Appalachia's black lung rates highest in nearly 50 years as miners' protections stall

Like many miners with advanced black lung disease, Tim Balthis looks healthy, sitting with his wife Fran Balthis on their porch in Pound, Va. But a scan of his lungs shows so much fibrotic tissue a doctor told Balthis he was surprised he was still alive. Roger May for NPR hide caption

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 hardworking 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."

Respiratory therapist Marcy Freeman has treated hundreds of coal miners with complicated black lung disease at her clinic in Norton, Va., including her husband, a coal miner who worked close to 27 years underground. Justin Hicks/Louisville Public Media/LPM hide caption

This 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 (NIOSH), a federal research agency.

Public Health Watch, Kentucky Public Radio and NPR obtained a draft of the NIOSH research letter before publication.