Deep Inside Mountains, Work Is Getting Much More Dangerous – by Drew A. Harris (New York Times – August 2, 2023)

Drew Harris is the medical director of Stone Mountain Health Services black lung program and an associate professor of pulmonary and critical-care medicine at the University of Virginia.

As a high school baseball star, Denver Hoskins led Kentucky in home runs and was invited to try out for the Cincinnati Reds. But when his father got sick (and later died) from black lung, a disease caused by inhaling mineral dust, the younger Mr. Hoskins gave up his Division I college scholarship offer to support his family.

Following in his father’s footsteps, he went to work as a coal miner. By the age of 44, Mr. Hoskins was diagnosed with his own case of the most severe form of black lung. He now breathes from an oxygen tank at night and watches his son’s batting practice from the sidelines.

I met Mr. Hoskins in St. Charles, Va., a former coal mining hub in Lee County, the place immortalized in Barbara Kingsolver’s 2022 novel “Demon Copperhead.” Though the town has shrunk to a population of 72, coal miners from across Appalachia — including Virginia, Kentucky, West Virginia and Tennessee — are now flocking there to seek care at Stone Mountain Health Services, a community health clinic that includes the nation’s largest black lung clinic, where I serve as black lung medical director. Last year we cared for over 500 former coal miners with the most severe form of black lung, a record for the clinic’s 32-year history.

By the end of the last century, thanks, in part, to federal safety standards, severe black lung had nearly been eliminated. But with changes in technology and conditions in coal mines in central Appalachia, cases of severe black lung disease are back to the highest level in decades after the last major study, in 2018. As of that year, more than one-fifth of experienced Appalachian miners have black lung.

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