Discovering A Hidden Epidemic of Severe Black Lung Disease

By the 1990s, cases of black lung — an incurable respiratory disease that afflicts coal miners — had hit historic lows, and its most severe form was thought to be “nearly eradicated,” according to the National Institute for Occupational Safety and Health (NIOSH).

But a new FRONTLINE and NPR joint investigation — Coal’s Deadly Dust — reveals how thousands of coal miners now face an epidemic of the most severe and deadly form of black lung, known as progressive massive fibrosis, or PMF.

NPR Correspondent Howard Berkes was reporting on the resurgence of black lung when he received a tip two years ago about an outbreak of severe black lung — the disease that epidemiologists thought was nearly gone. He met Brandon Crum, a radiologist in Kentucky whose clinic was overwhelmed with such cases.

In this scene from Coal’s Deadly Dust, Crum displays X-rays of multiple miners with PMF. “The biggest concern at the time, for me, was seeing young men my age — and I’m 43 — or younger than I am, with the most severe form of the disease,” he told Berkes.

Crum said he took his concerns to NIOSH, a federal agency that tests working miners for disease and tracks the occurrence of black lung.

Scott Laney, an epidemiologist at NIOSH, said he didn’t believe Crum’s findings at first. His agency hadn’t detected the sharp increases in PMF in its testing of miners.

But then, Laney visited Crum’s clinic and looked at the X-rays. His reaction, he told Berkes, was, “Horror. Shock.”

“I was really taken aback, not only that these cases were legitimate, but just how severe they were,” Laney said. “It indicated that we had a huge problem, and we realized immediately that it wasn’t going to be isolated to a single clinic.”

In Coal’s Deadly Dust, FRONTLINE and NPR reveal just how large the epidemic has become. Over five years, researchers at NIOSH had reported 99 cases of severe black lung across the country. But NPR/FRONTLINE have now identified more than 2,000 cases in just five Appalachian states over the same time frame.

The film investigates how the coal mining industry and government regulators failed to protect miners from this devastating epidemic.

Coal’s Deadly Dust premieres Tuesday, Jan. 22 at 10 p.m. EST/9 p.m. CST on PBS stations (check local listings) and online.