William McCool was always a stickler for safety.
A 63-year-old retired miner from Kentucky, McCool wore his protective dust mask any time he descended into the underground tunnels. From his first day on the job in 1973 at Volunteer Coal Company in Tennessee to the day he left the mines in 2012, he would affix the mask firmly to his face—just as his father, who was a miner before him, had done.
Though many of his coworkers complained that the masks were clumsy to breathe through, McCool never questioned its importance. Every night, he would hand the mask to his wife, Taffie. And every night for 40 years, she would wash the mask clean, placing it in his dinner bucket for him to take to work the following day.
His precautions weren't enough. In 2012, McCool was diagnosed with advanced black lung. "We thought we were protecting our lungs," he says now. "[But] you can’t see the dust that really hurts you."
Black lung is the common term for several respiratory diseases that share a single cause: breathing in coal mine dust. McCool has the classic form of the disease, coal worker’s pneumoconiosis. Over time, his lungs had become coated in the same black particulates that he’d tried to protect himself against all those years. Their delicate passageways had become etched in dark scars and hard nodules.
These diseases are progressive, and they have no cure. More than 76,000 miners have died of black lung since 1968, according to statistics from the U.S. Department of Labor. These include several of McCool’s friends from the mines, who died in their 60s. One friend has been put on a list to receive a lung transplant, which is considered a last-resort treatment. Even if he gets one, it will likely only increase his lifespan by three to four years. “If I live to be 66 or 68, that’s a long time,” says McCool.
After every other sentence, he coughs—a dry, hollow sound—to clear his lungs.
Last month, President Trump visited the Washington, D.C., headquarters of the Environmental Protection Agency to approve an executive order that would reduce regulatory burdens on the coal and oil industries. Surrounded by coal miners from Rosebud Mining Company, he sat down to sign the Executive Order on Promoting Energy Independence and Economic Growth. “You know what it says, right?” he asked the miners. “You’re going back to work—that’s what it says.”
As many news outlets were swift to report, it’s not at all clear that the order will actually resurrect mining jobs in a declining industry. With increasing mine automation, competition from cheap natural gas, and technological advances driving down the cost of renewable energy, there is simply less demand for the product that sends people like McCool underground. But what is certain is that coal mining is still far from a safe job—and in recent decades, the work has become increasingly dangerous for long-term miner health.
On-the-job mine safety has improved drastically in recent decades, with deaths due to accidents now counted in the tens, not hundreds, as they were in the 1970s and 80s. Long-term health, however, is a different story. As the administration seeks to fulfill the campaign promise to send miners in coal country back to work, black lung has made a comeback. Today, the disease sickens roughly 1 in 14 underground miners with more than 25 years experience who submit to voluntary check ups—a rate nearly double that from the disease’s lowest point from 1995 to 1999.
Even more worrisome, the disease is striking miners earlier and in a more deadly form than ever before. Though experts are still working out the causes for the rise in disease, many believe it is a combination of both longer hours on the job and new methods of rock extraction. In the wake of Trump’s executive order, we asked legal and health experts: Just how dangerous are the jobs we could be sending miners back to?