Coal miners and countertop fabrication workers are developing black lung and silicosis at increasingly younger ages, despite decades-old knowledge of how to prevent these deadly diseases.
John Robinson, a coal miner from southwest Virginia, was diagnosed with black lung at 47 — decades earlier than previous generations of miners who typically developed the disease in their 60s, 70s, or 80s. His case reflects a disturbing trend: more coal miners in central Appalachia are falling ill from silica dust exposure at younger ages, while countertop fabrication workers across the country face similar risks from engineered stone containing up to 90% crystalline silica.
Outbreaks Among Younger Workers
Medical professionals began documenting concerning patterns around 2018. Doctors in Colorado identified seven cases of severe lung disease among countertop workers, while Texas reported 12 additional cases. Perhaps most alarming was the death of a 38-year-old Hispanic man in California who succumbed to respiratory failure after working with stone edges at a countertop fabrication company.
“Now, honey, how are these men getting sick? Something’s causing it,” Robinson said. “At one time, you didn’t say black lung around the coal site unless you wanted to lose a job. It’s such an outbreak right now they can’t hide it.”
A recent National Institute for Occupational Safety and Health (Niosh) study revealed that one in three coal miners in central Appalachia (Kentucky, Virginia, and West Virginia) now suffers from black lung disease — the highest rate since the late 1970s. Meanwhile, the New England Journal of Medicine published findings showing nearly 600 cases of silicosis among California countertop workers, including 65 who required lung transplants and 31 who died.
Industry Pushback Against Protections
Despite clear evidence of harm, industry groups continue challenging safety regulations designed to protect workers. The National Stone, Sand & Gravel Association (NSSGA) led legal action against the Biden administration’s 2024 Mine Safety and Health Administration (MSHA) silica dust rule, which aimed to reduce permissible exposure limits from 100 to 50 micrograms per cubic meter.
Kerry Lynch, NSSGA’s senior director of communications, stated the organization did not oppose lowering exposure limits but raised concerns about frequent air sampling and medical surveillance requirements. When the Trump administration failed to defend the rule in court, the Eighth Circuit Court of Appeals stayed its implementation.
The American Exploration & Mining Association (AEMA) also joined the legal challenge. Executive director Mark Compton argued that the rule “would actually undermine miner safety and health due to the restrictions MSHA imposed on its implementation,” claiming the approach was too rigid and didn’t account for operational differences across mining sites.
Regulatory Gaps Leave Workers Vulnerable
OSHA’s 2016 rule protecting construction workers from silica exposure has similarly faced industry opposition. Trade groups argued the stricter exposure limits weren’t “based on sound science” — a familiar tactic documented by epidemiologist David Michaels, former OSHA assistant secretary.
“It’s also often that many small employers are not in compliance. But even if they were in compliance I think we would still have a silicosis problem,” Michaels explained. “This product cannot be made in a way that’s both economic and safe.”
In January, Michaels testified before a congressional subcommittee about mounting lawsuits against stone slab manufacturers and retailers. Rather than focusing on worker protection, the hearing examined how to shield the stone slab industry from litigation. Subcommittee chair Congressman Darrell Issa framed the discussion around “abusive litigation” against manufacturers, despite being among 16 co-sponsors of a bill that would ban lawsuits against sellers of certain stone products.
Michaels, the sole non-industry witness, proposed prohibiting the sale of engineered stone products with high silica concentrations instead of blocking legal recourse. “There are substitute products that are comparable in use and cost, but which do not kill workers,” he testified.
California Moves Forward Despite Opposition
California’s OSHA announced rulemaking in May to prohibit fabrication and installation of artificial stone products containing more than 1% crystalline silica. The stone distributor Consentino responded with a letter arguing the proposed regulation was “premised on inaccurate information refuted by current scientific information, is unnecessary, is not feasible, and exceeds the Board’s authority.”
Rebecca Shelton of the Appalachian Citizens’ Law Center reviewed MSHA silica dust samples from January to June this year, finding that 17% of operations exceeded the limits set in the delayed 2024 rule. Most mines with the highest silica concentrations were located in central Appalachia.
“We show with our analysis that these exposures are happening now,” Shelton emphasized. Her findings directly contradict industry claims that new cases stem from historical exposures rather than current working conditions.
Dr. James Brandon Crum, a radiologist in eastern Kentucky who first alerted researchers to the black lung epidemic over a decade ago, continues documenting cases. “We continue to show every single year just how bad this is and nothing ever gets done about it,” he said. “The only thing higher than our black lung rates is the amount of excuses.”
Why it Matters
These preventable deaths represent a systemic failure to protect American workers from known hazards. Silicosis cannot be cured, but it can be prevented through proper safety measures and enforcement. When regulatory protections are weakened or delayed due to industry pressure, vulnerable workers — many of them young men and women from economically disadvantaged communities — pay with their lives. The pattern repeats across industries: scientific evidence identifies clear health risks, effective safety measures exist, yet political and corporate interests conspire to delay or block implementation. Without strong advocacy and unwavering commitment to worker safety standards, these tragedies will continue claiming lives that could otherwise be saved.