In Oak Hill, West Virginia, Lisa Emery, a respiratory therapist and director of the New River Health Association Black Lung Clinic, expresses deep concern for the health of local miners. These men, often still in their 30s and 40s, face severe respiratory challenges due to black lung disease, exacerbated by exposure to deadly silica dust in the mines. I love these guys, Emery states with a mix of pride and sorrow, noting that her patients are increasingly young and have been diagnosed with serious conditions previously seen only in older workers.
With rates of the disease rising, especially amongst younger miners, Emery and other healthcare professionals warn that the health crisis is worsening. Many miners are diagnosed with conditions such as progressive massive fibrosis, while traditional treatment options like lung transplants become more frequent among those in their 40s.
Government regulations aimed at reducing silica dust exposure have been proposed but face political challenges. The proposed rule from the Mine Safety and Health Administration (MSHA) seeks to cut permissible silica dust levels in half, a change Emery argues is critical to protect miners’ health.
There is strong resistance to these regulations from various political factions, with some arguing they impose excessive costs on mining operations. Recent changes under the current administration and efforts to rollback regulatory protections have further complicated matters, leaving miners without the protective measures needed to safeguard their health.
Emery's clinic provides needed support, but the statistics are grim—of the miners assessed by NIOSH-certified readers in central Appalachia from 2020 to 2025, over half showed evidence of black lung disease. In light of increased silica exposure from mining practices that dig deeper into harder rock, experts predict that the crisis will escalate unless actionable changes happen soon.
Amid the backdrop of West Virginia's rich mining history and its impact on workers’ lives, Emery emphasizes the urgent need for protective measures, stating, We’ve got to stop this... There are lives at stake, and we cannot allow politics to interfere with health care for miners. The heartbreaking reality is that many miners still show up to work with limited lung capacity, fearing the loss of their jobs and healthcare. As she reflects on their struggles, Emery remains steadfast in her mission to provide care and push for critical health reforms in the mining industry.
