A report by physicians from three clinics in Virginia and the National Institute for Occupational Safety and Health has identified the largest cluster of advanced black lung disease ever recorded.
The research, published in the Journal of the American Medical Association, examined radiographs collected during a two-year period from 11,200 current and retired coal miners. Of these, 416 (3.7 percent) showed evidence of progressive massive fibrosis (PMF) – a condition characterized by inflamed fibrotic lesions in the lungs caused by an immune reaction to accumulated coal particles. Eventually, lung tissue begins to die, resulting in chronic breathing difficulties and heart attacks due to high blood pressure in the lung’s arteries. There is no treatment other than a lung transplant.
Improved health and safety oversight combined with more advanced equipment appeared to have decreased the prevalence of PMF in recent years, yet clearly something is still very wrong with mining work conditions.
"We've gone from having nearly eradicated PMF in the mid-1990s to the highest concentration of cases that anyone has ever seen," said investigator and NIOSH epidemiologist Scott Laney to NPR. (Follow the organization’s ongoing investigation here)
Because the authors only looked for PMF, a complication of coalworker’s pneumoconiosis, many less developed yet still severe cases were not accounted for. In the year since study data collection ended, the clinics have made another 154 PMF diagnoses.
"That's an indication that it's not slowing down," clinic director Ron Carson said to NPR. "We are seeing something that we haven't seen before."