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President Trump's sweeping cuts at federal health agencies include the Coal Workers' Health Surveillance Program. Over the past half century, that program dramatically reduced black lung disease, which once sickened or killed over a third of miners. Mining communities must now grapple with its disappearance. NPR's Yuki Noguchi reports.
YUKI NOGUCHI, BYLINE: Sam Petsonk grew up in southern West Virginia, visiting patients with his father, one of the country's first doctors to specialize in black lung disease.
SAM PETSONK: When I was a child, I'd look up and I'd see coal miners, seeming larger than life, you know, doubled over, coughing, scarcely able to walk, work or breathe.
NOGUCHI: Today, Petsonk's entire law practice represents coal miners sickened on the job. For his work, he relies heavily on a unit of the National Institute for Occupational Safety and Health, which runs the Coal Workers' Health Surveillance Program. The program ran a very unique kind of workplace health benefit. By law, it gave every miner in the country access to care for free. It sent mobile X-ray units to mines for regular screenings. It authorized job transfers for miners showing signs of disease, and the 25-person unit also trained and certified doctors to read specialized lung scans. Petsonk says it's an essential part of mining life. But as of last week, the Centers for Disease Control and Prevention slashed staff, and it is not operating.
PETSONK: It's a bedrock institution for the medical profession that has been obliterated. It's just unacceptable.
NOGUCHI: Yesterday, Petsonk filed suit against Health and Human Services and its new head, Robert F. Kennedy Jr., to reinstate the unit. Epidemiologist Scott Laney headed research at that Morgantown, West Virginia, office until he was placed on administrative leave on April 1.
SCOTT LANEY: We are the nation's doctors for coal miners when it comes to their lung health.
NOGUCHI: Laney says with no staff, the Coal Worker (ph) Health Surveillance Program and its database of X-rays, medical records and mobile screening vans are abandoned. He says his unit single-handedly reduced rates of black lung disease among longtime miners, from about 40% to under 5%. But it's still a huge concern today, as coal mines cut more from sandstone, which generates dust 20 times more harmful than coal. Without monitoring, Laney says, coal miners will die, and no one will keep score.
LANEY: It's going to have impacts on my neighbors. It's going to be killing young men. And that story will go untold.
NOGUCHI: Dr. Drew Harris says most miners are unaware of the program's recent fate. Harris is a pulmonologist who directs the Black Lung Program at Stone Mountain Health, the only such free clinic in Virginia.
DREW HARRIS: We hear coal trains running behind the clinic intermittently throughout the day.
NOGUCHI: Harris says the lung surveillance program is trusted and universally relied upon.
HARRIS: In central Appalachia, it's a big deal. I mean, these are towns that basically were built around coal mining. And coal miners are, like, the heart and soul of this community and sort of the economic livelihood for generations.
NOGUCHI: Harris says high levels of sand dust mean some patients need double lung transplants by age 40. The program, he says, is still very necessary.
HARRIS: If that goes away, then, you know, people won't know that they have black lung at an earlier age, and more people are going to end up with severe disease because they didn't diagnose it earlier.
NOGUCHI: Officials from CDC and Health and Human Services did not respond to requests for comment. Yuki Noguchi, NPR News.
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