Up First from NPR - The Sunday Story: Coal's deadly dust

Episode Date: November 19, 2023

In 2011, NPR correspondent Howard Berkes noticed an anomaly in the sidebar of a government report on the Upper Big Branch mine disaster in West Virginia. It suggested that there was an extraordinarily high rate of black lung disease among the coal miners who'd been killed in the explosion. And it set him on a decade-long investigation to understand the cause of a hidden epidemic, the toll it took on miners and their families, and why government agencies had failed to prevent it.You can find more of Howard's landmark reporting on black lung disease on the episode page.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

I'm Aisha Roscoe and this is the Sunday Story. In a journalist's career, there's often a story or two that will just end up following you. Like long after you filed your first piece, far beyond just covering your beat, it becomes a kind of calling. These are stories that push you to dig deeper and lean in closer with the hope that your reporting could help deliver justice for those who've suffered. Today on the show, the story that has followed Howard Berkus. now-retired correspondent here at NPR, whose investigative reporting on coal mine safety and black lung disease spans a decade. Since 2012, Howard and his reporting partners have been talking to dozens of miners in Appalachia

who suffer from black lung disease, reporting that has exposed the government's failure to protect them. The doctor says my lungs started shutting down. I said, it's hardened just like a lump of coal. It's bad when you can walk outside and all that air out there and you can't get none in your lungs. For instance, trying to take a bag of trash out. Steps and heels.

I can't even walk up my driveway and check mailboxes. You get up hacking, spitting black and blood. Coughing to the point of almost throwing up. This year, Howard Berkus came out of retirement to pick up the investigation again. We're going to die from it. There's no cure for it. It's a death sentence. And knowing that that's coming to you, it's pretty hard to take. Howard joins us today to talk about what's compelled him to return to this story again and again. And what's at stake as mind safety regulators try to do better today. So Howard, first of all, welcome to the podcast.

I really appreciate being with you. I just want to better understand this disease. So when I think of black lung disease, it's not something that I think of and associate with today. I'm thinking of the past, the industrial revolution. I'm not thinking 2023. You know, it's actually still pretty common in coal country in Appalachia to hear about dads and grandfathers, uncles, friends who mined coal and then suffered and died from black lung disease. It was typically an old miner's disease, and the deaths can be really horrific. The lungs slowly build up with fibrotic tissue. The affected portion of the lungs become hard and eventually they no longer work.

It's often death by suffocation. I mean, it sounds like a terrible way to die. Has the government done anything to address this? Back in 1969, 40,000 coal miners in West Virginia staged a wildcat strike over black lung disease, and that prompted Congress to enact a new mine safety law. It put tough limits on exposure to coal dust, and it made a big difference. The rate of black lung disease plunged 90% in the next couple of decades. Okay, so what prompted you to begin investigating black lung disease in 2011, like when you got started with all this? Actually, the year before in 2010, there was this terrible coal mine explosion

at the Upper Big Branch Mine in West Virginia. 29 coal miners were killed. It was catastrophic then. Dozens of mine rescuers, EMTs, and ambulances were mobilized. This was the worst mine disaster in 40 years. A year later, in 2011, a report about the disaster was released, and it contained a one-page sidebar. And that sidebar said that the autopsies on the miners who were killed in the explosion revealed an extraordinarily high rate of black lung disease. One of the miners who died in the explosion was named Gary Wayne Quarles. He was just 33 years old at the time. And his father, who's also named Gary,

and also was a coal miner, he told me this. He had black lung. Being in the mines for 13 to 15 years and already considered having black lung nowadays, it's unbelievable. And not only him, quite a few other younger guys, and being that young, that's uncalled for. So the thing that is striking about this is because with black lung disease in the past, this was something that hit minors when they were in their 60s and 70s, like their later years in life. And that image that kind of comes to mind of older retired miners hooked up to oxygen tanks after mining for 30 or 40 years, right? One of the shocking experiences we had right away was meeting coal miners who did not fit that description. They were far younger when they were diagnosed and they got far sicker more quickly. This included a minor named Mark McCowan. He was only 40 years old when he was diagnosed. We went to his house in southwest Virginia, and he held up an x-ray of his lungs in the light of

his living room window. You go from being normal to where all of a sudden one day you try to do something you used to do and you can't do it. And you're just heaving to catch your breath. And you say, this is crazy. It can't be this bad. And then you realize a couple months down the road that it can be. And you realize a year down the road after that that you ain't seen nothing yet. What does Mark McCowan mean by that? Mark was 47 years old when we interviewed him. He'd been living with the disease for seven years,

and it was getting worse and worse. So one of the things that he described is something we heard over and over and over again while interviewing dozens of coal miners with black lung disease. They talk about the simplest things that they can no longer do, like just being with their grandchildren. I say, little buddy, I've got to put you down for a few minutes. And he's learned to run a little bit. He'll say, run, papa, run. He wants me to chase him.

And I can't. I said, give Papa a minute. I might be able to in a minute. And I face Mount Everest every day. Sometimes I make it to the top, and sometimes I don't. You were hearing these heart-wrenching stories about how minors struggle with the disease. What did you do next? Did you have a hunch that these individual stories pointed to a much bigger trend? I did have that hunch, and so did the black lung experts who were as shocked as Gary Wayne Quarles' father. There was also another reporter who was thinking the same thing, Chris Hamby at the Center for

Public Integrity. We teamed up, and he did an analysis of government data that helped prove a dramatic resurgence of the disease. We found that the downward trend had reversed, that the rate of the disease had soared. And actually, a more recent study found that the downward trend had reversed, that the rate of the disease had soared. And actually, a more recent study found that one in five working coal miners who've been tested for black lung, and that's thousands of coal miners, have signs of the disease. Now, we also found one likely reason for this. In the decades since that law was passed in 1969, miners began working longer hours, including lots of overtime and six-day weeks.

By the time I was 40 years old, I'd mined more coal than most miners seen in a lifetime. And in fact, we found that on average, coal miners were each working 600 more hours a year. And there was something else that Mark McCowan and other miners talked about. The big coal seams were gone. The thinner coal seams that remained were still valuable, and they were embedded in rock. Sometimes the coal was reduced to a two-inch thickness,

and you have to stay with that two inches because you know that's your coal seam. But the rest of what you need to mine with that two inches because you know that's your coal seam. But the rest of what you need to mine may be solid rock. This is also something we heard repeatedly from the dozens of coal miners we interviewed. Everywhere I worked, we cut rock. No matter where you went, you had rock. Probably the last 20 years, I've cut more rock than I cut coal. Because there wasn't hardly no solid seams of coal left. A little seam of coal, probably eight inches thick.

The rest of that was rock, six and a half foot. In Appalachia, that rock contains quartz, and when quartz is ground up by mining machines, it produces a dust that is easily inhaled and contains sharpened particles of silica, which is far more dangerous than coal dust alone. After the break, the silica dust that made Black Lung worse, and the challenge for Howard and his reporting partners in determining how much worse.

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Berkus. Howard, I want to ask you about your motivation for continuing the reporting. Like you spent a year investigating that 2010 mine disaster in West Virginia. You spent another year investigating and documenting a dramatic resurgence of Black lung. For a lot of reporters, that would have been enough. You had exposed what was going on. You had borne witness to it. You could have left it there and moved on to other stories. And that's what usually happens. Why did you keep thinking about this? The truth is, Ayesha, I did move on to other reporting, some of which also involved other aspects of coal mine safety. But I met a lot of sick and dying coal miners while I was working on coal mine safety. I met a lot of crippled workers

and their families. I met a lot of loved ones of miners who were killed on the job. And I just came to believe that work should not be a death sentence, that coal miners and other workers deserve to go home every night whole and alive. And here's the thing. They were supposed to be protected. This was an era of tougher mine safety laws and a regulatory system that was supposed to protect them. But clearly, it wasn't working. There must have been something else going on. Now, before the break, you mentioned silica. This is a common mineral in rock. Can you talk more about it? What's the connection with this surge in black lung, especially among young miners? All that rock that miners were cutting produced this silica dust

and silica is actually 20 times more toxic than coal dust alone. And because it's sharp, it can embed in lungs forever. Every miner we talked to had a story about silica dust. The more rock you had to cut, the duster it was. It's like being in a room full of smoke. Like you're sitting in a cloud. Like walking into a fog bank. You're inhaling that into your lungs as well. You know, that's just like fiberglass that cuts your lungs out of hell. It'd choke you up. I used to spit it up constantly. We just couldn't keep the dust down good enough. These silica particles are invaders in the lung, and the lung tissue fights back. It becomes thicker and harder as it tries to expel this foreign substance. Fibrotic tissue builds up and builds up and it makes it more and more

difficult to breathe. Nodules form and when they get larger and more of them form, the disease becomes far more serious. This is known as progressive massive fibrosis, or simply it's called complicated black lung. It's incurable, it's fatal, and it was once rare among younger minors like Mark McCowan. So now you're on to silica and you're looking at that. How did you begin this part of the investigation? Of all things, it was a text message. In the summer of 2016, my cell phone buzzed. This was a text message from a very reliable source, and it simply said this, I've seen as many complicated black lung cases in the last month as I've seen in the last 30 years. Guys are really that sick. Something is up. Of course, I had to verify this, and I thought about

two kinds of places that would be witnessing a monumental escalation in cases if such a thing was actually happening. One, there are law firms that represent coal miners who are seeking state or federal black lung benefits. They'd have an increase in business. And two, the medical clinics that diagnose black lung and treat symptoms. And I quickly found that both were swamped with cases, especially in Virginia, Kentucky, and West Virginia. One clinic in particular in Eastern Kentucky had dozens of cases, including younger minors who were getting very sick very fast. I interviewed there one of the sickest minors I've ever met, Mackie Branham. He was just 39 years old when diagnosed,

and he compared his situation to his family's history of black lung. You can hear how hard it is for him to breathe. I'll probably be the first one to be this bad in the family. And what do you mean, this bad? For it to actually be this progressive and in this bad of shape. I mean, don't get me wrong. They can't breathe, but they can still get up and walk around and do stuff. The more I talk, the more I get out of breath. It's just a lot of pressure in my chest all the times.

And like a lot of sick minors I've met, Mackey also talked about his eventual fate. I've never been scared of death. It don't bother me a bit. It's just not seeing my kids grow up. But if I had it to do over, I would do it again, if that's what it took to provide for my family as long as I have. Oh, my goodness. That's difficult to even hear how hard he's struggling just to talk.

But then he says he'd do it all over again. I think that will be hard for a lot of people to understand. You know, mining jobs have been the best jobs in the hills and hollers of Appalachia. The best pay, the best benefits. Miners sometimes have the best houses. They sometimes have the newest pickup trucks. There isn't usually anything else that compares or even comes close to what mining can provide these workers. So how many Mackie Branhams were out there? How many cases are out there like this? To begin to answer that question, I went to the clinic where Mackie

Branham was diagnosed. A radiologist there named Brandon Crum is specially trained to assess the chest x-rays of coal miners. I think the percentage of black lung that we're seeing now here in central Appalachia is unprecedented in any recorded data that I can find anywhere. In this clinic, we're roughly around nine to ten percent complicated rate, which is around three times higher than even the highest reported numbers. Crum was so shocked he approached epidemiologists at the National Institute for Occupational Safety and Health, which tracks black lung disease. He spoke with Scott Laney, one of the nation's most prominent black lung researchers. He told us that he was seeing a lot of really advanced disease, and it was concerning to him.

And I guess my initial thoughts was, that's probably not true. Why was epidemiologist Scott Laney so skeptical? Because Laney's Federal Research Agency, which has tested tens of thousands of working coal miners for black lung for decades, had counted and reported just 99 cases of complicated black lung nationwide in the previous five years. Brandon Crum had two-thirds as many cases in less time at his small clinic in Kentucky. Laney wanted proof, so he went to Crum's clinic. And he agreed to show us some of the medical images,

and we sat there for an entire day, one after another after another, looking at these chest x-rays, the worst I've ever seen. And I asked Laney how he reacted to what he was seeing. Horror, shock, I don't know how many other words to use. I was really taken aback, not only that these cases were legitimate, but just how severe they were. It wasn't just Crum's clinic. Across the Kentucky border in Virginia, Ron Carson managed three black lung clinics operated by Stone Mountain Health Services, and he said he had more than 600 cases in just three years.

I'm not an epidemiologist or a scientist or a doctor. I just see the results that comes through the doors and something is going on. Something major is going on. So how could this happen? Like, how could the agency that is responsible for counting the cases of this disease miss so much? It turned out there was nothing really nefarious going on. Remember that I said that Laney's agency, the National Institute for Occupational Safety and Health, or NIOSH, tested working miners for black lung disease. That's its legal mandate. But 50,000 coal miners have lost their jobs since 2011. That's because coal plants have shut down and mines have closed. Some of those miners went into black lung legal and medical clinics to see if they might qualify for black lung benefits. So the clinics were testing laid off and retired miners who NIOSH was not testing. We surveyed clinics in Virginia, Kentucky, West Virginia, Ohio, and Pennsylvania. They diagnosed close to a thousand cases of complicated black lung, 10 times the NIOSH count. I mean, that's a big difference. And I guess if

they didn't really know how many people were sick, then they didn't even know to try to look for a cause of this rise, right? That's right. If the official count was so low, then there wasn't anything major to be alarmed about. In fact, there was never direct regulation of silica dust in coal mines. So at this point, you know, and government officials are starting to learn that the official count is way off and lots more miners have this complicated black lung than was previously known. And you suspect that the problem may be silica because miners, you know, these days are cutting through so much rock to get to the coal and they're encountering silica. But how did you prove that? We knew that the Mine Safety Agency had been sampling for coal dust and silica dust, and

we knew that the agency analyzed those samples. So in 2017, I turned to two of my colleagues on the NPR investigations team who are whizzes at analyzing complex sets of data. That's Robert Benincasa and Wojing Nan. And they obtained 30 years of sampling data going back to 1986. Now, we cast a wider net and went to even more black lung clinics to get a more complete count of cases. We were trying to definitively show how many dangerous silica dust exposures had occurred, what caused them, what the Mine Safety Agency did or not do

in response, and how many more cases were out there. When we come back, what all that data revealed about the deadly conditions miners were facing. We're back with Howard Berkus talking about his decade-long investigation into black lung disease among coal miners. Howard and his team analyzed 30 years of data to try to document the number of dangerous silica dust exposures. So, Howard, what did you find? Okay, stick with me here for a minute because it's a lot of numbers, but it shows how such important details were overlooked. First, we documented another 1,000 cases of complicated black lung, with a total then of over 2,000 cases since 2010. Second, we documented 21,000 instances of overexposure to silica dust since 1986, exposures that exceeded

the federal health standard. Third, we found that the agency's response to excessive silica dust exposures failed to lower the dust to safe levels close to 9,000 times. Fourth, we obtained government documents that showed that the Mine Safety Agency had identified a cluster of advanced lung disease and coal miners back in 1996. And officials at the time connected that cluster of disease to exposure to silica dust. They even sent out warnings to the mining industry. But nothing was done then or since to force protective action on silica dust. So it sounds like you had a lot of smoking guns here. More cases of disease, more evidence of this hidden epidemic,

enough excessive exposures to maybe show the cause of the epidemic, and then a failure by regulators to protect miners, even when they knew about the danger. What kind of reaction did you get to that? More shock, more horror, and a rare acknowledgement by a former top official at the Mine Safety Agency. Celeste Monfortin was a top aide in the agency during the Clinton administration in the 1990s. We failed. Had we taken action at that time, I really believe that we would not be seeing

the disease that we're seeing now and having miners die at such young ages from exposures that happened 20 years ago. I mean, I don't know how you can reach any other conclusion. I mean, this is such a gross and frank example of regulatory failure. Wow. I mean, that is quite an omission. And it's not normally what you would hear from a regulator or a former regulator. She's basically saying it's undeniable the Mine Safety and Health Administration is supposed to be protecting miners. So how do you account for this failure? Like, what were those officials doing instead?

Well, for one thing, they didn't look at their own data. They also ignored repeated recommendations by NIOSH going back to 1974, which called for a silica exposure limit that was twice as tough. That was also recommended by a special labor department commission on black lung in 1996. Well, I wanted to ask you about how minors can be protected from dangerous dust. Like the pandemic obviously taught us all about N95 masks. Don't coal miners use masks or respirators for protection? This is a subject we could talk a lot about. I'll just give you the highlights. And it starts with a fundamental principle in workplace safety, which is companies are supposed to provide first and foremost a safe working environment. environment, providing some kind of protection, supplemental protection it's called. And in this case with coal miners, we're talking about masks or respirators. There's also a fraught history

with the masks miners were issued in the past, including hundreds of lawsuits with settlements and multi-million dollar verdicts. And miners did not really like wearing these masks. They would clog up with dust, sweat, and spit. I just never could get enough air. And then it'd feel like somebody just sitting there with their hand over your face. About to give you a heart attack trying to breathe through. They're not going to stop 100%. There's finer particles getting through them filters.

Some of the companies I worked for didn't have them at all, period. Now, there are respirators and helmets available today that are more effective at screening out dust, but miners complain that they can limit vision or hearing or both. That's not good in a dangerous work environment where it's critical to clearly communicate with co-workers and to see the movement of massive equipment around you. Okay, so masks are not a perfect solution. What else can mining companies do to protect miners from dangerous dust? So mines have massive fans that push through clean air that sweeps away coal and silica dust. This robust ventilation is one thing that works if it's done right.

Mining machines also spray water as they cut into coal and rock that also tamps down dust if the sprays are working right. The other thing mining companies can do is slow down the mining machines, which can result in less dust. They could choose not to mine the thin seams with so much rock. Of course, both of those options involve mining less coal and making less money. So bring us up to date. We now know the government didn't bother to look at its own data, and it had failed to act on recommendations for tougher limits on silica dust,

but they're finally doing that, right? Well, the Mine Safety and Health Administration is finally proposing to make the silica dust exposure limit twice as restrictive. And it is proposing to directly regulate silica dust for the first time so that citations and fines are possible for exposing miners to dangerous levels of dust. But the proposal appears to be weak on oversight and enforcement, on making sure that coal companies actually follow the regulations and actually protect minors. And the agency does not include in this proposed regulation some of the key trends about complicated black lung that it has overlooked in the past. It's not citing the data that shows thousands of continuing overexposures to silica dust. It doesn't cite the actual numbers of minors who are sick and dying from the disease. These numbers are important because when agencies propose a new regulation,

they have to sell it. They have to sell it to the industry that's affected because they don't want to get sued and they don't want the industry to appeal to their friends in Congress to try to block it. And in fact, a House Republican has already launched an attempt

to block implementation of the new silica dust regulation, even though there's not even a final version of the proposal. So it's critical to make the best case, but the proposed regulation undersells the potential benefits. The proposal predicts that the new regulation will save just 63 coal miner lives and prevent just 244 cases of disease over 60 years. Our latest survey of Black Lung Clinics shows more than 4,000 cases of disease in the last decade. Has the Mine Safety Agency responded to your recent reporting? Like, did officials explain why they left out those compelling details? They responded, but they did not explain.

Instead, they said in a statement that they would now consider the actual number of diseased and dying minors. And they said officials there are deeply disturbed by that. Now, this is actually a work in progress. The proposal is now under review. A final regulation is likely months away. And we'll see if it actually incorporates what we've reported. Howard, so I know you could probably talk all day and probably longer about the details of the proposal and some of the other shortcomings. And listeners can find

out more about that in your story on our website at NPR.org. But I want to get back to the miners you've interviewed over the years, because that's what this is really about. I mean, their lives are at stake. coal plant shutdowns and mines closing, there will still be tens of thousands of workers mining coal for years to come. So what have these miners left you with after all these hours you've spent with them and all that you've learned in your reporting? What stays with you? I keep thinking about a miner named Danny Smith, who was a lot like Mackie Branham, one of the youngest and sickest miners I've met. Danny only worked 12 years underground. He was diagnosed with complicated black lung at just age 39. And when we visited with

him at his home in Eastern Kentucky in 2018, he was just trying to do something simple, mow his lawn. But he had a hacking fit that forced him to stop. He bent over. He started coughing so bad that he was spitting up what looked like crusted bits of black paper with red streaks. Later, his respiratory therapist told us that that was dead lung tissue that he was coughing up. Danny was taking his plight very hard. It's eat at me and eat at me

for at least the last two years that I'm going to die over this. It's heartbreaking, you know, not knowing where you're going to see, have grandkids, and you're going to ever see them. And of all the things that could have killed me while I did work there, Rock Falls and all that stuff, you know, and I lived through all that. And I find out years later that I'm going to die over a black lung, and it's heartbreaking. We was all young and strong and stout, and they took advantage of us. Every one of us was either crippled or dead, you know. We was all young men.

We was just kids. Danny Smith was 46 years old when we spoke with him in 2018, and he showed me then the burial plot that he'd picked out for himself in his family cemetery. Danny and I have been communicating since then, most recently by text message, because he says he doesn't feel strong enough to get through a phone conversation. He's being assessed right now for a double lung transplant. He has good days and bad days. In one text that he sent me recently, he said he'd rather be poor and homeless than suffer what he's been going through and knowing it will only get worse. But he also wrote that he was grateful for the good life mining made possible for him and his

family. He has two daughters he's immensely proud of, one a pharmacist now and the other studying to be a physician's assistant in emergency rooms. Both were inspired by Danny's suffering from complicated black lung. And I want to leave you with this. His older daughter, Sydney, wrote and performed a song about her dad and his disease. Digging black gold ten feet above hell But there's nothing he wouldn't do for us He put food on our table and clothes on our backs While his was bent over in the deep dark underground So down there's the scariest place there could be In the cold and black

A deep still wind down I have questioned, I have cried I've prayed to the Lord above me. For the man whose lungs are black is a coal miner in Kentucky. Howard Berkus, thank you for bringing us the voices of coal miners like Danny Smith and his daughter, Sydney. We wish them the best and hope your reporting helps coal miners get the protection that they need. Thank you, Aisha, for spending so much time with me and this reporting. I really appreciate it. Talk about all the money they made, or was it worth it? All the life they gave.

You can turn a light on, thank a miner. If you don't have to think about your next breath. Thank God. Howard Berkus is a retired correspondent with the NPR investigations team. But once a correspondent, always a correspondent. He recently updated his investigations of severe black lung Disease for Public Health Watch, an independent nonprofit investigative newsroom focused on public, environmental, and occupational health. You can find his latest reporting in this episode's page at n was produced by Justine Yan. Our editor is Jenny Schmidt. Maggie Luthar is our engineer.

Music in this episode from Audio Network, Blue Dot Sessions and Romteen Ira Bluey. The song you heard earlier is called Coal Mine in Kentucky. The musicians were Erica Coleman, Chris Preston, Tyler Ball and Sidney Smith. Howard's latest reporting on Black Lung was edited by Jim Morris at Public Health Watch, Carmel Roth and Erica Peterson at Mountain State Spotlight in West Virginia. Justin Hicks at Louisville Public Media

and Alan Siegler at Mountain State Spotlight contributed to the reporting. Liana Simstrom is our supervising producer and Irene Noguchi is our executive producer. We'd love to hear from you.

Send us an email at thesundaystoryatnpr.org. I'm Aisha Roscoe. Up First is back tomorrow with all the news you need to start your week. Until then, have a great rest of your weekend. Thank you.