WHEELING - Dr. Donald Rasmussen has spent his medical career campaigning on behalf of victims of black lung. And now he sees the disease that afflicts nearly all coal miners making a comeback.
Rasmussen, of Beckley, is regarded as one of the world's leading experts on black lung. While coal mines have done much over the past 40 years to help alleviate some of the issues that lead to black lung, such as coal dust, Rasmussen believes that new, more powerful and efficient mining equipment is leading to the disease's resurgence.
"The current mining machines are so much more powerful than the old ones," Rasmussen said. "They can mine coal with a lot of layers of rock. The power releases a lot of coal dust and silica, too. The more silica in the dust, the more toxic it is.
"I don't have proof of that, but that's a theory I think needs to be looked at. There's going to have to be a better means of reducing the silica."
Rasmussen believes Northern Panhandle miners are less prone to the affliction because the coal in the Pittsburgh No. 8 seam is less toxic to the lungs than what is mined in southern West Virginia.
Black lung is known officially in medical circles as pneumoconiosis, but it's also been called miner's asthma and miner's cough. Regardless of the name, more and more cases of black lung disease are being reported - particularly in southern West Virginia, Virginia and Kentucky, research indicates.
Built on 2003 research, a recently published report in the Center for Disease Control's Morbidity and Mortality Weekly Report showed pockets where black lung disease has been progressing rapidly.
Researchers suggested several possible reasons for the increase and severity of the black lung cases: that the allowable dust limit may be too high; that the levels of coal dust reported may be underestimated; and that the toxicity of the coal being mined may be higher.
National Institute for Occupational Safety and Health investigators have suggested that they are seeing more cases of miners with black lung disease in small, nonunion mines. Genetics also plays a role in who develops black lung disease.
Rasmussen is a specialist in occupational pulmonary medicine at the Rheumatology and Pulmonary Clinic in Beckley.
Rasmussen said he has his own theories regarding the increase in black lung. He said current mining equipment causes more dust and also allows miners to reach coal not accessible in years past. The coal that once could not be reached is more toxic and contributes to the increase in black lung cases, he believes.
He said the equipment now used also is capable of mining through rock. That process releases the substance silica dust, which is dangerous to miners. The dust also is contributing to black lung cases, Rasmussen said.
J. Davitt McAteer, former head of the federal Mine Safety and Health Administration and current vice president for sponsored programs at Wheeling Jesuit University, agrees with Rasmussen's theory regarding coal technology's impact on the increasing number of black lung patients. But he is not yet ready to support another of Rasmussen's theories.
Rasmussen believes the coal in the northern portions of West Virginia is less toxic than that in the southern areas of the Mountain State. He also believes coal in the United States decreases in toxicity to the west. McAteer noted that theory needs to be researched.
"There has been research done, but I think it needs further explored," McAteer said. "There's a hypothesis, but we can't say for certain that it's correct. It's a legitimate inquiry. We need to get to the bottom of this."
McAteer again suggested the evolution of mining equipment has been both a blessing and a curse.
"It's a step forward in the production aspect, but it's a step back in terms of the dust produced," McAteer said. "Over the past 25 years there has been an increase in speed, efficiency and energy. They are mining coal at a faster rate and increasing the amount dust."
NIOSH's study looked at two West Virginia counties in particular. A survey of 109 miners in Raleigh County found 23 miners had some signs of the disease, with five having advanced cases.
Another survey of 54 miners in Upshur County, located in central West Virginia, found five miners with some signs of the disease, including three with advanced cases. Numbers of black lung cases in Northern Panhandle miners were not included in the survey. Rasmussen said he can think of only one or two Northern Panhandle miners treated at his facility.