NPR It's a familiar tale across Appalachia. Two hours north and east, beyond twisting mountain roads, Danny Smith revved up a lawn mower. He wore jeans, a T-shirt and a white face mask stretching from eyes to chin, and he pushed only about 15 feet before he suddenly shut off the mower, bent to his knees and started hacking uncontrollably.
"Oh God," he gasped, as he spit up a crusty black substance with gray streaks, and then stared at the dead lung tissue staining the grass. Still coughing and breathing hard, Smith settled into a chair on his porch and clipped an oxygen tube to his nose.
NPR For decades, government regulators had evidence of excessive and toxic mine dust exposures, the kind that can cause PMF, as they were happening. They knew that miners like Kelly and Smith were likely to become sick and die. They were urged to take specific and direct action to stop it. But they didn't.
"We failed," said Celeste Monforton, a former mine safety regulator in the Clinton administration who reviewed the NPR/Frontline findings.
NPR "You have a much harder time breathing so that you can't exercise," Cohen noted. "Then you can't do some simple activities. Then you can barely breathe just sitting still. And then you require oxygen. And then even the oxygen isn't enough. And so ... they're essentially suffocating while alive."
NPR But our investigation found that this indirect approach to controlling silica dust didn't always work. MSHA's 30 years' dust sampling data show dangerous levels of silica or quartz where miners were working close to 9,000 times, even after coal mines were required to meet reduced limits for coal mine dust.
"They didn't pay sufficient attention," Weeks concludes. "And ...we've 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."
NPR Mining companies also knew they were cutting more quartz, creating more silica dust, and exposing miners to toxic dust. They were not only clearly warned by MSHA in the 1990s; they could see what was going on in their mines. Cutting rock slows mining machines and hurts production. And rock has to be removed from coal before it can be sold.
So NPR and Frontline wanted to know why mining companies didn't act on their own to protect their workers.
"Sure they could have done that," responded Bruce Watzman, the National Mining Association's top lobbyist for more than 30 years. "But ... I'm not going to speculate on why they did or didn't do what they chose."
NPR "It's [been] eating at me for the last two years," he said, "that I'm going to die over this. ... Of all the things that could've killed me while I did work there, the rockfalls and all that stuff, I lived through all of that. And I find out years later I'm going to die over black lung. And it's heartbreaking."
Smith then mentioned his wife and two daughters and wondered what will happen to them when he's gone. He wondered about the grandchildren he may never see. His voice breaking again, he talked about the excitement of being a young miner, about the hope and promise of good pay and good lives.
"We was all young and strong and stout and they took advantage of us. Every one of us is either crippled or dead. We was all young men," he said, crying softly.
TL;DR modern coal mining is leading to faster deaths from black lung disease because they have to bore through quartz to get coal and quartz dust is even worse for lungs than coal dust.