PIKEVILLE, Ky. — Nearly 1,000 former coal miners suffering from pneumoconiosis, also known as black lung, have filed individual lawsuits against the 3M company and other dust mask manufacturers. 

The miners, represented by Pikeville attorney Glenn Martin Hammond, have collectively worked at more than 100 coal mines and claim the dust masks being supplied are substandard and contributed to their contracting the disease. A majority of the masks used are from 3M but other companies such as Mine Safety Appliances, American Optical Corp. and Cabot also make masks. 

“Appalachia families have long been deprived of quality health care and basic quality education and basic opportunities for a better life, economic and otherwise,” Hammond said. “The spread of black lung has a long and grossly unappreciated history with decreasing state and federal benefits, both medical and income benefits, despite a significant surge in the disease even to younger generations not only in its presence, but also in the extent of the disease has become more progressive than ever before. The snake-oil mentality of the dust masks manufacturers has only placed a greater burden on the taxpayers through the Medicaid and Medicare programs, who largely pay for these problems, and on the small coal operators who had to pay higher black lung workers’ compensation premiums.”

According to the American Lung Association, black lung disease can develop when coal dust is inhaled over a long period of time. When the coal dust is inhaled, the particles can travel through the airways all the way into the alveoli (air sacs) that are deep in the lungs. After the dust particles land and settle in the lung, lung tissue may try to get rid of the dust particles, causing inflammation as the body tries to fight the foreign particles. In some cases, the inflammation is severe enough to cause scar tissue to form. The damaging effects of the inhaled coal dust may not show up for many years, and many patients don’t develop symptoms until long after their initial exposure.

In the early stages, the most common symptoms are cough, shortness of breath and chest tightness. Sometimes the coughing may bring up black sputum (mucus). These symptoms may initially occur after strenuous activity, but as the disease progresses, they may become present at rest as well. If the scarring is severe, oxygen may be prevented from easily reaching the blood. This results in low blood oxygen levels, which put stress on other organs, such as the heart and brain, and can cause additional symptoms.

For an opinion from someone not affiliated in any way with lawsuits, Spectrum News 1 spoke with University of Kentucky assistant professor Jamie Sturgill, Ph.D., who is an expert in pulmonary disorders. She said one of the more difficult things about detecting and treating black lung is the lack of available money for research. 

"You could have five or 10 men and women working in coal mines their whole lives and not all will develop black lung. Some will, some won't and some will have varying degrees," she said. "It's really hard to get research for that, because a lot of people say, 'Just stop mining and then there won't be any black lung.' That's not exactly easy to do."

Hammond said 3M has “cornered the market” on dust masks — paper masks and filters — and have generated approximately $450 million in annual profits per year since 1983. Hammond said the lawsuits claim 3M failed to comply with National Institute for Occupational Safety and Health (NIOSH) standards, which is the organization responsible for conducting research and making recommendations to prevent work-related injury and illness. 

“The dust mask manufacturers were successful in lobbying to have the minimum standards done away with in the early 1980s,” Hammond said. “All dust mask manufacturers have had significant compliance and testing problems and have benefited from the relaxed changes to NIOSH requirements. It has created a lack of compliance, a lack of accountability and a lack of responsibility.”

Dust masks are an optional piece of equipment for coal miners and the plaintiffs chose to wear them. In a statement, the 3M company said it is and has always been committed to providing safe and effective respiratory protection products.

Several types of coal dust masks and respirators on display in the law office of Pikeville attorney Glenn Martin Hammond. (Brandon Roberts/Spectrum News 1)

"3M particulate respirators help protect workers by reducing exposure to dust when properly selected and used,” according to a statement sent Friday, Nov. 12, in an email. “These respirators help reduce exposure to particles of all kinds, including hazardous particles that have been associated with conditions like black lung. We invest significant time, resources and expertise into creating effective respiratory protection products. We also help inform our customers how to select and use them properly. We share information with federal agencies about our products, including NIOSH, to help them assess and certify our products for safety and effectiveness for their intended uses.”

3M also said in the statement that independent research entities and NIOSH have examined the increased incidence of black lung and other respiratory conditions in coal miners and have uniformly not blamed respirators. 

“Individual instances of disease cannot be tied to 3M respirators,” according to the statement. “3M has shared these facts with multiple juries. In 15 of 16 cases, 3M has prevailed. We will continue to defend the effectiveness of these important products vigorously.”

3M cited a Centers for Disease Control and Prevention (CDC) study from 2012 that stated: “The cause of this resurgence in [coal workers’ pneumoconiosis] is likely multifactorial. Possible explanations include excessive exposure due to increases in coal mine dust levels and duration of exposure (longer working hours) and increases in crystalline silica exposure. As indicated by data on disease prevalence and severity, workers in smaller mines may be at special risk.”

Sturgill said agencies such as the Occupational Safety and Health Administration (OSHA) have tried to implement ways to decrease exposure with masks and other dust monitoring devices.

“It's a catch 22," she said. "Some of the masks will work if worn properly, but when you have young miners working for their families, and companies don't provide this [personal protective equipment], it can be costly. Is it a failure of not everyone was provided a mask? Not everyone was educated about a mask? Do people know the ramifications of wearing or not wearing a mask? While wearing a mask is voluntary, there is data that says a properly worn mask should filter out particles. We know that particle filtration will reduce the likelihood of long-term exposure.”

A 2020 study by the Department of Labor’s Office of the Inspector General (OIG) noted the increase in black lung cases among coal miners could be attributed to the Mine Safety and Health Administration’s (MSHA) unwillingness to regulate exposure to respirable crystalline silica, a major cause of black lung and other diseases.

“MSHA has not sufficiently protected coal miners from exposure to respirable crystalline silica,” according to the report. “MSHA's current silica exposure limit is out of date, MSHA cannot cite and fine mine operators for excess silica exposures alone, and MSHA's sampling for silica may be too infrequent to be sufficiently protective.”

Still, Hammond and the coal miners he is representing allege companies, including 3M, knew their masks and respirators, particularly those made before 1998, did not protect the wearers from inhaling particles that later caused black lung disease. They claim the mining companies knew the 3M masks were defective, but still sold them to workers. 

“The problem is we've got individuals who relied upon a false representation and are now in a situation where they are suffering needlessly, their last breaths, dignity and quality of life is sloping down rapidly,” Hammond said. “We don't have the medical infrastructure in Eastern Kentucky, the quality of health care necessary to take care of these individuals. A lot of them didn't get it before they died. That's what's scary. There are more people per doctor here than anywhere else. Miners have a short life expectancy from their exposure to this just for them to have the pride to live the American dream and put food on the table.”

A jury verdict was reached in 2016 at the trial of a Kentucky coal miner, James Couch, who filed a products liability lawsuit against Mine Safety Appliances due to their defective coal dust masks. This was the first coal-dust respirator case to go to trial in the United States. Couch was diagnosed with black lung, and a jury ultimately awarded him a $7.2 million verdict. Couch, explained in an interview with television station WYMT, that he wore his coal dust mask for 15 years, not knowing it was not properly filtering the air he breathed while working in the coal mines.

Attorney Bryant Spann is representing 3M. He said 3M has been successful defending 15 of the 16 lawsuits filed against the company regarding dust masks and respirators because of federal regulations, particularly 30 CFR 70.100, that requires coal mine operators to keep dust below a certain level. 

"You can't run a coal mine a little dirty and rely on respirators to keep your workers safe," Spann said. "If you can't get the dust level below the legally required limit, you can't assign respirators for certain tasks to protect the workers and take them the rest of the way to what's supposed to be a safe level. You can't do that in coal mines. In coal mines, the air has got to be, by federal law, below a certain limit 100% of the time."

Spann said there is no arguing the fact there is an increase in black lung disease among coal miners in Eastern Kentucky. He added NIOSH has not only been certifying respirators since the 1970s, but is also researching what is actually making coal miners sick. 

"How is it that someone getting sick is the fault of an optional piece of safety equipment that when used makes their life better and not worse," he said. "That's sort of how we see it. What NIOSH identified is some smaller coal mines, because they tend not to have a full safety staff and are cutting the narrows seams of coal, which has become more and more prevalent in Eastern Kentucky as the bigger and bigger seems are mined out. Why that matters is guys are cutting rock above and below the seam and the rock dust itself creates or contains silica dust, and silica is about 20 times more toxic than coal dust and causes pneumoconiosis, and silicosis and other diseases."

Spann also said NIOSH determined that although there were fewer overall coal-mining jobs in the late 1990s and 2000s, the ones that did have jobs were working longer hours creating prolonged exposure to dust. 

"The safe levels of dust exposure for coal miners were set for an eight-hour shift," he said. "These guys were working 12 and 16 hours. By working those longer and longer shifts, even if the coal dust levels are kept safe, if you're working for 50% longer every day than the standard, you're going to end up with more dust in your lungs, and you might end up sick."

Sturgill said the ability to screen and detect who is going to develop black lung is extremely difficult. 

"If you are a miner, and you start to have respiratory symptoms and go to a pulmonologist, the benefits office could say since you already had symptoms and you're ineligible," she said. There's a whole kind of navigation of the system. I do believe many people are probably not going to a doctor for early screening and detection and it may affect benefits later on down the road. Before COVID, I was actually traveling to a huge black lung clinic in Eastern Kentucky, and working with patient advocates and physicians. The burden of lung disease in Eastern Kentucky is mind-boggling."

A jury awarded $67.5 million to two brothers, Kentucky coal miners Leslie Cox and Michael Cox, in 2018. The brothers alleged that masks manufactured by 3M Company were defective and did not adequately protect them from inhalation of coal dust, which caused injuries to them that include black lung disease, emphysema and decreased lung function, according to the article in the Lexington Herald-Leader.

“This country was built on the backs of our coal miners, and this is the thanks they get,” Hammond said. “The bigger picture here is that these companies are not worried nearly as much about safety by putting product and profits above people's health.”

Sturgill said many miners are developing silicosis, a pulmonary disease similar to black lung.

"Silicosis is the same pathophysiology but it's different from black lung, so they're actually being almost misdiagnosed," she said. "We actually use a nomenclature called CWP, which is coal workers pneumoconiosis, and that is better to encompass all of the occupational lung exposures for people in any area of mining."