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Black Lung Disease

Every year, almost 1,500 people who have worked in the nation’s coalmines die from black lung disease. That’s equivalent to the Titanic sinking every year, with no ships coming to the rescue. While that disaster which took place so long ago continues to fascinate the nation, black lung victims die an agonizing death in isolated rural communities, away from the spotlight of publicity.
Black lung is the legal term for a man-made, occupational lung disease that is contracted by prolonged breathing of coalmine dust. Some call it miner’s asthma, silicosis, pneumonoultramicroscopicsilicovolcanoconiosis, coal workers' pneumoconiosis, or black lung. However, they are all dust diseases with the same symptoms.
Only the smallest particles of the coal dust make it past the nose, mouth, and throat into the alveoli found deep in the lungs. The alveoli, or air sacs, are responsible for exchanging gases with the blood, and are located at the end of each bronchiole. Microphages, a type of blood cell, gather foreign particles and carry them to where they can either be swallowed or coughed out. If too much dust is inhaled over a long period of time, some dust-laden microphages and particles collect permanently in the lungs causing black lung disease.
The main symptom of the disease is shortness of breath, which gets worse as the disease progresses. In severe cases, the patient may develop cor pulmonale, which is an enlargement and strain on the right side of the heart caused by chronic lung disease. Eventually, this may cause right-sided heart failure. Some patients develop emphysema as a complication of black lung disease. Others develop a severe type of black lung disease in which damage continues to the upper part of the lungs even after exposure to the dust has ended called progressive massive fibrosis.
Black lung disease can be diagnosed by checking a patient’s history for exposure to the coal dust, followed by a chest x-ray to see if the characteristic spots on the lungs are present. A pulmonary function test may help in the diagnosis. However, all coalminer’s should have chest x-rays every four years so the disease can be detected early.
Congress placed strict limits on airborne dust and ordered operators to take periodic air tests inside coalmines in 1969. Thanks to the law black lung disease has been reduced among the nation’s 53,000 underground coal miners by more than two-thirds. However, because of cheating the law has fallen far short of its goal, which is to virtually eliminate the disease. Many mine operators, aided by miners themselves, cheat on air quality tests to conceal lethal dust levels.
While the federal government has known about the cheating for over twenty years, it has little to stop it because of priorities and a reluctance to confront coal operators, according to an investigation by The Courier-Journal.




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