STEVE INSKEEP, HOST:
Several new scientific studies out today confirm what NPR News first reported. Hundreds of coal miners are suffering from the advanced stage of the fatal disease commonly called black lung. This epidemic of severe disease seems to be getting worse. NPR's Howard Berkes has the new findings.
HOWARD BERKES, BYLINE: The implications of the most significant new study are clear, says Kirsten Almberg of the University of Illinois at Chicago.
KIRSTEN ALMBERG: It does really underscore that this is a real phenomenon.
BERKES: Almberg and co-author Robert Cohen identified for the first time thousands of cases of severe black lung in the last 50 years. Other government research had identified just 99 cases in the last five years. And an NPR investigation found more than 2,000.
ROBERT COHEN: It's not that we're discovering a new disease. We're seeing a resurgence of a disease that should've been eradicated. You know, it's something that we should not be seeing any at all, and we're seeing thousands of cases still in 21st century.
BERKES: Cohen and Almberg looked at every coal miner's claim for federal black lung benefits since 1970 and counted those that were proven to involve the advanced stage of black lung, known as progressive massive fibrosis, or PMF. They found more than 4,000 PMF cases. And more than half occurred in just the last 16 years. They also found sharp increases in disease year after year, as much as 30 percent in the central Appalachian coal-mining states of Kentucky, Virginia and West Virginia.
COHEN: So it certainly is not a blip. It's not just the small spike. It's kind of a relentless and increasing progression of disease.
ALMBERG: We may not fully understand how big this burden is, especially in these central Appalachian states.
BERKES: Two other studies involve the damage black lung disease does to the lungs. One shows that lung function continues to get worse in miners with simple black lung even after they stop working and they're no longer exposed to the coal mine dust that causes the disease. The other study was released two weeks ago and documents a threefold increase in the rate of lung transplants due to black lung, according to David Blackley of the National Institute for Occupational Safety and Health.
DAVID BLACKLEY: That was a striking finding and one that suggested pretty strongly to us that this is a problem that's getting worse.
BERKES: At least 62 coal miners with seriously advanced disease have had lung transplants, nearly 80 percent in just the last decade. Blackley says the average cost of these transplants is a million dollars. And the study found that state or federal programs paid for two-thirds of them, costs that are expected to rise with the spike in advanced disease. Even more cases of advanced disease are expected, given the shocking results of a soon-to-be published study Blackley and his colleagues are already talking about.
BLACKLEY: We see increasing numbers and increasing rates of lung transplants, but if you look further down the chain of severity, within our surveillance program, we're seeing more early stage black lung. As a percent of all miners, we're seeing more of it than we've ever seen before.
BERKES: That rate is now 20 percent. So get this - 1 in 5 working coal miners in Appalachia could have diseased lungs. That's true for the thousands who've been tested. It could be the rate for the rest. And given the findings of other studies, many will likely develop the advanced stages of this fatal disease. Howard Berkes, NPR News.
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