Coal Mining Black Lung Disease

¶ … Coal mining [...] black lung disease in the mining communities of Kentucky, and the miners' resistance to getting proper health care screening for the disease.

A barrier to care in the coal mining community is the miners' fears that they might have black lung and can no longer work or provide for their families, so they just continue to labor in the mines without adequate screening. On top of this barrier, many miners believe they will lose their jobs if they get a screening. One miner said, "I was afraid they'd make me quit" (Ungar, 2009). In addition, although there are laws regarding black lung, the coal companies fight every case of black lung they can in the courts, leading to a feeling they will not win these cases, and they will not be able to pay for health insurance costs.

Coal mining is a relatively high paying job in an area with a very low standard of living and median income, and miners who can no longer work in the mines have few other work options. Because the problem is so prevalent, miners struck in 1968, and since then, the Federal Government created a program to help the miners. Another reporter notes, "Miner uprisings in the West Virginia coal fields in 1968 led to the creation of a federal black-lung benefits program in 1969 that is supposed to pay the health care and living costs of miners suffering the disease" (Lydersen, 2006). The responsibility for paying costs shifted to coal mining companies in the 1970s, and they began to vigorously appeal the decisions. Reporter Lydersen continues, "To qualify for federal benefits, miners have to be diagnosed with black-lung disease, provide evidence that coal-mine dust contributed significantly to their illness, and prove that they can no longer work in the mines or do comparable labor" (Lydersen, 2006). If the company appeals and wins, the family must repay the costs of health care to the government, often leading to financial ruin. With all of these barriers, many miners simply do not get the screening at all. Kentucky has the lowest levels of screening of any mining state (only 16%) (Ungar, 2009), so it is easy to see these are difficult barriers to overcome for many miners. There is also a lack of healthcare facilities capable of doing the screenings in many small, rural Kentucky communities, which is another barrier for many miners.

Health professionals need to become more involved in information and screening information. They need to stress the importance of early screening and regular screening, and they need to create educational resources for the miners, so they can take steps to avoid black lung. Health care professionals who deal with patients suffering from black lung could also become more involved with creating legislation that would regulate the coal mines more effectively. Currently, there are ways to prevent black lung, but the coal mining industry has resisted attempts to alter or create stricter regulations, and so far the state and federal governments have not really attempted to push the issue. Health care professionals could help push the issue by sharing their own experience treating patients with the disease, and how they suffer before they die.