OAK HILL, W.Va. — Lisa Emery loves to speak about her “boys.” With every phrase, the respiratory therapist’s face softens and shines with pleasure. However hold her speaking, and it doesn’t take lengthy for that zeal to change to harm. She is aware of the names, ages, households and the intimate tales of every one’s scarred lungs. She worries about a complete neighborhood of West Virginia coal miners — together with a rising quantity of their 30s and 40s — who come to her for assist whereas getting sicker and sicker from what was once thought-about an old-timer’s illness: black lung.
“I really like these guys,” she mentioned, wiping tears. “I inform them … ‘Each single one among y’all that sits down in that chair is why I really feel like I used to be placed on this earth.’”
As director of the New River Well being Affiliation Black Lung Clinic, Emery’s seen guys as younger as 45 getting double lung transplants as illness charges soar amongst miners compelled to dig by extra rock full of lethal silica to achieve the remaining coal — far worse than the mud their grandfathers inhaled. A rule accredited final yr by the U.S. Mine Security and Well being Administration would minimize the federal restrict for allowable respirable crystalline silica mud publicity by half to assist defend miners of every type nationwide from the present driving pressure of black lung and different sicknesses.
However, now, it’s in jeopardy amid different Trump administration cutbacks and proposals focusing on employees’ well being and security guardrails: Caught in a politically charged surroundings that promotes business, with lawmakers arguing to alter it and the federal company that wrote the rule not pushing to implement it. Some indignant retired miners with black lung are combating again, demanding that President Donald Trump honor guarantees he made to the individuals who voted him in.
The opposition comes months after Trump signed executive orders to permit coal-fired crops to pollute extra and to streamline the allowing course of and open up new areas for mineral manufacturing, together with oil and pure gasoline drilling and mining of “stunning, clear coal.” He was celebrated on the White Home by smiling miners in arduous hats, together with some with West Virginia stickers, as he promised to place extra individuals to work underground.
“One factor I realized concerning the coal miners: That’s what they need to do,” Trump mentioned. “You possibly can give them a penthouse on Fifth Avenue in a unique form of a job, they usually’d be sad. They need to mine coal.”
However since his inauguration in January, a volley of firings, division eliminations and proposed regulation rollbacks have focused hard-won well being and security protections fought for over many years to safeguard coal miners and different working-class people.
The silica rule was delayed in April after business teams suing the federal government filed an emergency request in courtroom to dam it from taking impact, citing prices and difficulties implementing it. Across the identical time, the Trump administration told nearly all employees on the Nationwide Institute for Occupational Security and Well being that their jobs have been being minimize. That included these working a congressionally mandated surveillance program that certifies black lung circumstances.
Loud public uproar and bipartisan criticism adopted, and a fraction of the company’s positions have been reinstated. That got here solely after a West Virginia coal miner identified with black lung sued. A federal judge in that case issued a preliminary injunction ordering the federal government to carry again respiratory well being division employees at NIOSH.
However some jobs, together with these centered on mine security and analysis, haven’t been restored. And even staff who’ve been recalled say a scarcity of funding and lack of experience in specialised positions, from chemists to engineers, have made it unattainable for them to function on the identical degree as earlier than.
As well as, the Labor Division has proposed altering some mining rules to weaken the authority of district mine well being and security managers that would influence air flow, roof prevention and coaching packages.
The results of all these adjustments is that many blue-collar employees and first responders nationwide — from industrial fishermen and miners to firefighters and development employees — may have fewer individuals working to assist hold them protected and wholesome whereas doing a few of the nation’s most harmful jobs, a lot of them deep in Trump nation.
In truth, the 2 reddest states in America — Wyoming and West Virginia — had the best total employee dying charges in 2023, based on the newest authorities figures. Collectively they skilled greater than a dozen fatalities within the mining, quarrying and oil and gasoline sector that yr.
As a United Steelworkers union chief representing about 700 trona miners in Wyoming, Marshal Cummings worries the little-known white powdery rock he digs — utilized in every thing from glass and detergents to paper — could possibly be making employees sick. He helped push for the silica rule to cowl miners like him, providing them the identical free well being screenings as coal miners, and was compelled to attend for researchers from NIOSH to analyze air high quality at his web site after a request he filed was initially killed by the layoffs.
“We acquired promised that we have been going to make America nice once more, make America wholesome once more,” Cummings mentioned on the time.
“You have to be making these cuts with the scalpel,” he added. “You shouldn’t be utilizing a chainsaw and chunking out all this stuff since you’re impacting employees.”
On the opposite aspect of the nation, Emery sits in her workplace off a busy freeway nestled amid West Virginia’s breathtaking mountains and whitewater rivers that entice vacationers from the world over. Knowledge collected from her clinic together with greater than two dozen others nationwide, spell out what she sees in actual time day-after-day: Of the 11,500 coal miners from central Appalachia with X-rays analyzed by NIOSH-certified readers from mid-2020 by mid-2025, 55% had some type of black lung with the best annual charge — 62% — recorded amongst miners seen previously yr, based on researcher Kirsten Almberg on the College of Illinois Chicago. That compares to 41% elsewhere within the U.S. over the identical five-year interval.
Specialists say that’s as a result of a lot of the easy-to-reach coal has already been extracted in West Virginia and neighboring Virginia and Kentucky, forcing miners to make use of large tools to eat by partitions of quartz-filled sandstone to achieve the remaining skinny coal seams. This creates extra mud laced with shards of silica, which additionally trigger lung most cancers and kidney illness. It’s 20 instances extra poisonous than coal mud, the foremost offender of the previous that always sickened older employees. The silica crystals embed in miners’ lungs, inflicting persistent irritation and finally irreversible scarring that peppers X-rays with chalky spots. It leaves proud, once-strong males skinny and weak. They choke on their meals and gasp after just some steps, cradling shiny cylinders that present a lifeline of oxygen by tubes snaking into their nostrils.
“In case you’ve ever about drowned — or anyone’s about drowned — they know what I’m speaking about as a result of I’m going by that each morning,” mentioned Mark F. Powell, a fourth-generation miner from southern West Virginia who’s upset with Trump’s insurance policies. “By the top of the day, I’m so drained. Generally I don’t even eat supper. I’ll come residence and generally I’m not even in a position to take a bathe. I’m not ashamed to inform it. I’ll lay on the ground and fall asleep.”
He mentioned he wore his protecting respirator all through his almost 30-year profession, however was nonetheless identified with a progressive type of difficult black lung and silicosis when he was 45. NIOSH licensed his X-ray, permitting him to maneuver to a job on the floor with no pay minimize. Now, simply 4 years later, he mentioned he doesn’t have the wind to mow his garden.
He mentioned he worries about youthful miners. Some, now not protected by unions, have been afraid to talk to The Related Press or query bosses who could also be skirting well being and security rules.
From 1970 to 2016, greater than 75,000 miners’ deaths have been linked to black lung, based on NIOSH. Illness charges dropped after Congress put the company’s Coal Employees’ Well being Surveillance Program in place, however have surged for the reason that late Nineties. NIOSH and unions have highlighted the necessity for the silica rule for many years, which cuts permissible silica mud ranges inside mines from 100 to 50 micrograms per cubic meter of air averaged over an eight-hour shift — the identical ranges already enforced by the Occupational Security and Well being Administration in different industries reminiscent of development. In 2018, NIOSH revealed a report displaying round one in 5 coal miners with at the least 25 years’ expertise in central Appalachia had black lung. These findings have been primarily based largely off of working miners who might not have been sick when X-rayed. Researchers say the newer numbers collected from black lung clinics like Emery’s present a bleaker image as a result of they seize miners who’re disabled or retired, a lot of whom have been by no means screened by NIOSH.
In July, seven Home Republicans, led by Rep. Tim Walberg of Michigan, who chairs the Home Training and Workforce committee, wrote a letter to the Mine Security and Well being Administration opposing elements of the silica rule, saying it ignored commonsense controls reminiscent of job rotation and private protecting tools. The letter didn’t point out black lung or different ailments attributable to silica mud, however mentioned the rule was an instance of Biden administration crimson tape and “imposed lots of of tens of millions of {dollars} in prices” on the mining business.
Walberg didn’t reply to questions from AP, however a committee spokesperson mentioned in a press release that whereas the Republicans assist making certain miner security, the present silica rule doesn’t present mine operators sufficient flexibility to use the requirements in an economically possible means.
The White Home and the Labor Division insisted the administration can keep miners’ well being and security whereas rolling again rules.
“President Trump cares about our miners greater than another president in fashionable historical past – which is why he has applied his power dominance agenda to guard their jobs and revive the mining business,” mentioned White Home spokeswoman Taylor Rogers.
However sick miners say the associated fee, for them, is their lives. Even after eradicating all publicity to silica and coal mud, signs proceed to worsen, sometimes leading to solely two choices: A dangerous, costly lung transplant or dying.
“I really feel like in our a part of the nation … we’re kinda forgotten about,” mentioned John Robinson, a former miner from Nickelsville, Virginia, who makes use of a strolling stick and oxygen after being identified with the illness 12 years in the past at age 47. “I don’t assume it’s proper.”
Emery mentioned her youngest affected person with essentially the most difficult type of black lung, known as progressive large fibrosis, was simply 31 when he was identified after solely 10 years underground. And he’s not alone: Charges within the area have jumped in recent times — hitting an all-time excessive for long-tenured miners within the mid-2000s, based on NIOSH knowledge.
“What we’re seeing on the black lung clinics is simply actually alarming,” she mentioned. “So actually, if the rule acquired put in place at the moment, slicing the silica publicity degree in half, you have already got sick miners. It’s going to take a stable 15 to twenty years for us to begin to see this taper off.”
The historical past of illness and sacrifice is all over the place in these mountains. Just some miles from Emery’s workplace, silica created one of many worst occupational disasters in U.S. historical past when greater than 750 miners — most of them Black — died from respiratory the poisonous mud whereas drilling the Hawks Nest tunnel within the early Nineteen Thirties to divert water to energy a steel plant. A small cemetery with rows of sunken, unmarked graves memorializes the tragedy in an space the place rumbling coal trains and steep mining tipples stay the backdrop in drained rural cities blighted by unemployment and decaying homes.
However the area additionally has a proud legacy of utilizing disasters to impress employees to struggle for better rights. And West Virginia coal miners have been on the middle of it.
Joe Megna was simply a teen when his dad left for the No. 9 mine in Farmington on the day he was set to retire in November 1968.
“I mentioned, ‘That is your final shift, don’t go to work, we’ll go trout fishing,’” Megna mentioned, recalling his dad’s dutiful response to the corporate. “He mentioned: ‘I owe them that a lot.’”
Megna mentioned his father then informed him he beloved him — for the primary time — and drove off.
“This was the final time we talked,” he mentioned.
Early the following morning, the bottom shook so arduous, it was felt miles away. Roaring plumes of smoke billowed greater than 100 toes into the sky from a raging hearth. Megna’s dad was amongst 78 miners who didn’t escape the explosion. His physique stays entombed there together with 18 different males who have been sealed inside.
It was the primary mining catastrophe broadcast on nationwide tv, surprising the general public and enraging employees. A number of months later, roughly 40,000 West Virginia coal miners walked off the job in an unauthorized wildcat strike, demanding higher black lung protections and advantages when the state was a Democratic stronghold. Congress responded by passing the Federal Coal Mine Well being and Security Act of 1969, which required authorities oversight and enforcement at coal mines and established breathable mud requirements — the identical ones the 2024 silica rule would minimize in half — and compensation for miners disabled by black lung.
The federal black lung surveillance program was created as a part of that act, which additionally helped lay the framework for broader office security laws a yr later that fashioned OSHA and NIOSH as businesses. Whereas OSHA is charged with imposing employee well being and security requirements beneath the Division of Labor, together with citing employers for violations, NIOSH is the quiet analysis and growth arm. It focuses on making suggestions to keep away from work-related sickness and harm and is overseen by the U.S. Facilities for Illness Management and Prevention.
NIOSH investigates and research firefighter deaths, together with cancers. It certifies N95 masks and critiques and verifies sicknesses involving 9/11 first responders who could possibly be eligible for advantages beneath the federal World Trade Center Health Program. Scientists in its Spokane, Washington, laboratory — which stays gutted — work to maintain wildland firefighters, oil and gasoline employees and industrial fishermen protected. Some have been additionally serving to to develop real-time displays to alert miners of silica mud overexposure.
The chaotic layoffs in April and Could have been made within the identify of redundancy when Elon Musk was on the helm of the Department of Government Efficiency, or DOGE, however no different company does what NIOSH does. Well being Secretary Robert F. Kennedy Jr., admitted throughout a congressional funds listening to in Could that “we made a few errors” whereas saying he restored 328 jobs at NIOSH, principally in Cincinnati and Morgantown, West Virginia.
“Beneath Secretary Kennedy’s management, the nation’s essential public well being capabilities stay intact and efficient,” a Well being and Human Providers Division spokesperson mentioned in a press release. “The Trump Administration is dedicated to defending important companies like those who assist coal miners by NIOSH.”
Unions estimate round 500 staff stay on administrative go away whereas their future is hashed out in courtroom after lawsuits have been filed to have the roles reinstated. Others took buyouts or have accepted positions elsewhere. The Trump administration has attacked federal worker unions, together with these representing the company, making an attempt to strip collective bargaining rights. That too has prompted lawsuits.
NIOSH was slated to turn out to be a part of the newly deliberate Administration for a Wholesome America, and Kennedy proposed its funds for fiscal yr 2026 be slashed to $73 million — an 80% lower from the earlier yr. In the meantime, in September, the Trump administration provided $625 million in funding to increase and enhance coal-powered crops.
Previous to the government shutdown, the Home and Senate appropriations committees really useful the company’s funding both be barely diminished or maintained close to pre-Trump ranges. Specialists have argued NIOSH is a cut price, costing about $2.20 per working American yearly. In 2023, the nonprofit Nationwide Security Council discovered office accidents alone quantity to about $177 billion every year.
“We prefer to say that NIOSH is the little company that nobody’s heard of that’s most likely helped save your life,” mentioned Micah Niemeier-Walsh, an industrial hygienist on the company’s Cincinnati places of work, who spoke as vp of the AFGE Native 3840 union. “Each single office security and well being regulation is written in blood.”
The struggle has not died for some ageing former West Virginia coal miners with black lung who meet commonly in a constructing adjoining to Emery’s clinic in Oak Hill. Final month, dozens of them drove hours together with counterparts from elsewhere in Appalachia to protest on the steps of the shuttered Labor Division, some pushing walkers and stopping to catch their breath each few steps. They held up pictures of useless pals and family members with indicators studying “Coal Miners Lives Matter.”
On the other aspect of the constructing, an unlimited banner with Trump’s face learn: “American Employees First.”
Former miner and coal truck driver Randy Lawrence mentioned each Trump and Kennedy ought to do an eight-hour shift underground to see why NIOSH and the silica rule are important. He mentioned he hopes to ship a loud message to the president he voted for, however now not helps.
“They’re doing every thing they’ll to harm the working man,” he mentioned, lugging his oxygen tank. “They ain’t anxious concerning the miners or individuals in West Virginia or coal miners anyplace. All they’re anxious about is the almighty greenback in D.C. They don’t care concerning the little those who put them there.”
Outgoing United Mine Employees of America union president Cecil Roberts went a step additional, accusing these delaying the silica rule of holding a pillow over miners’ faces, suffocating employees. The UMWA has tried to intervene within the silica rule lawsuit to assist push for its enforcement, however authorities attorneys have opposed it.
“Let’s cease the killing in Appalachia!” he yelled into the group. “This nation owes coal miners a lot. … We allowed these fat-ass individuals up on Wall Avenue to be millionaires and billionaires. It’s our flip!”
The silica rule lawsuit is backed by quite a few business teams that signify several types of mining nationwide.
“We’re completely supportive of the brand new decrease ranges,” mentioned Ashley Burke, a spokeswoman on the Nationwide Mining Affiliation, which is a part of the lawsuit. She mentioned the issue is as an alternative with how the brand new rule is regulated.
Business desires it to match extra intently with OSHA’s strategies of compliance, together with permitting private protecting tools for use extra to assist meet the requirements. However the mining rule requires firm air flow methods and dirt suppression gadgets for use as a part of the first technique of management.
Miners say respirators clog up continuously, making it arduous to breathe, they usually usually slip or don’t seal correctly as a result of beards, sweat or coal mud. They’ll additionally make it troublesome for them to listen to, see or discuss within the noisy surroundings underground.
Retired miners who attended the rally say in addition they are pushing to verify the Mine Safety and Health Administration isn’t weakened. Wayne Palmer was lately confirmed to steer the company, which has seen a dwindling variety of inspectors. Palmer beforehand labored as an government for an industrial minerals commerce affiliation that filed a authorized transient opposing the silica rule. Protest organizers say they requested to fulfill with Palmer, however by no means acquired a reply. The Labor Division didn’t reply to particular questions concerning the silica rule or whether or not Palmer deliberate to deal with the group.
“That’s like having a fox in a hen home,” mentioned Gary Hairston, 71, president of the Nationwide Black Lung Affiliation, who got here out of the mines in southern West Virginia sick at 48 years previous. He mentioned coal firms can’t be trusted to police themselves, including he used to place tape over his air monitor to verify he didn’t get unhealthy samples as a result of he feared being fired. He mentioned the corporate additionally alerted miners when inspectors arrived to verify all the security violations have been hidden. “You ain’t acquired no person to go to.”
The Mine Security and Well being Administration homes inspectors who could be accountable for imposing the silica rule, which the company agreed to pause in April, citing restructuring at NIOSH and technical points. This administration didn’t push again in opposition to the business lawsuit in federal appeals courtroom and was granted one other delay in October, because of the authorities shutdown. The Labor Division has additionally proposed adjustments that will restrict district managers’ authority to pressure mines to adjust to air flow, roofing and coaching rules to hold out Trump’s directive to eradicate forms.
However at Emery’s black lung clinic in southern West Virginia, removed from the lawsuits and the coverage adjustments, all she will be able to take into consideration is one gasping miner arriving after one other. Many are nonetheless working with restricted lung capability simply to maintain their medical health insurance, they usually come to her with questions, hoping she may also help delay the inevitable. She sees the younger ones struggling to throw a soccer within the yard or make it to highschool sporting occasions.
“These households, you understand, they’re my households,” she mentioned. “It’s miners whose youngsters go to highschool with my youngsters.”
The worst ones have the quantity to her cellphone, which isn’t turned off. Generally they name in a panic, determined for assist.
“‘Lisa, I can’t breathe! Lisa, what do I do?’”
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Contact AP’s international investigative group at [email protected] or https://www.ap.org/tips/.
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