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Respiratory therapist Deena Neace checks James Muncy's blood pressure and pulse during a therapy session at the New Beginnings Pulmonary Rehab Clinic in South Williamson, Ky. Muncy is one of thousands of coal miners across Appalachia who are dying of advanced black lung. Matthew Hatcher for NPR hide caption

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Matthew Hatcher for NPR

'I Figured It Was Going To Be A Horrible Death, And It Probably Will Be'

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"There's a lot of memories here, some good, some bad," says Smith, while reflecting on his years working at the now defunct Solid Energy mine in Pike County. Rich-Joseph Facun for NPR hide caption

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Rich-Joseph Facun for NPR

An Epidemic Is Killing Thousands Of Coal Miners. Regulators Could Have Stopped It

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Excised and preserved lungs on display at the National Institute for Occupational Safety and Health in Morgantown, W.Va., in 2012, show the dramatic effect of black lung disease. Howard Berkes/NPR hide caption

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Howard Berkes/NPR

David Zatezalo, the Assistant Secretary of Labor for Mine Safety and Health, was asked about the advanced black lung epidemic at a congressional hearing in Washington, D.C., on Feb. 6, 2018. Huo Jingnan/NPR hide caption

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Huo Jingnan/NPR

Black Lung Study Finds Biggest Cluster Ever Of Fatal Coal Miners' Disease

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James Bounds is a West Virginia miner with black lung disease; it took him 4 1/2 years to get compensation benefits. A provision in Obamacare later made qualifying for those benefits much easier. Kara Lofton/West Virginia Public Broadcasting hide caption

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Kara Lofton/West Virginia Public Broadcasting

Obamacare Repeal Threatens A Health Benefit Popular In Coal Country

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The National Institute for Occupational Safety and Health sent a mobile testing unit to a fire station in Wharton, W.Va., in 2012 to screen coal miners for black lung disease. Howard Berkes/NPR hide caption

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Howard Berkes/NPR

Branham wears reflective mining pants in his home in Elkhorn City, Ky. Branham has advanced stage black lung and was forced to quit mining earlier this year. Benny Becker/Ohio Valley ReSource hide caption

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Benny Becker/Ohio Valley ReSource

Advanced Black Lung Cases Surge In Appalachia

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A worker in Claysville, Pa., shovels the fine powder that's part of a watery mixture used in hydraulic fracturing. Silica dust is created in a wide variety of construction and manufacturing industries, too. Keith Srakocic/AP hide caption

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Keith Srakocic/AP

Tighter, Controversial Silica Rules Aimed At Saving Workers' Lungs

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A memorial at the entrance to Massey Energy's Upper Big Branch coal mine represents the 29 coal miners who were killed in an explosion in 2010. Jeff Gentner/AP hide caption

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Jeff Gentner/AP

Coal miner Lee Hipshire in 1976, shortly after emerging from a mine in Logan County, W.Va., at the end of his shift. A few years later, Lee took early retirement because of pneumoconiosis, or black lung disease. He died at 57. Courtesy of Earl Dotter hide caption

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Courtesy of Earl Dotter