Sen. Rand Paul’s letter responding to the recent news stories about the alarming increase in black lung disease — coal worker’s pneumoconiosis (CWP) — among Appalachian coal miners and disputing the need for regulations proposed to reduce the level of respirable coal mine dust requires a response.
The 1969 Coal Act required that the concentration of respirable dust in the mine be at “a level of personal exposure which will prevent new incidences of respiratory disease and the further development of such disease in any person.” The law was designed so that a coal miner could work and never develop black lung disease.
However, more than 40 years later, the number of coal miners — both underground and surface — afflicted by this incurable and progressive disease is rising. The National Institute for Occupational Safety and Health (NIOSH) has conducted extensive research on black lung for many years. NIOSH has determined that younger miners are developing advanced black lung, the lung disease is progressing rapidly to the end stages, and increasing numbers of miners are dying and require heroic treatments including life-saving lung transplantation. Nationally, measures of CWP mortality have increased 47 percent. Screening chest X-rays show nearly double the amount of pneumoconiosis in the last 10 years.
Sen. Paul claims that black lung has been nearly eradicated. There is no sound basis for this statement. Information from numerous independent scientific and public health studies all point toward an increasing problem. This was illustrated by the autopsy results from the miners killed in the Upper Big Branch mine disaster in 2010. Disturbingly, 17 of the 24 miners autopsied had developed CWP.
Sen. Paul dismisses the mounting scientific evidence by claiming that the Mine Safety and Health Administration’s data that black lung rates are increasing as based on a single survey of only miners who chose to participate. Dozens of scientific studies and peer reviewed reports document that pneumoconiosis is a severe and increasing problem in U.S coal miners. In 1995, NIOSH reviewed medical studies and recommended the level of respirable dust be reduced to protect miners. In the 17 years since, the problem has been documented by scientists and medical doctors at NIOSH and at universities (including those in Kentucky and West Virginia). The studies and reports are based upon information collected from multiple independent sources.
It is curious that Sen. Paul asserts that the science has demonstrated that silicosis, rather than coal worker’s pneumoconiosis, is a problem. There is ample evidence that silicosis cannot entirely explain the epidemic of lung disease in U.S. coal miners. In the autopsies of the Upper Big Branch miners, silicosis was not mentioned. Autopsy reports published in 2011 from 660 American coal miners who had begun work after 1970 found evidence of CWP in 59 percent but silicosis was noted in only 8 percent.
Considerable evidence shows that silicosis does not fully explain the current epidemic of severe dust disease in U.S. coal miners. However, there is no question that silica is a highly toxic substance, and studies have shown that miners can be exposed to hazardous levels during work. Control of all dusts in coal mining is important, and Sen. Paul is clearly correct when he asserts that silica levels need to be much lower. As far back as 1974, a review of the available science concluded that workers should not be permitted to inhale more than half the currently permitted amount of silica. The evidence is even stronger today.
To combat the alarming rise in the incidence of black lung, two years ago MSHA proposed comprehensive regulations to reduce the level of miners’ dust exposure. Since the accuracy of measuring respirable dust has long been a source of concern, the regulation also required that mines use Continuous Personal Dust Monitors, which enable a miner to obtain a “real time” reading to ensure that he is not exposed to excessive amounts of harmful dust. In fact, the proposed regulation also addressed exposure to silica. Yet, while many Kentucky miners gasp for breath every day, Sen. Paul wrongly asserts that black lung is no longer a serious problem. Instead of obstructing, Sen. Paul should be pushing for strict legislation that could assure Kentucky miners a safer workplace, free from toxic, and ultimately fatal, levels of mine dust or silica.
As a physician, Sen. Paul clearly understands the human suffering that is a predictable consequence for each miner who is struck by these severe and totally preventable dust diseases. Numerous scientific studies and reports have been published and are available for Sen. Paul. Why hasn’t he supported his arguments with scientific research? Only he knows why he chooses to turns a blind eye to the best science, why he fails to listen to the country’s leading public health officials, and why he refuses to bring a halt to the suffering of Kentucky’s coal mining families, who encounter deathly illness simply by going to work every day.
STEPHEN A. SANDERS
Attorney at Law
Director, – Appalachian Citizens’ Law Center Inc.
Whitesburg, Ky. 41858