Dig, Baby, Dig
The High Price of Coal: Black Lung Returns
The Trump administration has renewed America’s appetite for coal. He might as well be shouting “dig, baby, dig” instead of “drill, baby, drill.”
Under the influence of a powerful fossil-fuel lobby, he’s trying to drag the nation backward instead of pushing toward cleaner, more sustainable energy like solar and wind.
We all understand the cost of breathing polluted air from smokestacks, but this renewed appetite comes with another price — a hidden human toll on an overlooked workforce: coal miners.
For generations, miners have suffered from pneumoconiosis, or black lung disease, caused by the long-term inhalation of coal dust. Dust builds up in the lungs, causing inflammation, fibrosis, and in severe cases, lung necrosis. There’s still no cure — only symptom management and gradual decline.
The passage of the Federal Coal Mine Health and Safety Act of 1969 finally brought relief. Through the 1970s and 1980s, black lung cases steadily declined, and by the 1990s, most believed it was largely controlled, even eliminated — a relic of an uglier industrial past.
But the industry didn’t stop digging. As rich Appalachian seams were exhausted, miners were forced to cut into thinner seams, slicing through silica-bearing rock to reach what coal remained. Crystalline silica is far more toxic than coal dust, causing silicosis, an even more aggressive form of lung disease.
Longer shifts, heavier production demands, and lax enforcement multiplied exposure. Dust samples were manipulated, inspections softened, and the government failed to update exposure limits set half a century ago — limits we now know were dangerously high.
Then came the new deregulation drive. In 2025, the Trump administration suspended the Coal Workers’ Health Surveillance Program (CWHSP), which provided on-site and mobile screenings for early detection of black lung. The earlier that simple black lung disease is found, the better. That’s why screening is so important.
Dozens of employees at NIOSH’s respiratory health and epidemiology divisions were laid off. Lawsuits and court orders have forced partial reinstatements, but miners are still losing access to early detection, benefits, and job protections.
By promoting coal while dismantling worker safeguards, Trump has revived black lung’s career. Once thought to be a disease of the past, it now afflicts a new generation — younger, poorer, and just as disposable as their grandfathers.
Fossil fuels come at a price.
The question is whether we can keep pretending we can afford to pay it.
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