When the Black Lung Disability Trust Fund was created, it was meant to be a temporary measure. Lawmakers expected rates of the incurable disease to gradually decrease.
That’s not what happened.
Instead, Black Lung, or coal workers’ pneumoconiosis, is at its highest rate in Appalachia in 25 years, according to a recent report from NPR–and there are even more cases that remain unreported. Local clinics are struggling to keep up with the influx in patients, and advocacy groups have resorted lobbying in the nation’s capital to extend the trust fund.
For Lynda Glagola, program director at the Lungs at Work Black Lung and Respiratory Disease Clinic, the rise is nothing short of a public health crisis. Running a small, rural clinic with three or four staffers, Glagola said her days have become swamped with patient care and outreach clinics.
“We travel around to various counties we serve,” Glagola said over the phone, taking her lunch break from an outreach event last month. At these outreach clinics, Glagola’s staff provides regional onsite testing to patients who don’t have access to the means to get to the clinic in McMurray. Testing for black lung includes observation during a six-minute walk and a prescription for a test x-ray.
“If we identify disabling numbers on any of our tests, then we assist in filing a claim,” Glagola said.
On a typical day in the office, that’s what Glagola can be found doing – in addition to providing basic medical advice, the clinic assists with legal aid.
“I am a lot of the time working on claims, getting medical evidence out for review, participating on depositions and writing briefs when the case is over,” Glagola said. The rest of the office is just as involved, she said, filling out paperwork, communicating with miners and recording detailed work histories. A physician comes in to see patients only two or three mornings a week, she said.
Glagola said in recent years, the clinic workers have noticed a more patients coming in suffering from the advanced stages of black lung – resulting in an increasing demand that her staff simply can’t match. But when it comes to pinpointing what is causing the disease’s rise, no one has any definitive answers.
“That’s the $100,000 question,” Glagola said.
Glagola thinks it’s related to silica exposure in the mine. As miners burrow deeper into the coal deposits, they begin cutting through rock, which is even more toxic than coal dust, Glagola said. Additionally, as a result of layoffs, miners are spending more time in the mines to make up for the deficit in labor.
“Their lungs really didn’t even have a chance,” she said.
The Black Lung Disability Trust Fund, which pulls from an excise tax on all underground mining production, was set up for miners whose employer companies cancelled their health policies for reasons like budget cuts or bankruptcy. The tax has fluctuated over the years, but has hovered around 4.4 percent, said Sarah Martik, campaign manager at the Center for Coalfield Justice. At the end of 2019, though, the fund will be decreased by 55 percent–going from about $1.10 to $0.50 for ton of underground coal.
That’s why Martik’s organization, in cooperation with the Alliance for Appalachia, visited Washington, D.C. two weeks ago to lobby for the fund’s extension beyond 2019, and to ask that the excise tax be increased.
For three days in late September, Martik and other lobbyists met with multiple legislators in the nation’s capitol, including Bobby Scott, Va.-R from Virginia, Connor Lamb, Pa.-D, Michael Doyle, Pa.-D and Joe Manchin, Wv.-D.
Martik said that, overwhelmingly, legislators were supportive of the “ideology,” behind the Center’s requests, even if they didn’t commit to helping.
“Overwhelmingly, people were receptive,” she said. “They care a lot about this. They want to make sure that miners are protected.”
But there still isn’t any concrete legislation to actually provide the legislation, Martik said, and many legislators weren’t willing to lead the effort. They wanted to “see what happens,” Martik said.
“We were looking for leadership on this issue,” Martik said. “We were asking people to step up, to write some legislation, to co-sponsor legislation, whatever. There was less interest in doing that.”
Martik said the fund is currently operating at a deficit, borrowing from the state treasury supported by taxpayers. She wants to see the tax on mining production increased by 25 percent, to fill the gap.
Glagola thinks the problem stems from a lack of knowledge, and more resources need to be dedicated to finding answers.
“It’s a public health crisis and I think if it was a disease that more people were aware of, maybe we would see more action on this,” said Glagola. “We need the researchers, the clinicians, the government entities to really come together on all of this.”
For Martik, the priority is helping the population of southwestern Pennsylvania – a sizeable portion of which are coal miners.
“This is a thing that impacts so many people and so many lives in such a small area. That was really meaningful, to make sure that southwestern Pennsylvania is not forgotten about; we are an important place in the general picture of this issue.