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Free black lung testing to be offered in four counties

| Monday, July 6, 2009

As part of a five-year effort to determine why advanced cases of black lung disease seem to be on the rise in certain areas, the National Institute for Occupational Safety and Health is providing the free health screenings to working underground coal miners in 13 counties in Pennsylvania, Kentucky, Maryland, Ohio and West Virginia.

Mobile testing vans will visit the region during the next two weeks, making stops in Somerset, Cambria, Armstrong and Indiana counties. The mobile service already has visited some counties, including Greene and Washington.

Somerset County has one of the highest percentages of miners progressing rapidly to the advanced stages of black lung disease, said Anita Wolfe, public health analyst and project officer with NIOSH.

A study by Occupational and Environmental Medicine, a journal published by the British Medical Association, reported that 29,521 coal miners were examined nationwide between 1996 and 2002.

Fourteen of the 281 Somerset County miners who participated tested positive for black lung, and nine had reached an advanced stage of the disease.

Wolfe said mobile visits in the East are attracting an average of 150 to 200 miners per week.

The program's goal is early detection and disease prevention while monitoring trends and identifying risk factors.

In the past, miners typically had lung X-rays done on a regular basis at a doctor's office, clinic or hospital.

NIOSH findings in 2007 showed the incidence of black lung disease dropped as much as 90 percent from 1969-95, after the passage of the Coal Mine Health and Safety Act. But since 1995, studies show, black lung cases have been on the rise, with some miners developing advanced cases.

"We started seeing areas around the country we are calling hot spots," Wolfe said.

On the East Coast, the hottest spots were in Pennsylvania, West Virginia and Kentucky.

"There were counties where we were seeing miners progressing very rapidly through the different stages of black lung," she said. "We wondered what was going on."

The disease, while treatable, has no cure.

"Once you have black lung, you have black lung," Wolfe said. "It does not go away. There is treatment ... You can possibly keep it from progressing. But the best way is to take yourself away from exposure. That's a lot easier said than done."

Miners come to Somerset Hospital for both black lung treatment and preliminary testing, said Jason Weber, hospital supervisor of respiratory services.

Most of those being treated are older, he said.

"As the disease progresses, we see them more," he said.

Diagnosis numbers at the hospital have not risen in recent years, Weber said. But, he added, "Everything we hear about it is (that it is) being diagnosed younger and younger."

That might be as a result of better diagnostic testing, he said.

Phil Smith, communications director for the United Mine Workers of America, said the union is following NIOSH's work.

An apparent rise in black lung progression is "very troubling to us," he said.

Smith said numerous theories about the increase are being debated.

It's possible that federal regulatory standards are "not the right standards," he said, or "companies are not following the law — or both."

NIOSH says miners working longer hours in recent years might be part of the reason for the rise in cases, as that would increase their exposure to dust. Changes in mining practices, including cutting rock containing silica after other coal reserves have been depleted, also have been cited as possible causes.

"Silicosis (a respiratory illness caused by inhaling silica dust) may be showing up," Wolfe said.

Smith said the UMWA supported the S-MINER Act, sponsored by Rep. George Miller of California in 2008. The measure would have required miners to wear coal dust monitors and prohibited them from being forced to work in areas where coal dust concentration exceeds 1 milligram per cubic meter of air averaged over 10 hours. Current regulations restrict the milligrams to 2 per cubic meter, Smith said.

The bill passed in the House but was not taken up in the Senate.

He said the UMWA is working with NIOSH and the Occupational Safety and Health Administration to make personal dust monitors available for miners within the year. Workers would wear the monitors to get a readout of dust exposure, and companies could transfer affected miners to areas with lower dust concentrations.

Wolfe expects the mobile visits to conclude in September. The agency will study the data and publish the results, possibly within the year, she said.

Additional Information:

About the disease

• Black lung disease, also known as coal workers' pneumoconiosis, is a lung disease caused by inhalation of coal mine dust.

• Symptoms include shortness of breath, respiratory infections, chest pain and coughing.

• Diagnosis is made primarily by X-ray.

• There is no cure, only treatment of symptoms.

• Between 1996 and 2005, nearly 10,000 American miners age 15 and older died of black lung disease.

Source: Centers for Disease Control and Prevention

Additional Information:

Testing sites

Testing is scheduled at these sites:

• Orenda Park, near Boswell, Somerset County, Monday through Wednesday.

• Cambria County War Memorial Arena in Johnstown, July 9 and 10.

• Giant Eagle, Leechburg, Armstrong County, July 13.

• Wal-Mart, Kittanning, Armstrong County, July 14.

• Indiana University of Pennsylvania, July 15-17.

All testing is done from 7 a.m.-7 p.m.

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