AYESHA RASCOE, HOST:
An epidemic of an incurable disease among coal miners in Appalachia got new attention this past Tuesday. Federal regulators propose major changes in the rules that are supposed to protect miners from black lung disease. Our former NPR colleague Howard Berkes has been reporting on this since 2011. His new "Frontline" PBS film, "Coal's Human Cost," also came out Tuesday. He joins me now to discuss the film and the difficulties in regulating the mining industry. Thank you so much for being here, Howard.
HOWARD BERKES: It's good to be with you, Ayesha.
RASCOE: For many people, black lung disease sounds like something out of the dark days of coal mining a hundred years ago. Why is there still an epidemic of black lung disease?
BERKES: Because the biggest coal seams in Appalachia were mined out in recent decades, and mining companies turned to much thinner strips of coal. And they're embedded in rock, and so the mining machines pulverize rock as they cut into coal. That results in very fine, easily inhaled particles of highly toxic silica, which cause severe scarring and stiffness in the lungs.
RASCOE: I mean, that just sounds horrible. Before we get to that human cost you focused on in the film, what rule changes did the federal Mine Safety and Health Administration propose Tuesday?
BERKES: You know, this goes back actually to 2024 when the Biden administration imposed strict limits on silica dust and, for the first time, direct enforcement. The changes proposed on Tuesday give mining companies more control over monitoring silica dust because, the agency says, mine operators have 40 years of experience. But, you know, that experience hasn't prevented thousands of cases of disease, and the rate of disease now among some miners is back to what it was in 1978. So the bottom line for mining advocates is that the proposed changes make enforcement weaker.
RASCOE: What does the failure of mining companies and federal regulators to keep miners safe look like on the ground?
BERKES: I met miner Tim Balthis in Virginia. He was diagnosed five years ago with the advanced stage of disease.
(SOUNDBITE OF DOCUMENTARY, "COAL'S HUMAN COST")
TIM BALTHIS: The death is real. That's going to happen. If the rest of my body stays in good shape and I don't get killed in a car accident or something like that, I'm going to die of black lung. I know that. With the diagnosis that I have, I'll probably be lucky to live into mid-60s.
BERKES: How old are you now?
BALTHIS: I will be 58 in November.
BERKES: Mid-60s isn't far off.
BALTHIS: No. No, it's not.
RASCOE: Your film also steps back in time a bit and revisits some scenes from another film of yours eight years ago. Why did you do that?
BERKES: We wanted to show how little has changed since then, so we talked to some of the same people we featured back then. That includes Ron Carson, the now-retired director of the Stone Mountain black lung clinics in Virginia.
(SOUNDBITE OF DOCUMENTARY, "COAL'S HUMAN COST")
RON CARSON: For us to be sitting here discussing what we are talking about over the past eight years and nothing's been done - it just - it's horrifying. It's just horrifying, 'cause we put the data out there. We put the facts out there. And something should have been done on a higher level to make sure that we wouldn't be here today talking about this.
RASCOE: Howard, like, is there no hope for minors with this disease, no treatment? Maybe lung transplants, for example - could that help them?
BERKES: There really is no cure, but one of the miners we featured in the film did have one of those double lung transplants five years ago. Greg Kelly described for us how difficult that surgery was.
(SOUNDBITE OF DOCUMENTARY, "COAL'S HUMAN COST")
GREG KELLY: The surgeon, when he talked to me - he said, I had to scrape your lungs out. He said, I couldn't even pick them up. He said, that's how bad they was. He said, you cold miners are extremely tough to do lung transplants on.
BERKES: That's how bad these miners' lungs get. Now, lung transplants for coal miners are rare, and recovery isn't easy. Greg Kelly is one serious infection away from losing his new life. He's thrilled that he's had five more years. But the median life expectancy for a minor with a lung transplant is just 6 1/2 years.
RASCOE: Yeah. That's really tough to go through. With this new proposed regulation, like, what's ahead for coal miners?
BERKES: Lawsuits are certain for the regulation. It'll likely be months, and maybe longer, before the new regulation is final. And in the meantime, the tougher regulation that the Biden administration put in place is on hold indefinitely. So miners today have the same protections that failed so many of them in the past.
RASCOE: Howard Berkes, thank you so much for joining us.
BERKES: Thank you, Ayesha.
RASCOE: The film "Coal's Human Cost" from the PBS program "Frontline" is now available for streaming on YouTube and at pbs.org. Transcript provided by NPR, Copyright NPR.
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