As black lung cases continue to climb, silica rule delay leaves miners vulnerable

CHARLESTON, W.Va. (WCHS) — In his 35 years working underground as a coal miner, it was typical for David Bounds to work ten hours a day and six days a week, only taking off Sunday. However, when it came time to retire in 2005, he certainly was not catching any breaks then either. He was struggling to even catch his breath.

“It sneaks right up on you and then you realize ‘I’ve got black lung’ and you can’t do nothing,” Bounds said.

Bounds, who lives in Oak Hill now, is one of thousands in the state who need oxygen and nebulizer treatments just to get through the day. The CDC estimates that about one in five miners in Appalachia is impacted by the disease.

While cases continue to go up, the medical community is also seeing another troubling trend: that black lung is affecting miners at a young age in more significant ways due to more silica exposure from smaller coal seams. This is why Bounds and other active and retired miners have been advocating for what has been deemed the silica rule.

It is a rule that was passed in 2024 by the Mine Safety and Health Administration, or MSHA. It is supposed to impose regulations on mines to reduce and measure silica, a compound found in coal and rock, which is believed to be the primary cause of the disease.

The rule was supposed to go into effect this past April but has faced a legal challenge from the National Stone, Sand and Gravel Association. It is currently held up in court until at least October.

“It’s really frustrating when you see coal miners in their 20s and 30s, and they’re walking around begging for air,” Bounds said. “These people – they won’t pass the bill. They won’t enforce it. And you wonder why. Why?”

For Bounds, who already has an advanced form of the disease, his main concern is with the people still working in the mines, worried that they could face the same issues he goes through daily.

“I couldn’t walk my dog out here if I wanted to. My wife has to do all that for me,” he said. “If I would start out going downhill, I’d be OK, but coming back home, I’d just have to stop.”

Bounds started mining in 1969. By 1984, he was diagnosed with black lung.

“I was buying a home, had a kid in school, two car payments and stuff like that. You can’t just walk off your job” he said. “I thought I’ll just try to cope with it and do something about it. It was bigger than I was.”

Black lung is a slow-moving but deadly disease with no cure. A 2023 Black Lung Incidence Report from the U.S. Department of Labor revealed that black lung cases have been increasing in the U.S. since the 1990s, but especially in the Appalachian region.

It said that across the United States, there were 4.34 average cases per county from 1970 to 2014 and 3.44 cumulative deaths from 1999-2020. However, in Appalachia, the average case count per county was 28.79 cumulative cases and 10.88 cumulative deaths.

U.S. Department of Labor data from 2024 shows that West Virginia is second only to Kentucky nationwide on the number of claims for black lung benefits filed and dollars paid out.

Dr. Carl Werntz is one of the first stops for miners looking to be evaluated for black lung. The Morgantown-based occupational medicine specialist spends a few days a month also seeing patients at the Cabin Creek Black Lung Clinic in Dawes.

The Kanawha County clinic opened 50 years ago in response to the growing need for black lung care.

“The crazy thing is, down here we’re still seeing young guys and gals with black lung. Not just people in their 70s and 80s with a little bit of black lung. These are people in their 40s and 50s with pretty advanced disease,” Werntz said. “It’s crazy the amount of black lung we’re seeing down here. I have not detected that it’s dropping off.”

Werntz sees patients coming from around the state and sometimes out of state seeking their diagnosis and black lung benefits. He can determine, through a series of tests and X-rays, if someone has it, how advanced it is and if they are disabled by it.

“Black lung is a disease of scar tissue,” Werntz said. “The lungs, where you’re supposed to be exchanging gases, is converted into scar tissue, which doesn’t exchange gas. If that slowly progresses, it’s harder and harder to get enough oxygen into your blood to be able to do anything.”

Werntz said silica dust is the main culprit. He explained that miners these days are not just mining coal but also more rock that has much more silica content.

“If you’re just mining coal, the dust in the mine is 1% silica. If you’re mining 20 inches of coal and 20 inches of rock, the dust in your mine is 50% silica, and that’s going to be a lot worse for the miners,” he said. “That’s a lot of the basis for the silica rule that was passed for miners, which has still not been implemented.”

The silica rule delay was recently referred to by the United Mine Workers of America as a “death sentence.”

As an occupational health specialist, Werntz is most interested in the preventative side. He considered the passage of the silica rule from the MSHA to be a turning point, as it monitors and sets the standard for exposure to silica dust and ventilation techniques.

Right now, there is no such monitoring going on in the mines for silica, despite its connection to the disease. Coal operators have expressed concern about cost and implementation variables.

“It is very frustrating. I was so happy when the regulation was announced, and then it just isn’t doing anything to protect the miners yet. It is just disappointing,” Werntz said.

Also disappointed by this is Dennis O’Dell, who has been an advocate for miners’ health and safety for decades. O’Dell, a Fairmont native, is a former miner himself but also worked on the health and safety side. He retired as the head administrator for occupational health and safety for the United Mine Workers of America International, covering all 50 states and Canada.

Aside from responding to mining disasters and performing inspections nationwide, a big part of O’Dell’s job was to advocate for better working conditions, especially when it comes to preventing black lung.

“It’s 2025, we’re still having coal miners die of black lung,” O’Dell said. “Both my grandfathers worked in the mines, and they had to face these kinds of conditions because they didn’t have the technology we have today. We’re not doing enough, and that should be a red flag to everybody.”

O’Dell traces it back to the early 1930s Hawks Nest Tunnel Disaster. Throughout a major tunnel construction project, almost 1,000 workers died, primarily African Americans, from silica exposure. He said we have known since then about the dangers of silica dust.

“We have miners who are still being exposed to all these dangers as far as silica dust and coal dust, and we’re not doing anything about it. Ninety-five years later, we’re still talking about what we need to do, but we’re not doing anything,” O’Dell said. “That’s a sin.”

In his work on the health and safety side, O’Dell noted that a silica rule has been on MSHA’s radar since the late ’90s. He said it took until 2023 to actually get it on the agenda. From there, it was not passed until a year later.

“In knowing that we’re accepting those hazards doesn’t mean we have to accept the fact that at the end of the day, we may die from a terrible disease that the government has every ability to eradicate. It’s disturbing if you look at it from that sense,” O’Dell said.

Delays aside, O’Dell said it has been a challenging year in general for Black young patients and advocates as a whole. In the Spring, 200 people were laid off at the National Institute for Occupational Health and Safety, or NIOSH. With a facility in Morgantown, NIOSH is responsible for black lung screenings and the next steps for miners, whether they are ruled disabled or are transferred to a low-dust job.

Though some jobs were restored later, those layoffs created temporary delays in miners’ healthcare. From the layoffs to other federal programming cuts in the Trump administration, O’Dell said said any progress they have made in the past few years for occupational health and safety, he said they are now twenty steps back.

“All those budget cuts have been detrimental to pretty much shutting these agencies down to where they can’t do the things that are supposed to protect coal miners,” O’Dell said. “Maybe we love coal, but we better start loving coal miners because what we’re doing is killing them in the process. I think our priorities need to be coal miners first, profits next.”

Though black lung progresses slowly, people like Werntz, say time is of the essence when it comes to the preventative side.

“Are they going to die tomorrow? No. Are they going to get to walk their daughter down the aisle? Maybe not. That’s difficult,” he said. “These are people that have a pretty advanced disease, and it’s not going to resolve on its own, and there’s no good treatment options.”

For retired miners, like Bounds, an enforced silica rule will not do anything for him at this stage in his life, but he wants better for all of the miners after him.

“I want to make it better for them. I don’t want them to go through the things I go through right now, even with the coal dust. I don’t want them to come up 50 and 60 years old, begging for breath,” Bounds said.

Bounds said the way he is living now, extremely limited in physical ability and dependent on oxygen, he is just existing, but he is hopeful for a day when miners can both make a living and truly live to enjoy it.

“Get out of the dust,” Bounds said. “Do what you have to do to get out of it because it’s a killer. You don’t know how bad it really makes a coal miner feel when they get up in age, if they make it that long.”