The risk of contracting black lung disease is directly related to the duration and extent of exposure to coal dust. When present, the most common symptoms are shortness of breath, obstruction of airways, and a severe chronic cough. Black lung disease can be diagnosed through a series of tests including checking patients' history for exposure to coal dust and conducting chest x-rays to discover whether dust deposits are present. Pulmonary function tests are also utilized in the diagnosis of black lung disease. In its most severe state, black lung disease can lead to heart related problems, emphysema, and the risk of premature death for patients. At this time, there is no cure for black lung disease. The treatments undertaken are aimed at the symptoms and complications of the disease. Ultimately, black lung disease can be prevented only by avoiding long-term exposure to coal dust.
Historical Background
Beginning in the 1820s and 1830s, doctors, both in the United States and in the United Kingdom, began to treat coal miners for the early symptoms of black lung disease. In the beginning, doctors called this condition “miner's asthma”; In 1831, however, the term black lung was introduced to describe the black pigmentation found in coal miner's lungs. Despite the efforts of British investigators and the United Mine Workers of America (UMWA), black lung was not widely recognized in the United States until the 1950s. In 1952Alabama became the first state to provide compensation for coal workers' pneumoconiosis. In 1965 Pennsylvania enacted legislation providing for compensation, subsequently, in 1968, Virginia amended its compensation law to include coal workers' pneumoconiosis. On November 20, 1968, a devastating coal mine explosion at Farmington, West Virginia, killed 78 miners. In late 1968 a number of miners organized the West Virginia Black Lung Association, which successfully led a campaign to introduce a bill in the 1969 session of the West Virginia legislature making coal workers' pneumoconiosis a compensable disease. When their campaign ran into heavy opposition from the West Virginia legislature, which was heavily influenced by the coal industry, 40,000 miners in West Virginia went on strike, and many marched on the state capital demanding passage of the bill. The strike, lasting three weeks, was one of the largest and longest ever on the single issue of occupational health and played a vital role in the enactment of the Federal Coal Mine Health and Safety Act of 1969 (CMA) and the Occupational Safety and Health Act of 1970.
For the first time in history, through the enactment of the CMA, Congress mandated the elimination of an occupational disease occurring in a major industry. As coal workers' pneumoconiosis was the only disease indicated throughout all of the state and federal statutes up to that time, Congress legalized the term black lung as a synonym for that disease in Title IV of the CMA. The CMA also stipulated dates on which decreasing levels of respirable dust must become effective and required that working miners must now have periodic chest x-rays to check for symptoms of black lung disease.
In 1972, Congress established the Black Lung Benefits Act, also the first of its kind, to compensate victims of an occupational disease. In 1977 the Black Lung Benefits Reform Act established a Black Lung Disability Trust Fund, financed by taxes paid by all coal operators. The 1977 law also made coal companies directly responsible for compensation and medical costs for black lung victims that had worked for them. Coal companies reacted by finding bureaucratic means to slow down the enforcement of these regulations, but the UMWA has remained active, continuing to advocate legislative and administrative reforms to make it easier for black lung victims to establish eligibility for benefits.
Recent Government Actions
In 1997, the U.S. Department of Labor proposed regulations that would amend the process by which miners apply for black lung benefits, including limiting the amount of medical evidence to be submitted by either side and allowing greater weight to the medical opinion of those physicians treating the patient who are more familiar with the black lung patient's pulmonary condition. These rules were to take effect on January 19, 2001, but on December 22, 2000, the National Mining Association (NMA) filed a lawsuit in District Court challenging the new regulations and seeking an injunction to delay the implementation of the new rules.
On February 9, 2001, the new regulations were suspended by the judge until the new Secretary of Labor, Elaine Chao, could state her position on the matter. This caused the claims of miners and survivors filed after January 19, 2001, to be halted until the lawsuit was resolved, delaying the process for many months. In the end, the Department of Labor officially sided with the black lung victims; however, the government's position was that the NMA's challenges should not be heard in court as such but should instead be raised in individual benefit claims cases. Both the UMWA and the NMA disagreed, arguing that the District Court had the power to and should settle the matter rather than allowing the issues to be resolved in individual claims cases. On August 9, 2001, District Court Judge Emmet Sullivan upheld the regulations and dissolved the injunction so that the rules could take full effect. The NMA immediately appealed to the Court of Appeals in which the case was expedited and the parties maintained their positions each had taken in the District Court case. The Court of Appeals issued its decision on June 14, 2002, finding that the court did have the power to decide the case and, with a few minor exceptions, upholding the rules as they apply to cases filed after January 19, 2001. As for the cases filed before January 19, 2001, the court found the regulations to be generally lawful except as to a few minor exceptions. The exceptions noted by the Court of Appeals can be found either in the Court's official decision or online at the UMWA's official webpage.
