she said that in 20 years of her work, she has never heard of anyone being fired for undergoing black lung testing or filing a claim.
There also may be a nagging sense that the disease doesn’t really exist. People still talk dismissively about black lung, a possible holdover from the not-so-distant era before a social movement in the Appalachian coalfields brought the issue to light. Coal companies also spend millions disputing miners’ diagnoses.
Nancy Massie largely blames coal companies for not following regulations, but she said miners have a responsibility to look out for themselves, too.
“It takes the whole group together as one to stop this stuff,” she said.
“I think everybody works because they feel like one day they’re going to retire and have this great life. But if you get to that point and you can’t breathe, it’s not worth it,” said Criss.
— E-mail: firstname.lastname@example.org
Local resources for black lung
prevention and care:
-- National Black Lung Association
Provides free benefits counseling and general support for miners and their families. They maintain local chapters throughout the state.
Call Joe and Nancy Massie at
-- New River Breathing Center,
Provides medical care, benefits counseling services, and general support.
Call 304-469-3261 or visit http://blacklungwv.org.
A breathing test at New River Breathing Center is $65, a chest X-ray is $84, and a doctor’s visit is $74. The clinic doesn’t charge for talking to people or helping them file a claim.
Their hours are Monday through Friday from 9 a.m. to 5 p.m. They can also refer people to other clinics around the state.