The Sunday Story: Coal's deadly dust

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.

The doctor says My lungs started shutting down, they said. It's hardened, just like a lump of coal. It's bad when you 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 my mailbox. You get up hacking, spitting, black and blood. I'm 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.

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, you know, 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 percent in the next couple of decades.

OK, 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. Twenty nine coal miners were killed. It was catastrophic. Then, dozens of mine rescuers, EMTs and ambulances were mobilized.

If you want to get the total disaster control, I need all the resources you can give me.

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 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 miners 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 miner named Mark McCowan. He was only 40 years old when he was diagnosed. We went to his house in southwest Virginia.

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 got to put you down for a few minutes.

You were hearing these heart-wrenching stories about how miners struggle with the disease. What did you do next, like, 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.

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.

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've cut coal because there were 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.

Support for this podcast and the following message come from Wise, the app that makes managing your money in different currencies easy. With Wise, you can send and spend money internationally at the mid-market exchange rate, no guesswork and no hidden fees. Learn more about how Wise could work for you at Wise..com.

On the Ted Radio Hour, MIT psychologist Sherry Turkle. Her latest research into the intimate relationships people are having with chatbots. Technologies that say, I care about you, I love you, I'm here for you. Take care of me. The pros and cons of artificial intimacy. That's on the Ted Radio Hour from NPR, we're back with The Sunday Story and we're talking with retired NPR correspondent Howard Burkus.

The truth is, Aisha. I did move on to other reporting, some of which also involved other aspects of coal mine safety. But, you know, 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.

Now, before the break, you mentioned silica, this is a common mineral in rock. can you talk more about it? Like, what's the connection with this, you know? 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.

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.

So now you're, 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.

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 time.

And like a lot of sick minors I've met, Mackie also talked about his eventual fate.

I've never been scared of death. It don't bother me a bit.

Oh.

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 Branham's 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 9 to 10 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 the 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? 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 minors 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.

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 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?

OK, 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 in coal miners back in 1996. And officials at the time connected that cluster of disease to exposure to 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 acknowledgment 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?

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 miners 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. They're not supposed to be able to get away with having an unsafe 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.

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. That would give you a heart attack, trying to breathe through it. They're not going to stop 100 percent.

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.

OK, so, 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.

So bring us up to date, like 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 miners. 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.

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 miners. And they said officials there are deeply disturbed by that. Now. This is actually a work in progress. The proposal is now under review.

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 and 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.

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.

It's eaten at me and eaten at me for at least the last two years that I'm going to die over. It's over, you know, it's heartbreaking, you know, not knowing where you're going to have grandkids and you're going to ever see them.

Danny Smith was 46 years old when we spoke with him in 2018. And he showed me then the burial plot that he 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.

Digging black gold ten feet above hell. But there's nothing he wouldn't do for us.

But down there's the scariest place there could be, in the cold and black. But he still.

Went down.

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 Ayesha for spending so much time with me and this reporting, I really appreciate it.

Do they talk about all the money they made, or was it worth it?

All the life they gave.

If 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 npr..org. Slash up first.