The Journal. - Why Black Lung Is Rising in Coal Country

Episode Date: October 2, 2023

Black lung, a devastating illness caused by prolonged exposure to dust, has made a comeback in the past two decades after hitting a low in the 1990s. One in five coal miners in Central Appalachia now have the disease. WSJ’s Kris Maher and former miner James Howerton on how black lung is gripping coal country and upending miners’ lives. Further Reading: - Black Lung Resurgence Prompts New Mining Rules  Further Listening: - Europe is Turning to Coal. What Does That Mean for Climate Change?  Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello? Hello. Hello, is that James? Yes, that's James. Hi, James. Recently, I got on the phone with James Howerton. He's 48 and lives in West Virginia. What's something that you like a lot about where you live?

Kind of quiet, peaceful, surrounded by some woods. Do you go out into those woods often? I used to. I can't anymore. I used to hunt, used to fish. I can't do it anymore, especially alone. There's a lot of times if I go out trying to walk through the woods, I'm scared. The mountains around West Virginia is kind of steep. So if I get out there and start coughing, there's a good chance I'll pass out.

And if I pass out, I don't want to wake up at the bottom of the mountain or in the hospital. James was a coal miner for more than 20 years until his lungs gave out. When did you first start to feel your lungs? It would be about 2007. I would wake up and blow my nose. That'd be blood. I'd start coughing, and I'd have streaks of blood. His diagnosis?

Black lung. It's a deadly illness caused by prolonged exposure to dust. There is no cure. After decades of decline, black lung is now on the rise again. Roughly one in five miners in central Appalachia have the disease. Do you regret going into mining? I regret not going to school, furthering my education. I regret going underground completely.

It shaved off a lot of my life. I don't know from day to day when my lungs are going to go completely. I don't know when I'm going to pass out and just not wake up. You know, it scares me. I regret a great deal. Welcome to The Journal, our show about money, business, and power. I'm Kate Linebaugh. It's Monday, October 2nd.

I'm Kate Linebaugh. It's Monday, October 2nd. Coming up on the show, black lungs resurgence in coal country. When it comes to smart water, alkaline 9.5 plus pH with antioxidant, there's nothing to overthink. So, while you may be performing mental gymnastics over whether the post-work gym crowd is worth it, if you'll be able to find a spot for your yoga mat, or if that spin instructor will make you late for dinner again, don't overthink how you hydrate.

Life's full of choices. Smart Water Alkaline is a simple one. Wow. This summer, our colleague Chris Marr went to West Virginia to report on the rising number of black lung cases. I showed up at a black lung clinic. It was actually a health clinic in Oak Hill, West Virginia, which is about in the middle of southern West Virginia. And it's a strip mall with a parking lot.

And there was a white RV in the lot with about, I was there early in the morning, close to about 8, and there were at least about two dozen minors kind of just waiting in line. At this clinic, there were doctors to administer x-rays, respiratory therapists to check on lung function, and caseworkers to help them sign up for government benefits. It was a one-stop shop for miners who have, or think they might have, black lung. I talked to some miners who were online there, and two of the miners I talked to initially, it turns out they had worked in the same mine,

and they hadn't seen each other since about 1999, I think. They didn't recognize each other, but they did recognize each other by their nicknames when they said what they were. In a way, it was kind of, you know, lighthearted and like they were joking. But on the other hand, they were there because they do have black lung and they're trying to get benefits. Can you explain what black lung disease is and what causes it? So, yeah, black lung is caused by exposure to dust, basically. It could be coal dust. It could be silica dust. And it's a disease for which there's no cure.

It's a progressive disease. What happens is the coal dust gets caught in people's lungs and causes inflammation. And then from what I understand, as the lungs try to expel the dust, you know, that causes the inflammation and the scarring over time. And eventually what happens is these masses can form in lungs and it just becomes harder and harder to breathe. How long does it take for black lung to kill someone? Yeah, I think that is a really difficult thing to answer because it's

such a unique disease for each person. I mean, some people can be exposed to the exact same amount of dust and not develop black lung. That's what I'm told from physicians and these respiratory therapists. It's very, very unique to someone's genetic, their body. So the progression of the disease is going to be individual as well. The thing that I find surprising is I'm like, black lung? I thought that was a thing of the past. Yes, and I think it's just very surprising that this disease, black lung disease, which in itself has this ring of something from the past, is actually on the rise right now. And here we are

in the 21st century, and we're having this disease that, you know, you would think had occurred decades ago and probably was gone by now, but it's actually not. People are still dying and the industry is dying. You know, maybe it's sad or poignant or something that you have an industry that is fading. It's going through this transformation where mines are closing. Power plants that burn coal have been shutting. But yet for the workers who are still in the industry, they're facing these even graver threats to their health and their life, in fact. While coal production has fallen substantially, there's still about 1,000 mines operating in the U.S. with 66,000 coal miners.

But the job has gotten harder. After decades of extraction, the coal deposits are thinner and more difficult to get to. So miners have to grind up more rock to retrieve the same amount of coal, creating more dust. Federal officials trace rising black lung rates to higher levels of toxic silica dust in these mines. This summer, regulators introduced a new rule to cut the levels of silica dust in mines by half. What have the mining companies said about this? And what are they doing to address it? So the National Mining Association, the biggest mining trade group in the U.S., does not oppose this new rule. They say, in fact, they would like some other changes to take place. They have said they're in favor of mandatory screening for black lung. So the industry would also like to see newer technologies adopted more quickly.

They're saying that, in particular, there are better respirators out there that could be used in mines. If black lung is so lethal and prevalent, why do people still go to work in the mines? Yeah. Well, some of the miners I talked to, I'm thinking of one in particular who said that his son is now a miner. And I'm talking to a man who has black lung, who knows other people in his family who have had it. And now his son is in the mine and he can see, you know, maybe my son's starting to have symptoms. Maybe my son's coughing. He wants his son to stop being a miner right now. That man was James Howerton, the miner we heard from earlier.

James dropped out of high school after finding out he had a child on the way. And he went to work in the mines. after finding out he had a child on the way, and he went to work in the mines. When I first started, it's fun in a lot of ways. It's exciting. It's not like working the day-to-day job. You can talk how you want, act pretty much how you want,

as long as you get your job done. And as a young person, you think it's the greatest thing in the world. The people underground, they're like brothers. You spent more time with them than your own family. What was your actual job at the mines? When I first started, I was helping move belt and I was running what they call a bridge. They mine the coal from the miner, put it onto the bridge. It's kind of like a portable belt line that feeds it to the belt conveyor and outside. And then I ran a scoop for quite some time, actually years. I'd been a section foreman. I had my own section for right around seven years.

How hard was this work? Very, very strenuous. You earned your money. You worked real hard. I came home so beat, wore out. I would sit down. There was a lot of times my wife would fix me a meal halfway through my meal and just fall asleep right on the couch. Were there any alternatives?

The majority of people that go to college, they come out of college, and they make $30,000, $60,000 a year. And you can go underground and make $60,000 to $80,000 a year with no college degree. Working in the mines, James was able to support his family and raise five kids. But then came the lung problems. That's next. With Smartwater's pure, crisp taste, there's nothing to overthink. So while you may be spiraling over double texting your crush, whether your skincare routine is working because you look the same

or is doing nothing because you look the same and whatever the heck red light therapy is, it's definitely not that. Don't overthink how you hydrate. Life's full of choices. Smartwater is a simple one. Wherever you're going, you better believe American Express will be right there with you. Heading for adventure?

We'll help you breeze through security. Meeting friends a world away? You can use your travel credit. Squeezing every drop out of the last day? How about a 4 p.m. late checkout? Just need a nice place to settle in? Enjoy your travel credit. Squeezing every drop out of the last day? How about a 4 p.m. late checkout? Just need a nice place to settle in? Enjoy your room upgrade. Wherever you go, we'll go together.

That's the powerful backing of American Express. Visit amex.ca slash yamx. Benefits vary by card. Terms apply. James Howerton began having health concerns after he'd been working in an underground mine for a few years. Well, I started seeing the doctors. You know, they started putting me on medicine. I started doing a little bit better, feeling better. You know, they gave me nasal spray and everything else,

you know, more or less for allergies and asthma, COPD. And then right around 2016 is when it started hitting me real hard. I started having a real hard

time to the point where I'd walk a little ways and start coughing to the point where I'd start dry heaving and vomiting. And it made me worried. Did you think about stopping? No. At that time, I was making over $100,000 a year. And there was no other job out there in this state, you know, without a college degree that would pay me over $100,000 a year.

But his condition kept getting worse. And eventually, James did have to stop. In 2020, he went on disability. What did you think when you had to stop working because of your lungs? Well, honestly, at first I was kind of happy about it. You know, it was kind of a relief in some ways. some ways, but at the same time, going out in my yard, around the house, trying to do things that I normally did that I can't do, and get winded, out of breath, start coughing, pass out.

I'm looking at my age, and it made me quite depressed, and I felt completely sorry for myself. I felt miserable. I'm not going to lie. I felt completely miserable and pretty much gave up on life, and I felt helpless, sorry, pitiful, like I couldn't do for my family. But it's my family that showed me that it doesn't matter what I can do for them as long as I'm there for them.

So now I just push to try to be there for them and to try to make sure that they're going to be all set when I'm gone. That's my only goal in life right now. Another thing James is trying to do is get his 30-year-old son out of the mines. He's got about six kids. His thing is the money. Being able to pay his bills, provide for his kids, have nice transportation, a decent home. It's the same thing that I went through. It's the same thing everybody goes through. That's really the only reason they work there is the money they make.

What have you said to him about working there? The money they make. What have you said to him about working there? I've been telling him he needs to go see a lung doctor. Because to this day, he has a chronic cough. He keeps a chronic cough. And that's how mine started. I had a chronic cough off and on.

You know, it would never go away. It don't matter what you take for medicine. It just won't go away. That's pretty much what he's going through right now. Who do you think is responsible? Well, in some ways, it would be the actual person like myself. You know, foolishness in a lot of ways. Yeah.

Trying to be a man. I think nothing can harm you. And then other ways, it's the mine operator. For the mine operators, certain mines I've worked at that push you and pretty much make you do things for the mine operators, certain mines I've worked at, that push you and pretty much make you do things that you don't feel comfortable with doing

and that you know is going to harm you. It takes a heck of a person to know that you're risking your health and your life. You may go in one day and not come out. You don't know with the minds. You really don't. And it takes a heck of a person to do that, to make sure their kid's got food on the table.

Well, you're a heck of a person, James. I try to be. You know, nobody's perfect. You know, I've made my mistakes in life just like many other people while trying to do the right thing that I thought at the time was for my family. But, you know, in a lot of ways, your family can be extremely happy with a little bit of money and a little of nothing. You know, I should have, truthfully, from when I was growing up. We didn't have a whole lot,

but we were happy. Well, thanks for talking to us today. You're welcome. Before you go, the trial of Sam Bankman Freed starts tomorrow. We'll be covering what happens in the courtroom in our new series, The Trial of Crypto's Golden Boy. New episodes starting Wednesday morning.