Epidemiologists at the National Institute for Occupational Safety and Health say they've identified the largest cluster of advanced black lung disease ever reported, a cluster that was first uncovered by NPR 14 months ago.
In a research letter published Tuesday in the Journal of the American Medical Association, NIOSH confirms 416 cases of progressive massive fibrosis or complicated black lung in three clinics in central Appalachia from 2013 to 2017.
"This is the largest cluster of progressive massive fibrosis ever reported in the scientific literature," says Scott Laney, a NIOSH epidemiologist involved in the study.
"We've gone from having nearly eradicated PMF in the mid-1990s to the highest concentration of cases that anyone has ever seen," he said.
The clinics are operated by Stone Mountain Health Services and assess and treat coal miners mostly from Virginia, Kentucky and West Virginia, a region that includes what have historically been some of the most productive coalfields in the country.
"When I first implemented this clinic back in 1990, you would see ... five [to] seven ... PMF cases" a year, says Ron Carson, who directs Stone Mountain's black lung program.
The clinics now see that many cases every two weeks, he says, and have had 154 new diagnoses of PMF since the fieldwork for the NIOSH study concluded a year ago.
"That's an indication that it's not slowing down," Carson says. "We are seeing something that we haven't seen before."