Black Lung

Upon reaching East Tennessee in 1969-70, SHC community workers immediately encountered Black Lung Disease (Pneumoconiosis). For years, the SHC engaged Black Lung Disease on several levels: medical diagnosis and treatment; representation for federal benefits claims; and organizing for reform of the United Mine Workers Union.

A working, non-technical definition of Black Lung Disease is a condition caused by the inhalation of coal dust into the lungs, the most dangerous being microscopic particles which settle in the tiny air sacks (alveoli) that transfer oxygen through interstitial tissue into the blood stream. The coal dust fills the alveoli and scars the tissue, making it impossible to transfer oxygen. Worse, it can lead to progressive fibrosis resulting in continued scarring even after exposure to coal dust ends. In extreme cases, cross sections of affected lung tissue become black and are literally hard as a rock.

As currently defined by federal regulations, Black Lung Disease can encompass other diseases caused by inhaling coal dust such as emphysema, chronic bronchitis and, where silica from sandstone is present, silicosis (Code of Federal Regulations (CFR) title 20, section 718). There is an excellent explanation of Black Lung Disease in Chris Hamby’s recent book, Soul Full of Coal Dust, published in 2020 by Little, Brown, and Company.  For more on the persistence of Black Lung Disease in Appalachia, see update here from November 2023 NonProfit Quarterly.

While Britain recognized Black Lung in 1942, the U.S. didn’t establish a statutory definition of Black Lung Disease and a system of monetary benefits until 1969 with passage of the Federal Coal Mine Health and Safety Act of 1969, signed reluctantly by President Nixon on December 30th, 1969 (see: Soul Full of Coal Dust, pp 62-63).

The Act set up a system of monthly benefits to qualified miners, initially administered by the Social Security Administration. Beginning in 1971 and continuing through the life of the Appalachian branch of the SHC, law students and law school “grads” assisted and represented coal miners with claims for black lung benefits. That soon became another service provided by the East Tennessee Research Corporation as well.

The third aspect of Black Lung Disease was the reform of the United Mine Workers Union (UMW). The touchstone of that effort was the explosion of Farmington Mine in West Virginia on November 19th, 1968. Those events and the ridiculously inadequate response of the then-UMW president, Tony Boyle, are extensively addressed in Soul Full of Coal Dust and in Blood Runs Coal by Mark Bradley, published in 2020 by W.W Norton & Company.

As those books explain, angry coal miners formed Black Lung Associations for the twin purposes of gaining federal legislation and reforming the UMW. While the Act passed in 1969, reform took longer. By 1971 Arnold Miller of West Virginia was running against Tony Boyle. That summer organizers reached Tennessee, a relatively small coal producer, coinciding with the arrival of SHC workers. Retired Tennessee miners, with some assistance from the SHC formed a Black Lung Association in LaFollete with Columbus McGhee of Jacksboro as its head. Arnold Miller won UMW election in 1972, but reform efforts continued long after that.

The local Black Lung Association didn’t fold its tent, but began working toward the establishment of a primary care clinic in Jacksboro, Tenn. That clinic opened its doors in the late Spring of 1975. It became the basis for a program that provided a pulmonary specialist who circulated through the clinics of Mountain People’s Health Services. It also provided outpatient treatment under the auspices of a program operated by the UMW using federal and state funds.

—To learn more about the Black Lung Association, check out the video below featuring John Kennedy ‘s discussion about the organization’s origins

Related Content:

On the East Tennessee Research Corporation (ETRC) in eastern Kentucky

In supplement to ETRC’s involvement with the Black Lung Association in LaFollette and the Black Lung Clinic in Jacksboro, John Kennedy describes its ongoing activity outside of East Tennessee, too. Namely, he discusses his role setting up clinics in eastern… Continued

On the Bradley’s motivation to organize a community clinic in Petros, Tenn.

Kate Bradley frames the initiative to organize a local health council and community clinic as a direct response to the Petros health fair’s preliminary identification of needs. She details early fundraising efforts, including Pat Kalmans’ key role in securing grant… Continued

On John Kennedy’s management of UMW’s Black Lung Treatment Programs, Kentucky and Tennessee

John Kennedy describes the evolution of his career and transition to Washington in 1974. Upon suggestion from Eula Hall, Director of the Mud Creek Clinic, and with an official offer from Tom Ludwig, the union rep responsible for occupational health… Continued

Key issues tackled by ETRC

John Williams and Neil McBride share a list of the East Tennessee Research Corporation’s range of legal issues addressed between 1974 and 1977, including but not limited to: coal industry regulation, industrial development, environmental litigation, barriers to independently-run rural health… Continued

John Kennedy

Contributed by John E. Davis, November 2019. The summer before his final year at the Vanderbilt Law School and during the summer and fall after his graduation, John Kennedy worked for the Student Health Coalition in 1971 and 1972. He… Continued

On miner’s limited access to health and/or legal support for Black Lung Disease management

John Kennedy describes the initial inundation of legal clinics with Black Lung cases, due largely to nonexistent dust control in underground mines and extremely limited access to physicians and lawyers who could help with disease management. He provides further insight… Continued

SHC in Mud Creek, Kentucky

[Story contributed by Jack Beckford, with assistance from Sara Platt Williams] During the Fall of 1970, the SHC was contacted by the Eastern Kentucky Welfare Rights Organization (EKWRO), centered in Floyd Co, Ky. EKWRO was already doing organizing among low-income… Continued

Byrd Duncan

Contributed by John E. Davis When the newly recruited medical workers and community workers of the Student Health Coalition gathered in Nashville in June 1970, beginning a week of orientation for the SHC’s second summer in Appalachia, they were introduced… Continued

Progression of black lung care toward government-funded clinics, 1973

John Kennedy describes monumental developments in black lung care during the summer of 1973, primarily as it pertains to the establishment of state and federally funded clinics. He details the complex effort in acquiring these funds, including the role key… Continued

Changes in perception of black lung, 1971 vs 1975

John Kennedy reflects on the difference between 1971 and 1975 perceptions of black lung, including recognition of the disease, access to healthcare, and availability of legal support. For more information on John Kennedy’s involvement with the East Tennessee Research Corporation… Continued