AILSA CHANG, HOST:
Despite mounting evidence and a stream of dire warnings, federal regulators and mining companies failed to protect coal miners from toxic dust.
MARY LOUISE KELLY, HOST:
NPR and the PBS series "Frontline" spent more than a year looking into this. We have obtained documents and data that show federal mine safety officials had evidence of the danger more than 20 years ago, but they never addressed it.
CHANG: And now more than 2,000 miners are dying from an epidemic linked to that toxic dust. NPR's Howard Berkes traveled across Appalachia to meet many of those miners and to bring us this story.
HOWARD BERKES, BYLINE: Before we get to why it happened, here's why it matters. Listen to some of the three dozen coal miners we interviewed, all suffering from progressive massive fibrosis, the advanced stage of what's known as black lung. It's a disease that turns lungs crusty and useless.
JERRY HELTON: The doctor says my lungs started shutting down. He said it's hardened just like a lump of coal.
LACEY DUTTON JR: It's bad when you can walk outside - all that air out there, and you can't get none in your lungs.
GREG KELLY: For instance, trying to take a bag of trash out, steps and hills - I couldn't even walk up my driveway to check the mailbox.
ROY SPARKS: And whenever your grandchildren come up and they say let's go out and play ball or let's go look at the creek or something or other, you ain't able to walk out with them. And it makes you feel about an inch high.
BERNARD CARLSON: You get up hacking, spitting black and blood.
JACKIE YATES: Coughing to the point of almost throwing up.
CHARLES SHORTRIDGE: It's a death sentence.
JIMMY WAMPLER: We're going to die from it.
EDWARD FULLER: There's no cure for it.
WAMPLER: It's going to kill you.
ROY MULLINS: And knowing that that's coming to you, it's pretty hard to take.
BERKES: That's from inhaling coal mine dust, for Roy Mullins, Jimmy Wampler, Edward Fuller, Charles Shortridge, Jackie Yates, Bernard Carlson, Roy Sparks, Greg Kelly, Lacey Dutton Jr. and Jerry Helton. They mined coal underground and above for 20 to 40 years in Kentucky, Virginia and Pennsylvania. And they share simple milestones for ruined lives.
DANNY SMITH: I was, like, cutting grass, and I've got a big yard. And there's only one part that we have to have actually push mode. And it's 18 passes is all it is.
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BERKES: Danny Smith pushes a lawn mower in front of his white ranch home in a hollow and narrow valley in Canada, Ky. He wears a T-shirt, jeans and ball cap and a cloth dust mask stretching from eyes to neck.
SMITH: And I used to be able to mow in about six minutes. And the last time that I tried it, it took me about six hours to cut it. And I'm not exaggerating at all. I would have to stop and go in and sit down and rest, put my oxygen on, then go back out and make the three more passes.
BERKES: Smith spent only 12 years mining coal. Six years ago, he says, when he was only 39, he was diagnosed with progressive massive fibrosis. And after a few minutes mowing...
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SMITH: (Coughing, spits). Oh, God.
BERKES: ...Smith spits up a wet crust, dark grey with black streaks. It's dead lung tissue. It dies so fast, it just peels away, his respiratory therapist says. Smith recovers enough to settle into a chair on the perch and clips to his nose a tube that leads to an oxygen tank.
SMITH: I'm terrified. I'm scared of suffering like my dad suffered 'cause I sure don't want to go through what he went through. I've seen a lot of guys that died of black lung. And they all suffered like that.
I worry about my kids and my wife, and how are they going to make it when I'm gone? And it's heartbreaking. If I was to die tomorrow, they'll lose everything.
BERKES: In the last eight years, more than 2,000 coal miners were diagnosed with progressive massive fibrosis, according to black lung legal and medical clinics surveyed by NPR in Ohio, Pennsylvania, West Virginia, Virginia and Kentucky. Some are part of the largest clusters of the disease ever reported, says Scott Laney an epidemiologist at the National Institute for Occupational Safety and Health.
SCOTT LANEY: I think this is clearly one of the worst industrial medicine disasters that - that's ever been described.
BERKES: Laney and his colleagues have also documented the highest rate of basic black lung since the early 1990s. Among miners still working in central Appalachia with at least 25 years on the job, 1 in 5 has the disease, he says.
LANEY: We're counting thousands of cases - thousands and thousands and thousands of black lung cases - thousands of cases of the most severe form of black lung. And we're not done counting yet.
BERKES: Here's what NPR and "Frontline" discovered about why this is happening. In the last 30 years, miners in Appalachia cut more and more rock while mining coal, rock that contains quartz. And when quartz is cut by mining machines, it creates fine and barbed particles of toxic silica dust. Almost all the sick and dying miners we interviewed with 12 to 40 years in mining describe more of this rock in coal seams. That includes Bill Cantrell, James Muncy, Harold Dotson and Randall Owens.
KELLY: Back in the '80s and early '90s, I was, a lot of just mostly coal. But as it went on, no matter where you went, you had rock.
DUTTON JR: Probably the last 20 years, I've cut more rock than I've cut coal.
KELLY: All the good seams were gone 'cause there weren't hardly no solid seams of coal left. And there were more rock in the coal.
DUTTON JR: A little seam of coal, probably 8 inches thick, the rest of that was rock, 6 1/2 foot.
HAROLD DOTSON: The more rock you had to cut, the dustier it was.
JOHN GIBSON: It's like being in a room full of smoke.
RANDALL OWENS: Like you're sitting in a cloud.
DOTSON: Like walking into a fog bank.
SHORTRIDGE: You're inhaling that into your lungs as well.
DOTSON: You know that's just like fiberglass. It cut your lungs all to hell.
JAMES MUNCY: It'd choke you up.
GIBSON: I used to spit it up constantly.
SHORTRIDGE: And we just couldn't keep the dust down good enough.
BILL CANTRELL: Everywhere I worked, we cut rock.
BERKES: The silica dust that results is easily inhaled and lodges in lungs forever. Epidemiologist Scott Laney.
LANEY: It makes a huge impact because silica is a lot more toxic than coal mine dust, somewhere around 20 times more toxic, and it can cause disease much more rapidly.
BERKES: So get this. NPR and "Frontline" documented thousands of instances in which miners were exposed not just to coal dust, but to that toxic silica dust at dangerous levels. That's what we found in 30 years of data collected by federal regulators. They measure coal and silica dust where miners are working, and 85 percent of the time, they reported safe levels of silica. But the rest of the time, there were 21,000 instances of dangerous exposures to silica.
JIM WEEKS: That's what causes disease, is the excessive exposure. I think if the intent of enforcement is to reduce exposure and you're getting overexposure, it didn't work.
BERKES: Jim Weeks is an industrial hygienist who has worked for the federal mine safety agency and the United Mine Workers union. NPR and "Frontline" found that federal enforcement does not directly address silica dust. If there's too much silica, mines are put on a much tougher limit for overall coal mine dust. That's supposed to lower the silica exposure because the coal and silica dust are usually mixed. But it didn't always work. There were still dangerous levels of silica, or quartz, close to 9,000 times in the last 30 years.
WEEKS: They didn't pay sufficient attention, and, you know, we got the bodies to prove it. I mean, these guys wouldn't be dying if people had been paying attention to quartz. It's that simple.
BERKES: And when federal mine inspectors issued citations for too much silica, which they did only a fraction of the time, they said more than 9,000 miners were affected. Now, the data only show what happens when regulators are checking. They often didn't check during some of the most dangerous exposures.
SMITH: This was a big operation right here.
BERKES: Not far from his house in Kentucky...
SMITH: I won't pull on their property, but that's it right there.
BERKES: ...Danny Smith slows his SUV as we pass an abandoned coal mine. He and other miners used drills and mining machines here, cutting through solid rock underground to get from one coal seam to another.
SMITH: You know it was a rock dust. We had all kinds of air, but I was still breathing it all in, I guess, anyway, regardless.
BERKES: And how many days, weeks, months...
SMITH: Oh, it took months to do that. Oh, lord. I would say it was seven days a week, minimum 16 hours a day.
BERKES: This is called slope mining, and it's not really mining. There's no coal involved. It's all about cutting through solid rock to get to coal seams, and because there's no coal, there's no requirement for sampling the air for dust, even if it's the most dangerous dust. That's optional. Danny Smith cut at least two slope mines.
Is it possible that your disease came from cutting through solid rock for hour after hour, day after day, month after month?
SMITH: Very possible, yeah. Most of my mine career, I run a continuous miner. I rode a roof bolter also, and it's very possible from all the hours that we worked.
BERKES: Roof bolters drill into solid rock. Continuous miners cut rock and coal. Dust is supposed to be controlled by massive ventilation fans, curtains that channel air and constant water sprays. Sometimes they work, miners told us, and sometimes they didn't.
There's also this. Dust masks or respirators are not required. Miners who used them told us they often didn't work anyway.
EDWARD WAYNE BROWN: They would clog up with dust, sweat and spit.
KELLY: I just never could get enough air.
BROWN: And then feels like somebody just sitting there with their hand over your face.
DOTSON: About give you a heart attack trying to breathe through it.
JAMES HAYS: They're not going to stop 100 percent.
CARLSON: There's finer particles getting through them filters that creates what I've got.
NOAH COUNTS: Some of the companies I worked for didn't have them at all, period. I mean, there was no such thing as a dust mask.
BERKES: Noah Counts, James Hays and Edward Wayne Brown are among the miners who weren't protected by dust masks. In fact, dozens of other miners, including Danny Smith, are suing dust mask suppliers.
There's also this. Federal law makes masks secondary and optional in protecting miners. First and foremost, the law says, is keeping mine air safe. It all adds up to this for Celeste Monforton, a top mine safety official in the Clinton administration.
CELESTE MONFORTON: It's a combination of the regulations were not adequate, the enforcement of those regulations was not sufficient, and the mine operators themselves were not held accountable.
BERKES: That didn't seem to be the direction back in 1992, when presidential candidate Bill Clinton met with coal miners in West Virginia suffering from black lung.
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UNIDENTIFIED PERSON #1: He's going to be our nominee. He's going to be our president. He's from Arkansas. His name is Bill Clinton.
BERKES: Clinton told the miners and a crowd in Charleston that he knew what black lung could do because he represented miners seeking black lung benefits when he was a young lawyer in Arkansas.
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BILL CLINTON: I saw those big, strapping men who could no longer push a lawn mower across their front lawn, who could no longer pick their grandchildren up. Some of them could not even make their own beds in the morning. And I learned a lot about what a caring government would do as compared with what a heartless one would.
BERKES: We found internal memos from the Clinton administration that showed alarm way back then about a cluster of advanced lung disease among coal miners as young as 40. The Mine Safety and Health Administration warned the industry back then about excessive exposure to silica and severe disease among miners. A Department of Labor advisory committee and the National Institute for Occupational Safety and Health called for separate regulation of silica and an exposure limit twice as tough.
Davitt McAteer led the Mine Safety Agency at the time.
DAVITT MCATEER: And we started a national campaign first to raise awareness. And it was that campaign that began to try to go after the silica requirements and raise the silica standard and start on a separate path to control silica.
BERKES: There were other dust control loopholes so big, you could drive coal trucks right through them.
Loophole No. 1 - one mine inspectors did not check for coal and silica exposure most of the time. They inspected just four times a year underground and twice a year at surface mines.
Loophole No. 2 - sampling devices did not check for mine dust the entire shifts miners worked, despite more and more overtime, double shifts and six-day weeks.
Loophole No. 3 - when inspections turned up excess silica, mining companies could then take their own samples of mine dust unsupervised. They could average the results, which hid the worst exposures. And their samples were sometimes fraudulent, resulting in criminal prosecutions as recently as this year.
Loophole No. 4 - it could take weeks to get dust samples analyzed for silica. Overexposure could continue for dozens of shifts.
Davitt McAteer says he tried to fix it all, but the National Mining Association, the industry's biggest lobbying group, sued and won.
MCATEER: That threw the silica standard back, and we weren't able to pick that up again and go forward with that. And then we ran out of time. And it's something that's unfortunate and put a lot of lives at risk in the meantime.
BERKES: Remember, this was 20 years ago. There were clusters of severe disease like there are today. Miners were sick and younger like they are today, and cutting rock creating silica dust was blamed then, too. There's nothing new about any of this, except thousands more miners are suffering severe disease, and silica is still not directly regulated. Celeste Monforton.
MONFORTON: We failed. Had we taken action at that time, I really believe that we would not be seeing the disease that we're seeing now and having miners die at such young ages from exposures that happened 20 years ago. I mean, I don't know how you can reach any other conclusion. I mean, this is such a gross and frank example of regulatory failure.
BERKES: Nothing changed in the next administration of George W. Bush, when a former coal mining executive ran the mine safety agency. Then President Obama put Joe Main in charge. Main came from the United Mine Workers union. And he was on that Labor Department advisory committee that sought tougher regulation of silica back in 1996.
JOE MAIN: So it was very obvious that that whole scheme that had been in place, that has left so many people sick, had to be changed and had to be fixed.
BERKES: Main closed some of the big loopholes. No more sampling by mining companies, no averaging of samples, no sampling for just part of the work shift. New, real-time, coal-dust-sampling devices were deployed to make the process more honest. And the exposure limit for coal mine dust got tougher but not for silica.
MAIN: A high tide rises all boats, as the saying goes. We were going to get a benefit out of reducing the overall dust exposure by what we did - would not only lower coal mine dust, but all dust that was part of that, including silica.
BERKES: But as we found in the agency's own data, that formula had failed thousands of times. Celeste Monforton wonders why the agency missed that or ignored it.
MONFORTON: The fact that you went back for 30 years and looked at that data, and that data was available to the agency to assess as well, why wasn't that problem recognized and rectified?
BERKES: None of the former agency officials we spoke with could explain that. They thought they were doing what they needed to do. But another agency did act on silica, the Occupational Safety and Health Administration. So now every industry that cuts rock - every industry except mining - has those separate and tougher regulations on silica.
Joe Main left it to the Trump administration to address silica in mining.
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UNIDENTIFIED PERSON #2: Ladies and gentlemen, please welcome our lecture today, Secretary Zatezalo.
BERKES: At West Virginia University in September, President Trump's choice to lead the Mine Safety and Health Administration spoke to mining students. David Zatezalo was a former mining industry executive and lobbyist, and his agency declined multiple requests for interviews. So we were there, too, when Zatezalo sounded unequivocal about silica and disease.
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DAVID ZATEZALO: You hear the phrase in health circles of progressive massive fibrosis, these sorts of things. To me, I believe those are all clearly silica problems. Silica is something that has to be controlled.
BERKES: But when we approached Zatezalo afterword, he was suddenly uncertain.
ZATEZALO: I don't think the science is that well-defined on it yet, Howard.
BERKES: You have 2,000 miners right now with progressive...
ZATEZALO: I don't - I don't think that the science of the causation is that well-defined. I don't know...
BERKES: You said yourself 'cause silica was...
ZATEZALO: Could you - no, I said I suspect silica. I didn't say it was. I said I suspect it. I think until such time as you figure out what it is, you don't really know.
UNIDENTIFIED PERSON #2: Excuse me, students...
BERKES: Zatezalo was whisked away to pose for photographs with students. So far, his agency has no plan for separate and tougher regulation of silica at coal mines.
UNIDENTIFIED DOCTOR: All right, sir. I want you to take in a big, deep breath.
BERKES: In a black lung clinic in St. Charles, Va...
UNIDENTIFIED DOCTOR: Blow it out.
BERKES: ...A coal miner stands face first against a wall-mounted X-ray panel, his bare back lit bright, except for a target shaped like a cross.
UNIDENTIFIED DOCTOR: And breathe. You can go ahead and move, sir.
BERKES: This clinic continues to diagnose new cases of progressive massive fibrosis at the rate of a dozen a month. The epidemic continues. So does the finger-pointing. Even the National Mining Association, the industry trade group, pushed for specific regulation of silica.
But mining companies also knew they were cutting more quartz. Quartz slows the mining process, and it has to be removed before coal can be sold. So why didn't mining companies act on their own? Here's Bruce Watzman of the National Mining Association.
BRUCE WATZMAN: Sure, they could have done that. But again, Howard, I'm not going to speculate on why they did or didn't do what they chose. You know, our focus here is forward-looking. How do we prevent this in the future? I can't answer for those what occurred in the past.
BERKES: Isn't part of figuring out what you need to do in the future recognizing maybe what you failed to do in the past?
WATZMAN: Sure it is. But at the same time, I recognize that we're doing better today than we did in the past, far better.
BERKES: The Mine Safety Agency says the same thing. Based on new data, on those changes Joe Main pushed through a few years ago, mining companies now meet exposure limits for coal dust and silica 99 percent of the time. That's a deceptive statistic says epidemiologist Scott Laney.
LANEY: Well, they're sampled very infrequently. So we don't know what's going on with these miners when they're not being sampled. Ninety-nine percent of the time, we don't have information on that.
BERKES: And it'll be 10 years or more, given the time it takes for disease to develop, to know whether the new dust rules really work.
SMITH: They can't stop us from parking on the road.
BERKES: Danny Smith pulls up to a parking lot choked with weeds. This was a Massey Energy mine when Smith worked here. Massey is a defunct company now with deadly disasters in its history and a CEO who went to prison for conspiracy to violate mine safety laws. A ball cap shades Smith's face, sunglasses hide the tears.
SMITH: It's ate at me and eating me for at least the last two years that I'm going to die over this, over - you know, and it's heart - it's heartbreaking, you know, not knowing whether you're going see - have grandkids and you're going to ever see them and - and - of all the things that could've killed me while I did work there - rockfalls and all that stuff, you know and I lived through all that - and I find out years later that I'm going to die over black lung. And it's heartbreaking.
BERKES: Despite a downturn in mining, coal mines still employ about 50,000 workers nationwide.
SMITH: We was all young and strong and stout. And they took advantage of us. Every one of us is either crippled or dead, you know? We was all young men. We was just kids.
BERKES: Back at Danny Smith's house in the holler in Canada, Ky., a small family cemetery sits at the edge of the lawn he has so much trouble mowing. It holds a single gravestone bright with flowers, and chiseled into it are the names of his parents. Behind it in the shade is the plot Danny Smith has picked for his own burial. He's 46 years old.
Howard Berkes, NPR News.
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CHANG: You can see our entire investigation on npr.org. The "Frontline" documentary called "Coal's Deadly Dust" is scheduled to air January 22 on PBS.
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