08/05/2026
Respiratory therapist Marcy Freeman doesn’t need a research study to confirm for her a return to the dark days of coal mining. She finds evidence in a stack of more than 150 funeral programs, all for former patients at her pulmonary rehabilitation clinic in Norton, Virginia.
“Each one of these represents a life that’s gone because of black lung,” Freeman explained as she flipped through the programs, recognizing names and images.
“These are husbands. These are brothers…These men were just hard-working men and the only thing they did was go to work and provide for their families. And it cost them everything…This is the aftermath of black lung.”
The aftermath is more dire than even black lung clinicians and researchers expected, according to new data published Wednesday in the American Journal of Respiratory and Critical Care Medicine.
The data appears in a peer-reviewed research letter from the National Institute for Occupational Safety and Health, or NIOSH, a federal research agency.
Public Health Watch, Kentucky Public Radio and obtained a draft of the NIOSH research letter before publication.
NIOSH researchers found that working veteran underground coal miners in central Appalachia are suffering from the incurable and fatal lung disease at the highest rates in nearly 50 years.
Miners working in Kentucky, Virginia and West Virginia who’ve had at least 25 years underground have the worst rate of coal workers’ pneumoconiosis, or black lung disease. One in three — 32.5% — tested positive in X-rays conducted by NIOSH during the last five years.
The last time the rate of disease was that high for miners with the same work history was 1978. In 2018 when NIOSH last reported rates of the disease, the rate was 20.6%.
The new research shows that even miners with as few as 15 years underground have higher rates of black lung — rates not seen in nearly 40 years.
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It’s now as bad as the 1970s, with thousands of miners sick and dying.