Over the weekend, the Lexington Herald-Leader remind us of the continuing worker health crisis in the Appalachian coalfields, with a story headlined, After decades of decline, black lung on the rise in Eastern Kentucky. They reported:

Congress intended to eradicate the disease known as black lung with a landmark 1969 law that limited underground coal miners’ exposure to dust.

Roger Cook can tell you that didn’t happen, but only if he pauses mid-sentence to take a labored breath.

Cook, 57, has black lung even though he started his 32 years as an underground miner in 1978, well after the new standards were put in place. He is among a growing number of Eastern Kentucky miners afflicted in recent years with black lung, reversing a decades-long decline of the torturous, incurable disease.

The Letcher County man had to quit the mining job he loved in April 2010 when he was diagnosed with black lung, which scars the lungs, impairs breathing and often leads to premature death.

Cook now relies on an oxygen tank to help him breathe 24 hours a day, and he still gets short of breath even while sitting. He once was an avid hunter and fisherman, but about the best he can do these days is pull close in his pickup truck to watch his grandchildren fish.

“I won’t last that long if I don’t get a transplant,” Cook said.

Their story explained:

Black lung has been the underlying or contributing cause of death of more than 76,000 miners since 1968, according to figures from the National Institute for Occupational Safety and Health. That total does not include deaths from silicosis, which is caused by breathing dust from rocks such as sandstone.

Before the 1969 mine safety act, more than 40 percent of longtime miners in some regions of the United States got black lung, according to NIOSH data. Overall, 11.2 percent of underground coal miners screened for black lung from 1970 to 1974 had the disease.

Prevalence of black lung declined steadily for several decades, dropping to 2 percent in screenings conducted from 1995 to 1999, NIOSH said in a May 2011 report. Then, mysteriously, black lung rebounded. Screenings in 2005 and 2006 found the disease in 3.3 percent of surveyed miners.

The Herald-Leader notes:

MSHA chief Joseph A. Main has said current rules are not adequate to protect miners. For instance: miners wear dust monitors for only eight hours, even though they might work longer shifts; companies can slow production to generate less dust when dust samples are taken; and MSHA uses an average of five samples to gauge compliance.

The agency has proposed a number of changes, including lowering the limit on miners’ exposure to coal and silica dust; requiring miners to wear personal monitors to provide real-time dust readings; using a single, full-shift sample to measure compliance; and keeping production closer to normal levels while sampling.