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BLACK LUNG: Anatomy of a Public Health Disaster.

BLACK LUNG: Anatomy of a Public Health Disaster By Alan Derickson Cornell University Press, $29.95

Black's law dictionary says that "criminal homicide constitutes manslaughter when it is committed recklessly." Criminal homicide constitutes murder when "it is committed recklessly under circumstances manifesting extreme indifference to the value of human life." Do either of these categories apply to the conduct of an industry which knows that it is causing fatal disease in its workers, covers up the harm, opposes remedial measures and then cheats on monitoring tests designed to assure its workers' safety?

Certainly Alan Derickson's Black Lung: Anatomy of a Public Health Disaster offers a searing indictment of the industry. In a richly detailed account of the worker, public, corporate and medical understanding of the diseases once grouped under the name "miners' asthma" but now called black lung, Derickson shows that the devastating effects of coal dust on miners' health have long been known, but long denied by coal operators, medical doctors--many company-influenced--and government regulators.

Derickson's book opens by recounting an 1881 presentation by H.A. Lemen, a professor of medicine at the University of Denver, to the Colorado State Medical Society. Discussing a coal-miner patient, Lemen reported not only on his "harassing cough" but that he spit up a pint of black liquid--of a "decidely inky appearance"--a day. "The sentence I am reading was written with this fluid," he said. Lemen was not a maverick. British medical researchers had linked coal mining and respiratory ailments a full half century earlier. By the beginning of the twentieth century, there was widespread recognition of "miners' asthma" among medical professionals in the United States, although there was no good epidemiological evidence available. And while there was substantial confusion over the etiology of miners' asthma, some doctors emphasized the need for ventilation as a preventive measure to address a disease for which there was no cure. "Even the coal operators grudgingly conceded that miners' asthma existed," Derickson reports.

But following the great 1902 strike, progress toward understanding the disease came to a halt, and the mining companies, company doctors, and even independent physicians increasingly denied the existence or at least importance of miners' asthma. Indeed, for a long period of time it was argued that exposure to mine dust may provide a protective coating for the lungs, which would guard against tuberculosis.

The turnabout was due in part to developments in the medical profession, such as the increasing reliance on x-rays, which often fail to reveal black lung, but especially to a newfound recalcitrance among mining companies. The industry exerted its political power in state after state to ensure that workers' compensation did not cover miners' asthma, except silicosis, a severe form of black lung visible in x-rays.

Government and industry acknowledgement of black lung came only in the late 1960s. The shift was spurred not by any scientific breakthroughs, but by miners' organizing efforts to influence the legal, medical and popular conception of what had long been a disease defined by politics. Responding to a handful of progressive doctors who validated their disease and forcefully articulated the case of coal dust causation of lung impairments, thousands of miners joined the West Virginia Black Lung Association. In early 1969, 40,000 miners went on strike, demanding that West Virginia recognize black lung as a compensable condition. The strike led directly to passage of West Virginian workers' compensation legislation covering all forms of black lung, and soon to passage of the Federal Coal Mine Safety and Health Act of 1969.

The Mine Safety and Health Act had numerous shortcomings, but it represented a giant leap forward for the miners. It established a federal compensation scheme; it required mines to transfer workers with early signs of black lung to less dusty jobs with no loss in pay; and it put in place a federal standard for coal dust exposure. That federal standard stipulated that three years after enactment, miners could not be exposed to more than two milligrams of dust per cubic meter of air, the standard still in effect. Finally, it seemed, the cruel black lung deaths of coal miners would fade into history, as exposure declined and new cases were prevented.

As dramatic and hard-fought as the miners' victory was, it proved much less effective at curbing coal company abuses than must have been expected. Coal companies routinely cheat on coal dust sampling tests designed to evidence mine compliance with federal standards, making it impossible to know how serious dust exposures are. Black lung remains commonplace in coal country, with nearly 1,500 black lung deaths registered in 1994.

In 1991, then-Secretary of Labor Lynn Martin announced that coal operators had demonstrated a virtual "addiction to cheating" on coal dust sampling tests, charging that more than one third of the underground mines in the United States had tampered with coal dust samples submitted to the Mine Safety Health Administration (MSHA). Following a guilty plea by the nation's largest coal company, Peabody Coal, the Labor Department found "abnormal white centers" (AWCs) in the mine dust sampling cassettes submitted by approximately 500 mine operators. The Department alleged that the AWCs were caused by companies vacuuming the cassettes before forwarding them to inspectors. The mine operators bitterly fought the charges, arguing that the AWCs could result from the cassettes being dropped or from rough handling. Without eyewitness evidence, a judge threw out most of the citations.

But the Louisville Courier-Journal has done the Labor Department one better. In a stunning series on black lung published in April 1998, the paper examined coal dust sampling records and found that, in fiscal year 1997, 80 percent of the nation's underground mines submitted air samples that were impossibly clean. Samples taken in working areas at these mines registered .1 milligram of dust--the level that would be expected on a city street and a level which MSHA head J. Davitt McAteer calls "unfathomable" and "statistically impossible" Nearly half of the mines cheated on at least one in seven of their sampling tests.

In an extraordinary piece of journalism, reporter Gardiner Harris supplemented the statistical analysis with interviews with foremen and workers who describe how the coal companies cheated on the dust sampling tests. "You just don't get bad samples and stay with these companies. They will fire your butt," explained one foreman. "They run them [dust tests] for 30 minutes and it's supposed to be eight hours," said a miner. And another foreman: "I was told by the superintendent or the owner to see to it that the dust pumps was turned off.... I turned off the machines myself where I was a foreman."

There are, of course, other hazards of mining, as Duane Lockard recalls in Coal, an interesting meld of analysis and personal memoir from a Princeton University professor emeritus who comes from a coal family and spent some time in mines as a young man. Lockard's book provides a useful but rather general overview of mine explosions and other disasters, low pay, the successful fight of the Miners for Democracy to clean up the miners' union and other chapters in the story of the coal industry in twentieth century America. Where Lockard's book comes alive is with his personal recollections and quotations from the diary he kept as a young man. Through the eyes of a child in coal towns and of a young miner, Lockard conveys the life of a mining family--how they simultaneously depend on, and suffer at the hands of, the unaccountable corporations that dominate their community.

Life in coal country has certainly improved since Lockard's Depression-era childhood. Company towns are a thing of the past, pay is much higher, mine explosions are much rarer and workers have won significant pension rights. These gains are largely due to the efforts of the United Mine Workers of America (UMWA), nothwithstanding all of its faults during the 40-year autocratic reign of John Lewis and a decade of rule under a corrupt successor. The union is now a forceful advocate for health and safety, and union mines are much less likely to cheat on dust samples than non-union mines, according to the Courier-Journal's analysis.

But even as the triumph of Miners for Democracy, a democratic insurgent movement, installed a more responsive union leadership, mechanization and a shift of the U.S. mining industry to the largely non-union West has drastically shrunk the size of the union and, consequently, diminished its bargaining strength and political influence. In the near term, at the very least, it does not appear that the miners' union will be able to function as a sufficient countervailing force to offset the mine owners' power.

How then to deal with the ongoing black lung issue, among the many problems still created by King Coal? MSHA head McAteer, a harsh industry critic before he assumed a place in government, says the federal government should take over dust monitoring responsibilities from the mines. But the UMWA says this move would be inadequate unless the number of federal inspectors was significantly increased. If the feds only test four times a year, the union says, the mine operators will be able to operate dirty on 361 days.

Until McAteer is able to finagle a large enough congressional appropriation, another approach might make sense: cracking down on fraud. After the Bush administration lodged the 1991 high-profile charges of dust-sample tampering, fraud dropped, according to the Louisville Courier-Journal's analysis.

McAteer is disinclined to pursue this approach. "I'm not so much concerned about the criminal stuff," he told the Louisville paper. The "criminal stuff," however, is exactly what needs attention. And the seeming technicality of dust-sample tampering needs to be placed in an appropriate context. When violations of the law cause thousands of people to continue to suffer wrenching illness and die from foreseeable and preventable causes, why aren't criminal homicide prosecutions in order?

Robert Weissman is the editor of the Washington, D.C.-based Multinational Monitor.
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Title Annotation:Review
Author:Weissman, Robert
Publication:Washington Monthly
Article Type:Book Review
Date:Jan 1, 1999
Words:1656
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