Report Raises Concerns Over Miner Safety as Black Lung Rates Reach Nearly 50-Year High

 

September 26, 2026 – A new analysis from Appalachian mine-safety and worker advocates is raising concerns about federal mine-safety policy as the prevalence of black lung disease among long-tenured underground coal miners in Central Appalachia reaches its highest level in nearly five decades.

The report, prepared by the Appalachian Citizens’ Law Center, ReImagine Appalachia and researchers associated with Indiana University, examines federal mine-safety and health policy from January 2025 through September 2026. Its authors argue that reductions in federal staffing and funding, along with delays in implementing new silica protections, have weakened safeguards for miners at the same time the Trump administration is pursuing policies designed to increase domestic coal production.

The report comes after new research from the National Institute for Occupational Safety and Health (NIOSH) found that approximately 32.5% of veteran underground coal miners in Central Appalachia with at least 25 years of mining experience showed evidence of coal workers' pneumoconiosis, commonly known as black lung.

That is up sharply from 20.6% when researchers last reported comparable results in 2018. The current prevalence is the highest recorded among this group since 1978.

The increase is even more striking when compared with 1999, when the prevalence among long-tenured Central Appalachian underground miners had fallen to approximately 7%.

Researchers also found increasing rates of disease among miners with as few as 15 years of underground experience.

Central Appalachia — particularly the coalfields of Virginia, West Virginia and Kentucky — has been the center of the resurgence.

Silica Exposure a Growing Concern

Researchers have increasingly pointed to respirable crystalline silica as a major contributor to severe and rapidly progressing forms of black lung.

As coal seams in parts of Appalachia have become thinner, miners can encounter greater amounts of surrounding sandstone and other rock containing silica. Cutting and drilling through that material can release extremely fine particles capable of penetrating deep into the lungs.

Coal mine dust itself causes coal workers' pneumoconiosis, while silica exposure can cause silicosis. Mixed exposures have also been associated with progressive massive fibrosis, the most severe form of black lung disease.

Both conditions are irreversible, making prevention through dust control and exposure monitoring particularly important.

In 2024, the Mine Safety and Health Administration finalized a rule lowering miners' permissible exposure limit for respirable crystalline silica to 50 micrograms per cubic meter of air over an eight-hour shift.

The rule also established an action level of 25 micrograms per cubic meter and included requirements for exposure monitoring, corrective actions and improved respiratory protection.

Implementation for coal mines was originally scheduled for April 2025 but has been repeatedly delayed amid litigation and federal agency restructuring. Enforcement was eventually placed on an indefinite hold pending the outcome of legal proceedings.

Mine-safety advocates argue the delay has become increasingly significant as new evidence indicates excessive silica exposure continues to occur.

An Appalachian Citizens’ Law Center review of MSHA sampling data from the first half of 2026 found that the agency sampled fewer than half of active coal mines and facilities. Among operations that were sampled, 17% recorded silica concentrations exceeding the exposure limit contained in the delayed 2024 rule.

Seventeen mines reportedly recorded concentrations more than twice the new limit, with most of those operations located in Central Appalachia.

Under the 2024 rule, exposure above the permissible limit would trigger corrective measures and additional testing.

Federal Safety Programs Face Changes

The new report also focuses on changes affecting NIOSH and MSHA, the two principal federal agencies involved in researching, monitoring and enforcing protections related to miner health.

NIOSH operates the Coal Workers’ Health Surveillance Program, established under the Federal Coal Mine Health and Safety Act of 1969. The program provides free medical surveillance to miners, including chest X-rays and lung-function testing, while collecting data used to identify trends in occupational respiratory disease.

Federal workforce reductions in 2025 temporarily disrupted portions of NIOSH's mining programs, including its mobile screening operation and mining research activities.

Some employees were subsequently reinstated and the mobile screening program resumed. NIOSH conducted its annual mobile black-lung screening program in 2026 in coal-mining communities across Virginia, West Virginia, Kentucky, Alabama, Ohio and Indiana.

The Mine Safety and Health Administration has faced its own staffing and budget debate.

Congressional documents cited concerns that MSHA lost approximately 200 employees during federal downsizing in early 2025, representing roughly 10% of its workforce at the time.

Those reductions generated concern over the agency's ability to maintain mandatory inspections and other enforcement activities.

Federal law generally requires MSHA to inspect every underground mine in its entirety at least four times annually and every surface mine at least twice annually.

Administration Says Safety Remains a Priority

The Trump administration has pushed back against suggestions that budget reductions necessarily mean reduced protection for miners.

During a Senate appropriations hearing earlier this year, Department of Labor Acting Secretary Keith Sonderling said changes at MSHA were intended to make the agency more efficient while maintaining its safety mission.

Sonderling pointed to plans to use new technologies, including artificial intelligence and heat-mapping capabilities, to help inspectors identify and document violations more efficiently.

He also told lawmakers that the department expected to hire approximately 160 new mine inspectors and investigators.

The administration has additionally pointed to federal data showing that the mining industry's injury rate reached a record low in 2025.

“Mine health safety is one of our top priorities at the Department of Labor,” Sonderling told lawmakers, particularly as the administration seeks to expand domestic energy and manufacturing.

The administration has characterized proposed MSHA budget reductions as an efficiency measure rather than a retreat from mine safety.

The debate comes as President Trump continues a broad initiative to expand U.S. coal production.

An executive order signed in April 2025 declared coal essential to the nation's economic and national security and directed federal agencies to remove regulatory barriers to coal production, accelerate development of federal coal resources and encourage greater domestic coal use and exports.

The administration has said additional coal generation will be needed to support rising electricity demand from manufacturing and rapidly expanding artificial intelligence and data-center development.

Advocates Say Coal Expansion Should Include Miner Protections

The authors of the new report contend that federal efforts to strengthen the coal industry should be accompanied by an equally strong commitment to protecting the miners expected to produce that coal.

ReImagine Appalachia said its review of more than 500 days of federal policy found what it described as “disinvestment and regulatory rollbacks” affecting initiatives intended to combat black lung.

The organization argues that the administration's support for coal production has not been matched by sufficient action to address the resurgence of occupational lung disease.

The United Mine Workers of America has also called for immediate enforcement of the silica rule.

Following publication of the latest black-lung research, UMWA International President Brian Sanson called on federal regulators to implement the standard without further administrative delays, increase random dust sampling and maintain strict enforcement against excessive exposures.

The union argues that miners should not have to choose between maintaining coal production and protecting their health.

Industry Has Pointed to Historical Exposure

The National Mining Association has cautioned against interpreting today's black-lung prevalence as evidence of current mining conditions alone.

Because coal workers' pneumoconiosis is a latent and progressive disease that can take years or decades to develop, the organization has said current disease rates among miners with long careers largely reflect exposures accumulated over many years and do not necessarily represent today's operating practices, protections or regulatory environment.

Mine-health advocates acknowledge the disease's long latency but point to current MSHA sampling results as evidence that potentially dangerous silica exposure has not disappeared.

That disagreement is likely to remain central to the debate over the 2024 silica standard.

More Than 1,700 Miners Died With Black Lung From 2020-2023

The human and financial consequences of black lung remain substantial throughout the coalfields.

NIOSH research indicates that more than 1,700 U.S. coal miners died from black lung disease between 2020 and 2023.

Federal data also show that more than 26,000 miners or their surviving dependents received approximately $175 million from the federal Black Lung Disability Trust Fund in 2024.

Black lung has no cure. Depending on the severity of the disease, miners can experience chronic coughing, shortness of breath, declining lung function, disability and premature death.

The federal Coal Workers’ Health Surveillance Program continues to offer free screenings designed to identify disease earlier and allow miners to make informed decisions about their health and employment.

Debate Comes at Critical Time for Coal Industry

The latest findings create an unusual intersection between two major federal policy objectives: expanding domestic coal production while maintaining the health and safety of the workforce needed to produce it.

The administration maintains that mine safety remains a priority and says additional inspectors and new technology can improve MSHA's efficiency even amid agency restructuring.

Worker advocates counter that increasing coal production without fully funding enforcement, surveillance and disease-prevention programs could place additional miners at risk.

What is not disputed is the severity of the black-lung resurgence in Central Appalachia.

After decades of improvement following passage of federal mine-health legislation, disease prevalence among the region's most experienced underground miners has climbed from approximately 7% in 1999 to 20.6% in 2018 and approximately 32.5% today.

For the coal industry, regulators, miners and their families, the question now is whether that trend can once again be reversed.