Over the last five decades, more than 75,000 miners have died of black lung disease. To catch that disease and other health problems early, the National Institute for Occupational Safety and Health has screened miners at their mines, conducted research to track the diseases, and developed new tools to prevent diseases in the first place.

That didn’t stop DOGE from laying off about 90% of NIOSH’s staff, placing many of them on administrative leave.

Due to a lawsuit brought by a coal miner against the Department of Health and Human Services, which oversees NIOSH, the mobile clinic workers and other staffers are back at work. Yet other institute researchers working to prevent mining-related lung diseases heard nothing.

Now, Anita Wolfe, who once ran a mobile clinic for NIOSH and whose father started worked as a coal miner when he was around 12 and died of causes related to black lung and silicosis, two pulmonary diseases related to dust in mines, is leading the fight to recover those jobs and protect miners’ health.

“It comes down to how much is a life worth,” Wolfe told Capital & Main’s Meg Duff. “You want more coal, but you don’t care about the coal miners and what’s happening to them.”

People rally in April in support of some 185 researchers and other employees of the National Institute for Occupational Safety and Health (NIOSH) in Morgantown, W.Va., who received reduction-in-force notices. Read more

This article was produced by Capital & Main. It is published here with permission.

As Anita Wolfe sat in the hallway of a Charleston, W.Va., county courtroom, waiting to testify against the U.S. government, she thought of her dad, who first started working as a coal miner when he was around 12.

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She remembered his wild stories about coal-loading contests and working as a mule boy. But she also remembered his death certificate, which listed black lung and silicosis, two pulmonary diseases related to dust in mines, as contributing factors.

Before she retired, Wolfe launched and ran a mobile clinic through the National Institute For Occupational Safety and Health (NIOSH) that screened miners at their mines and tried to catch lung diseases early.

In April, as part of the Trump administration’s Department of Government Efficiency initiative, around 90% of NIOSH staff received layoff notices. Many were placed on administrative leave — including the mobile clinic crew, workers who review miners’ test results and researchers trying to prevent these lung diseases in the first place.

Wolfe was in the courthouse to try to get those jobs back. Now, her mobile clinic workers are back, along with all the other workers in the institute’s Respiratory Health Division. But researchers elsewhere in NIOSH who also work on prevention are still slated to be laid off.

To Wolfe, that’s a problem. About a fifth of the coal miners in Central Appalachia have black lung, Wolfe said. And from 1970 to 2016, more than 75,000 died. Nationally, a 2023 NIOSH study found that coal miners are twice as likely to die of lung diseases than nonminers. Wolfe called black lung and silicosis “entirely preventable.”

“It comes down to how much is a life worth,” Wolfe said. “You want more coal, but you don’t care about the coal miners and what’s happening to them.”

Going to court

For some coal miners, pausing the black lung programs at the National Institute For Occupational Safety and Health created an immediate problem, because without a stamp of approval from the institute, coal miners can’t access federal “Part 90” benefits that allow them to get reassigned to jobs with less dust exposure.

Black lung has no cure, but avoiding dust can stop the disease from getting worse. With the pause, X-rays and medical records now sat in folders, unexamined.

So Wolfe and others began campaigning, collaborating with public health workers and miners to try to get the NIOSH workers back. Wolfe enlisted the support of West Virginia Republican Sen. Shelley Capito, who successfully petitioned to get black lung workers off administrative leave in the short term. Still, that was just a temporary fix.

Sam Petsonk, a lawyer, and Harry Wiley, a coal miner, decided to sue the Department of Health and Human Services, which oversees NIOSH. “To me, he was very courageous for doing that,” Wolfe said of Wiley.

At trial, Wolfe and Wiley were both called to testify, and on May 7, they sat with other witnesses in the courthouse hallway. For hours, the group made small talk about kids and summer vacations, scrupulously following instructions to avoid any chatter about the department’s “reduction in force.”

One by one the witnesses entered the courtroom. Wolfe was last. “Everything was going through my head,” she said. She was nervous. But then, she remembered her dad. “I just felt like he was there with me, you know? Kinda egging me on, like, ‘You got this, baby girl.’”

When Wolfe took the stand, she was calm, and described the value of NIOSH’s programs. The defense, she said, “didn’t offer much defense at all.”

After the trial, Wolfe joined Wiley and Petsonk for sandwiches. “They seemed fairly confident that it was gonna be found in favor of the miner,” she said.

A few days later, the judge ruled in Wiley’s favor. Staff at the mobile clinic and the broader National Institute For Occupational Safety and Health Respiratory Health Division got their jobs back for now, although the program is still working to get back up and running. Staff at the institute’s National Personal Protective Technology Lab were also called back; they certify a variety of respirators that help keep miners and other workers safe.

But other institute researchers working to prevent mining-related lung diseases heard nothing.

While researchers in the Respiratory Health Division focus primarily on tracking disease and helping individual miners, researchers at NIOSH’s Pittsburgh and Spokane Mining Research Divisions focus on innovation, developing new tools to prevent disease in the first place.

The judge’s preliminary injunction said the law requires that kind of research. But the injunction did not explicitly put Pittsburgh and Spokane researchers back to work.

The Department of Health and Human Services did un-fire their boss, a statutorily required associate director overseeing the Office of Mine Safety and Health Research. But it did not bring back the hundreds of researchers who report to that administrator.

“He’s new. He hasn’t even met us yet!” said Cassandra Hoebbel, a NIOSH researcher in Pittsburgh and a union steward for the Association of Federal Government Employees.

“A lot of people contacted me and were like, ‘Oh my God, you got your job restored!’” she said. “It’s like, no they’ve only restored a tiny part of it.”

Hoebbel said that mine health and safety research at the institute has been mostly on pause since January due to the Trump administration’s restrictions on funding and travel. For almost five months, researchers have been unable to visit mines to measure dust levels, test new equipment or improve software tools.

That’s a long-term loss for miner health, but it’s a short-term loss as well: NIOSH field work often leads to quick-fix changes by the mine operators the researchers collaborate with. Now, those improvements aren’t happening. External grants for technology development and commercialization were also “terminated for convenience.”

That’s despite the fact that, after a long decline, lung diseases in miners are again on the rise: Black lung cases have been increasing for two decades, according to a 2018 NIOSH study, and severe cases have caught back up to their all-time high. And it’s not just black lung. A 2023 study found that coal miners are dying of a variety of lung diseases at higher rates than in the past. Some are also dying younger.

Silica dust exposure

“It used to be that people said black lung was an old man’s disease, and that’s not true. We just buried a 30-something miner,” Wolfe said.

Many younger miners suffer from lung diseases caused not by coal dust but from quartz dust, officially called respirable crystalline silica. As coal deposits became tapped out, mines went after harder-to-reach coal, generating more quartz dust from the surrounding rock. Modern mining machines may also contribute to the dust.

Silica dust exposure is not unique to coal miners, who represent a small sliver of miners in the U.S. Silicosis is common in miners at all sorts of mines.

While coal workers are eligible for “Part 90” transfers and benefits based on dust exposure, those who mine for sand, rocks, precious metals, and other material are not.

For all miners, silica dust protections are decades out of date. After Wolfe’s mobile clinics helped identify new clusters of lung disease, a 2014 rule lowered allowable limits for coal dust exposure. Similar standards lowered limits for silica dust in industries like construction.

But a rule to lower by half the silica dust exposure limit in mines stalled for a decade. The rule finally passed in 2024 — then a 2025 start date was postponed, after pushback from mine operators, who said implementation would be too difficult.

Mine operators objected to a final version of the rule that said it was not enough to implement a checklist of “good enough” dust control measures, to give miners masks or to rotate them in and out of dusty areas to reduce their exposure. Instead, the final rule says mines need to actually reduce the hazardous dust.

The rule also mandates silicosis monitoring programs, similar to Wolfe’s black lung monitoring work, but for non-coal miners.

However, the same day President Donald Trump held a news conference promoting the “abandoned” coal industry, the Department of Labor postponed the rule’s upcoming start date for coal mines from April to August. (Stone mines still have until April 2026 to comply.)

Earlier this year, the Department of Labor announced plans to close 34 of the mine enforcement offices that work to hold mine operators accountable for the current silica dust standard. In late May, those plans were reversed.

Air quality monitors

Dust is a constant presence in mines, and it lurks in overlooked places. Currently paused National Institute For Occupational Safety and Health research has the potential to improve the dust problem.

Decades ago, government mine safety researchers identified controls that could be used to reduce dust in mines, such as improving ventilation.

But mines have been using those strategies for years, and lung diseases stubbornly persist.

Traditionally, mine inspectors check dust levels a few times a year to confirm compliance. But those checks don’t provide much actionable information about how to make things better. That’s frustrating for mines and for miners. So NIOSH has been working on ways to make dust easier to spot.

Their personal dust monitors already let miners view their own mine dust exposure in real time. Other projects are helping miners make sense of that kind of data.

In 2015, Hoebbel observed field work for an award-winning study by institute researcher Emily Haas that outfitted miners with both a dust monitor and a video camera and then compared the feeds to see why dust levels spiked.

“They had two guys walking side by side,” Hoebbel said. One of their dust monitors “kept going up, up, up — and the other guy was walking right next to him and his was fine.”

The researchers, curious, asked, “When’s the last time you washed your sweatshirt?” Hoebbel said. “He’s like, ‘Oh man, I can’t tell you the last time I washed this thing!’”

Before the study, the participating miners felt confident that wearing masks and following established procedures would keep them safe. Afterward, they were full of questions about silica exposure. The mine in the study, for its part, replaced cloth vehicle seats and gloves with leather, which is easier to wipe clean.

But attaching monitors to miners, while good for sussing out dirty sweatshirts, is less effective for tracking dirty equipment or faulty ventilation, which may be getting dust on sweatshirts in the first place.

So another institute project used air quality monitors to help mines and miners better understand sources of exposure within mines. In a recently published pilot study, weekly reports of real-time data helped staff at sand mine notice minute by minute shifts in dust at key locations.

As a result, the mine’s industrial hygienist turned some machines on before miners arrived for the day, so they wouldn’t be exposed to an extra burst of dust that spiked when machines were starting up.

A foreman also noticed a dust hot spot near a particular conveyor belt and used parts they had on hand to come up with a fix, reducing dust in the area threefold.

The approach is promising, and NIOSH has a history of creating useful gadgets for miners that are now widely used and often legally required. From October to January, those researchers made several site visits. Then, nothing.

That project is currently paused, along with much of NIOSH’s other research into silica exposure and impacts.

Many dust monitors test general dust levels; teasing out silica in particular means distinguishing one speck of dust from another. So researchers were working to make same-day infrared spectroscopy tests more accurate. Others were developing continuous, real-time silica monitoring tools.

Mining researchers were also collaborating with the NIOSH chemistry team to understand exposures to silica in nano-clay, or particles of clay minerals. But the institute’s analytical chemists are all still facing layoffs. So are the researchers trying to address all the other hazards miners face.

Federal mine safety and health research began in earnest in the 1910s, around the time Anita’s father was born. Back then, hundreds of coal miners died each year in mine explosions.

NIOSH and its predecessors made those incidents rare. But mine risks keep evolving: As mines age, for example, massive sinkholes can appear, and institute researchers have been helping mine operators predict them.

They are also studying ways to keep lithium batteries from exploding, working to understand if a growing number of natural gas wells could leak explosive methane into mines and devising ways to better prepare miners to survive accidents using virtual reality and to prevent accidents involving giant haul trucks.

All of that work is now on pause.

Funding and staffing

Wolfe hopes that the Department of Health and Human Services will restore NIOSH researchers voluntarily. A recent Health and Human Services draft budget for 2026 includes stable funding for mining research, even though researchers are not currently working.

In the meantime, the fate of their work could be determined by another court case, this one brought against the Trump administration by plaintiffs including Hoebbel’s union, the American Federation of Government Employees.

It’s among several lawsuits that allege that by cutting funding and staff without authorization, the administration’s DOGE initiative has usurped the powers of Congress.

Many institute layoffs were previously scheduled for June 2. But several days before, a judge issued an injunction putting the layoffs on pause until that case is adjudicated. The Trump administration has appealed that injunction to the U.S. Supreme Court.

At issue is whether Congress has the right to commit to generational goals, like the health of miners, that require stability as executives come and go.

For Wolfe, the answer is obvious. “I always tell people: ‘I’m not gonna argue with you about whether coal is good or bad. But as long as it’s mined and there are coal miners, we need to take care of them.’”

Copyright 2025 Capital & Main

Josh Cochran, 45, an underground coal miner with more than 20 years of experience, holds his portable oxygen concentrator while sitting outside a law office in Oak Hill, West Virginia, U.S., April 10, 2025. REUTERS/Adrees Latif Purchase Licensing Rights , opens new tab

Item 1 of 5 Josh Cochran, 45, an underground coal miner with more than 20 years of experience, holds his portable oxygen concentrator while sitting outside a law office in Oak Hill, West Virginia, U.S., April 10, 2025. REUTERS/Adrees Latif

Summary Layoffs halt black lung protection programs for miners

NIOSH and MSHA programs suspended amid Trump administration cuts

Miners face increased risk as safety regulations enforcement weakens

OAK HILL, West Virginia, April 21 (Reuters) – Josh Cochran worked deep in the coal mines of West Virginia since he was 22 years old, pulling a six-figure salary that allowed him to buy a home with his wife Stephanie and hunt and fish in his spare time.

That ended two years ago when, at the age of 43, he was diagnosed with advanced black lung disease. He’s now waiting for a lung transplant, breathes with the help of an oxygen tank, and needs help from his wife to do basic tasks around the house.

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His saving grace, he says, is that he can still earn a living. A federal program run by the Mine Safety and Health Administration and the National Institute for Occupational Safety and Health called Part 90 meant he was relocated from underground when he got his diagnosis to a desk job dispatching coal trucks to the same company, retaining his pay.

“Part 90 – that’s only the thing you got,” he told Reuters while signing a stack of documents needed for the transplant, a simple task that left him winded. “You can come out from underground, make what you made, and then they can’t just get rid of you.”

That program, which relocates coal miners diagnosed with black lung to safer jobs at the same pay – along with a handful of others intended to protect the nation’s coal miners from the resurgence of black lung – is grinding to a halt due to mass layoffs and office closures imposed by President Donald Trump and billionaire Elon Musk’s Department of Government Efficiency, according to Reuters reporting.

Reuters interviews with more than a dozen people involved in medical programs serving the coal industry, and a review of internal documents from NIOSH, show that at least three such federal programs have stopped their work in recent weeks.

A decades-old program operated by NIOSH to detect lung disease in coal miners, for example, has been suspended. Related programs to provide x-rays and lung tests at mine sites have also shut down and it is now unclear who will enforce safety regulations like new limits on silica dust exposure after nearly half of the offices of MSHA are under review to have their leases terminated.

The details about the black lung programs halted by the government’s mass layoffs and funding cuts have not previously been reported.

“It’s going to be devastating to miners,” said Anita Wolfe, a 40-year NIOSH veteran who remains in touch with the agency. “Nobody is going to be monitoring the mines.”

The cuts come as Trump voices support for the domestic coal industry, a group that historically has supported the president.

At a White House ceremony flanked by coal workers in hard hats earlier this month, Trump signed executive orders meant to boost the industry, including by prolonging the life of aging coal-fired power plants.

“For too long, coal has been a dirty word that most are afraid to speak about,” said Jeff Crowe, who Trump identified as a West Virginia miner. Crowe is the superintendent of American Consolidated Natural Resources, successor to Murray Energy.

“We’re going to put the miners back to work,” Trump said during the ceremony. “They are great people, with great families, and come from areas of the country that we love and we really respect.”

Andrew Nixon, a spokesperson for the Department of Health and Human Services, which oversees NIOSH, said that streamlining government will better position HHS to carry out its Congressionally mandated work protecting Americans.

Courtney Parella, a spokesperson for the Department of Labor said MSHA inspectors “continue to carry out their core mission to protect the health and safety of America’s miners.”

Black lung has been on the rise over the last two decades, and has increasingly been reported by young workers in their 30s and 40s despite declining coal production.

NIOSH estimates that 20% of coal miners in Central Appalachia now suffer from some form of black lung disease, the highest rate that has been detected in 25 years, as workers in the aging mines blast through rock to reach diminishing coal seams. Around 43,000 people are employed by the coal industry, according to the Bureau of Labor Statistics.

MORE MINING, MORE RISK

Around 875 of NIOSH’s roughly 1,000-strong workforce across the country were terminated amid sweeping job cuts announced by HHS this month, according to three sources who worked for NIOSH.

That’s put the department’s flagship black lung program, the Coal Workers’ Health Surveillance Program, on hold, according to an internal NIOSH email dated April 4.

“We will continue to process everything we currently have for as long as we can. We have no further information about the future of CWHSP at this time,” the email says.

The CWHSP’s regular black lung screenings, which deploy mobile trailers to coal mines to test coal miners on site have ended too, because there’s no money to fuel the vehicles or epidemiologists to review the on-site x-rays or lung tests, according to sources familiar with the program.

For many miners, this program is the sole provider of medical checkups, according to NIOSH veteran Wolfe.

The loss of staff at NIOSH has also crippled black lung-afflicted miners’ ability to get relocated with pay as part of the Part 90 program.

Miners can only become eligible for the Part 90 benefit by submitting lung x-rays to NIOSH that show black lung. But all NIOSH epidemiologists in West Virginia required to review the x-rays were laid off, according to Scott Laney, who lost his job as an epidemiologist.

Laney told Reuters he and his fellow laid-off team have been working in an informal “war room” in his living room to try to draw attention to the issue among Washington lawmakers.

“I want to make sure that if there are more men who are going into the mines as a result of an executive order, or whatever the mechanism, they should be protected when they do their work,” he said.

Sam Petsonk, a West Virginia attorney who represents black lung patients, said relocating sick miners is crucial because the risks of continuing to work in dust-heavy areas while ill are so severe.

“It gets to the point that days and months matter for this program,” he said.

SILICA THREAT

Last year, MSHA finalized a new regulation that would cut by half the permissible exposure limit to crystalline silica for miners and other workers – an attempt to combat the rising rates of black lung , opens new tab

Enforcing that rule, which comes into force in August after being pushed back from April by the Trump administration, may prove difficult given the staff cuts and planned office closures at MSHA, said Chris Williamson, a former Assistant Secretary of Labor for Mine Safety and Health under the Biden administration.

He told Reuters that before he left MSHA in January, there were 20 mine inspector positions unfilled. A pipeline of 90 people that had already secured MSHA inspector job offers, meanwhile, had their offers rescinded after Trump took office, and around 120 other people took buyouts.

Mine inspectors are meant to uphold safety standards that reduce injuries, deaths and illnesses at the mines.

That loss of staff and resources raises the likelihood that black lung could become even more pervasive among Appalachian coal miners – particularly if mining activity increases, said Drew Harris, a black lung specialist in southern Virginia.

“As someone who sees hundreds of miners with this devastating disease it’s hard for me to swallow cutting back on the resources meant to prevent it,” he said.

Kevin Weikle, a 35-year-old miner in West Virginia who was diagnosed with advanced black lung disease during a screening in 2023, said the cuts make no sense at a time the administration wants to see coal output rise and will set back safety standards by decades.

“Don’t get me wrong, I mean, I’m Republican,” Weikle said. “But I think there are smarter ways to produce more coal and not gut safety.”

Reporting by Valerie Volcovici; Editing by Richard Valdmanis and Anna Driver

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The Trump administration’s efforts to expand coal mining while simultaneously imposing deep cuts to agencies tasked with ensuring miner health and safety has left some advocates “dumbfounded”.

Agencies that protect coal miners from serious occupational hazards, including the condition best known as “black lung”, have been among those affected by major government cuts imposed by the White House and the unofficial “department of government efficiency” (Doge) run by the billionaire Elon Musk.

“The [Mine Workers of America] is thrilled they’re looking at the future of coal,” said Erin Bates, a spokesperson for the United Mine Workers of America, about a series of executive orders signed by the president to expand coal mining. “But – if you’re not going to protect the health and safety of the miners, there’s not going to be anyone to work in the mines you are apparently reopening.”

Last week, Trump signed a raft of measures he said would expand coal mining in the US in order to feed the energy demands of hungry datacenters that power artificial intelligence software.

“All those plants that have been closed are going to be opened if they’re modern enough, or they’ll be ripped down and brand-new ones will be built,” Trump told a crowd of lawmakers, workers and executives at the White House while signing the order. “We’re going to put the miners back to work.”

The coal industry has shrunk precipitously in recent years, and now represents only about 15% of the power generated for the US electrical grid. Natural gas, wind and solar have proved to have a competitive advantage over coal, contributing to its decline, because plants are cheaper to operate, according to Inside Climate News.

Even as coal mining has shrunk, the potential dangers for people who still work in the field remain high. Pneumoconiosis is among the best known occupational hazards faced by coal miners, but is far from the only risk they face – others include roof collapse, hearing loss and lung cancer, to name a few.

Trump’s push for coal came less than a week after the health secretary, Robert F Kennedy Jr, imposed a 10,000-person cut to the federal Department of Health and Human Services (HHS). Cuts overseen by Kennedy, alongside those imposed by Musk’s unofficial Doge, represented the elimination of almost a quarter of HHS’s 82,000-person workforce.

Nearly 900 of those workers were dismissed from the National Institute for Occupational Health and Safety (NIOSH), including in the agency’s respiratory health division in West Virginia, which specifically oversaw an X-ray screening program for black lung. Doge has also pursued cuts to mine safety by eliminating 34 regional offices of the Mine Safety and Health Administration (MSHA) in 19 states.

The deep cuts especially worried those intimately familiar with the suffering caused by pneumoconiosis – such as Greg Wagner, a doctor and former senior adviser at the NIOSH.

“My thoughts were: ‘Why NIOSH? Why now?’” said Wagner, whose early work at a community clinic in a small West Virginia coal mining town led him to a career working to prevent the disease at both NIOSH and as assistant secretary of labor for mine safety and health.

Wagner also worked with the International Labor Organization and multiple countries in an effort to eliminate pneumoconiosis globally. He is now a professor of environmental health at Harvard’s TH Chan School of Public Health.

The cuts “gutted” NIOSH, said Wagner, even as agency experts were “doing what they were asked to do and doing it extraordinarily well … Over-performing with little recognition. And to see that appear to be going up in smoke – I just – obviously my feelings were profound and complex.”

The administration also wants to pause a new rule on silica dust, which causes a kind of pneumoconiosis or “black lung” disease that is increasingly striking younger miners in Appalachia, as workers dig for harder-to-reach veins of coal.

“To go into the silica rule – we’re almost dumbfounded,” Bates said. “The number of black lung cases that are showing up in the US is astronomical – it is increasing and not only are the numbers increasing, but it’s happening to younger and younger miners. Every single day this rule is delayed is another day our miners are contracting black lung.”

Silicosis is a disease caused by inhaling silica dust, a form of pneumoconiosis that can be even more severe than the black lung of a century ago, and which has long been known to harm the health of coal miners.

The government has been aware of the dangers of silica dust for decades, recommending dramatic reductions in exposure levels as early as 1974. In 1993, Wagner’s boss at NIOSH, Dr J Donald Millar, described the persistence of silicosis as “an occupational obscenity because there is no scientific excuse for its persistence”.

The MSHA finalized a rule in April 2024 reducing silica dust exposure in mines, which was set to go into effect this year. Last week, the National Stone, Sand & Gravel Association filed a suit seeking to pause enforcement of the silica dust rule pending a lawsuit. Days later, federal mine regulators told the court they wanted to pause enforcement of the silica dust rule for coal mining operations by four months, delaying any enforcement actions until August 2025.

“The sudden shift in litigation position signaled by MSHA’s ‘enforcement pause’, and by its unilateral proposal to hold this case in abeyance for a period of four months is a clarion call to this nation’s miners that the agency charged with the profound responsibility of protecting their health and safety is losing the stomach for the fight to vindicate its own rule,” attorneys for mine and steel unions wrote, seeking to intervene in the case.

Wagner said his concerns about delay of the silica rule extended beyond miners into workers in other industries – including people who work in sand blasting or carving engineered stone countertops, all known to be environments where workers can be exposed to potentially harmful levels of silica dust.

“I don’t have the right words,” said Wagner about the cuts to NIOSH, which was deeply involved in research that showed how silica dust harmed miners. “I feel like it was just done without thought, done without consideration, and the consequences of the loss of the agency I think will be felt for years.

“We will need to try to rebuild what NIOSH has been doing.”

MADISON, W.Va. — Emory “Curly” Carter sometimes feels like he can’t breathe. Household chores, such as cleaning and gardening, leave him gasping for air, making him feel like he has a “real bad” case of pneumonia. After nearly four decades working in underground coal mines, Carter was diagnosed with black lung, a deadly and incurable disease caused by inhaling coal dust over a long period. Now, the 70-year-old worries that the Trump administration’s steep cuts to health and safety programs will endanger the next generation of miners across the coalfields of West Virginia, Kentucky and Virginia.

At the National Institute for Occupational Safety and Health (NIOSH), the division of the Health and Human Services Department that provides free black lung screenings for coal miners, Trump appointees fired roughly two-thirds of the staff this month. There are no employees left to run the screening program in the agency’s office in Morgantown, West Virginia.

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Trump officials at the Labor Department’s Mine Safety and Health Administration, which protects against mine safety risks and disasters, have delayed enforcement of a landmark rule limiting miners’ exposure to coal dust. The agency also is considering shuttering 35 offices nationwide, leaving only two offices to inspect and monitor more than 100 mines in Kentucky.

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Taken together, these moves threaten to bring more disease and death to coal-dependent communities across Appalachia, miners and advocates say. They come despite Donald Trump’s recent executive orders aimed at boosting “beautiful, clean coal,” which the president signed while flanked by more than two dozen miners wearing hard hats.

“President Trump has said he wants to increase coal production, but it’s not rocket science that without these protections, we’re going to end up with a bunch of dead coal miners,” said Anita Wolfe, who spent nearly 40 years at NIOSH’s Morgantown office before retiring in 2020.

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The cuts also come despite the “Make America Healthy Again” agenda promoted by Health and Human Services Secretary Robert F. Kennedy Jr., which calls for combating the chronic diseases fueling a decline in U.S. life expectancy.

Asked for comment, White House spokeswoman Anna Kelly said in an email, “There is no greater ally to America’s coal miners than President Trump. … He is using every lever of his executive power to carry out his energy dominance agenda while keeping our hardworking coal miners safe.”

A second White House official, who spoke on the condition of anonymity because he was not authorized to comment publicly, said NIOSH and other health agencies would be combined to form a new entity called the Administration for a Healthy America. The reorganization will “improve coordination of health resources for Americans,” the official said.

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For Carter, who serves as president of his local chapter of the United Mine Workers of America, Trump’s recent actions on coal have prompted mixed feelings.

Carter was encouraged by the executive orders, which he said could spur shuttered mines to reopen in some of West Virginia’s poorest counties. But he was appalled by the suspension of the black lung screening program, which helped many of his former colleagues receive diagnoses and treatment.

Several of those former colleagues have died of black lung or complications from the disease, such as heart failure or lung cancer. Others need oxygen tanks to breathe and struggle to speak.

“For me, the NIOSH people losing their jobs is uncalled-for,” Carter said in a recent interview in his kitchen, where he keeps a ventilator from his doctor and a hard hat from his days as a miner. “I mean, why do away with a service that’s going to benefit people down the road? I’m no politician, but it doesn’t make sense to me.”

Long-standing protections

The black lung screening initiative, formally known as the Coal Workers’ Health Surveillance Program, owes its existence to President Richard M. Nixon. In 1969 he signed into law the Federal Coal Mine Health and Safety Act after public outcry over a mine explosion the previous year in Farmington, West Virginia, that killed 78 workers.

Under the landmark law, miners can receive free and confidential chest X-rays to determine whether their lung tissue is damaged. Those who are diagnosed with black lung can transfer to a less dusty part of the mine without a pay cut, and they can apply for federal compensation for medical treatments and prescription drugs.

The screening program offers contracts to radiologists across the country who are certified to evaluate X-rays for black lung. It also employs epidemiologists who recently concluded that one in five longtime coal miners in Central Appalachia has black lung — the highest level recorded in 25 years.

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In 2005, the program expanded to include a mobile health unit that traveled to far-flung mines across Appalachia. The mobile unit, which resembled an RV, provided a convenient way for miners to get X-rayed without missing a day of work.

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But on a recent sunny afternoon in April, the mobile unit sat idle behind a chain-link fence at NIOSH’s Morgantown office. It has been parked there since Inauguration Day.

In late February, Trump signed an executive order that prohibited federal employees from traveling for conferences and for “other nonessential purposes” — a directive that kept the vehicle idle. Then this month, the administration fired most of the staff working on the screening program as part of massive layoffs at the Department of Health and Human Services.

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There are no epidemiologists left to analyze the data on the region’s black lung epidemic. No IT staff to process the X-rays. No mail room employees to send letters to miners and their doctors. No procurement staff to renew expired contracts with radiologists. And certainly no one to drive the mobile unit.

“There is no way to provide these resources to these coal miners, which I will mention are congressionally authorized,” said Scott Laney, who led research for the screening program until April 1, when he was placed on administrative leave and told of his termination effective June 2.

“The entire program has gone through all of the stages of grief five times already,” he added. “We don’t know what we’re going to do with 750,000 X-rays and whether they’re just going to be thrown in the trash.”

Laney spoke at his home alongside Buffie Rosenberger, whose father, Chester Fike, was diagnosed with black lung through the screening program. Rosenberger grew emotional and teared up while discussing her father, who received a double lung transplant four months before he died. She said her son now works as a coal miner, despite the dangers he grew up hearing about.

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“My husband had 30 years in the coal mines and my son has 12 years underground,” she said. “I have uncles in there, too. They go where the money is, and they’re hard workers. I mean, not just anybody can do what they do. My husband was underground in a mine explosion one time. So, yeah, we’ve been through it.”

Rosenberger’s son declined to comment for this article. Several coal miners with black lung also declined to comment, saying they worried the administration would retaliate by revoking their federal benefits.

Dangerous dust

At the Mine Safety and Health Administration (MSHA), meanwhile, Trump officials this month suspended enforcement of a rule that curbed miners’ exposure to the toxic dust that causes black lung. The dust, known as crystalline silica, is generated when miners drill through rock to retrieve coal from thin seams. Once inhaled, these tiny particles can become trapped in the lungs, causing scarring and inflammation over time.

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The rule, finalized under the Biden administration, limited miners’ exposure to crystalline silica to 50 micrograms per cubic meter of air per 8-hour shift, down from 100 micrograms per cubic meter. Biden officials had projected that the stricter standard would prevent more than 1,000 deaths and 3,700 cases of silica-related illnesses.

While the rule was originally slated to take effect this month, it will now be enforced starting in August. In a notice to coal mine operators, Trump officials cited “unforeseen restructuring” at NIOSH as the reason for the change.

The delay has alarmed public health experts who hailed the rule as long-overdue, noting that the dangers of silica dust have been documented for centuries.

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“Miners may have the false assurance that this is regular dust, but it is very, very dangerous,” said Sunil Sharma, who treats black lung patients as chief of the Pulmonary, Critical Care and Sleep section at West Virginia University School of Medicine. “If these laws aren’t enforced and aren’t made stricter, I think we’re going to see a lot more young miners needing lung transplants and dying.”

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But the delay drew praise from industry groups that challenged the rule in court, including the National Mining Association and the National Stone, Sand & Gravel Association. The latter group had argued in a legal filing that the rule would impose “extreme costs for coal mining operators” and cause them “irreparable harm.”

The move comes as Elon Musk’s U.S. DOGE Service — which stands for Department of Government Efficiency — targets MSHA field offices for closure as part of its efforts to save taxpayers money. The DOGE website calls for terminating the leases for a total of 35 MSHA offices, including seven in eastern Kentucky alone.

It is unclear, however, whether the administration intends to enact this proposal. Several MSHA employees, who spoke on the condition of anonymity because they were not authorized to comment publicly, said they haven’t been informed about any plans to close their offices.

Courtney Parella, a spokeswoman for the Labor Department, said in an email that the leases “are still under review.” She added that MSHA inspectors “remain focused on MSHA’s core mission to prevent death, illness and injury from mining and promote safe and healthful workplaces for U.S. miners.”

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Mounting pushback

A growing chorus of coal miners and advocates is now pushing back on the cuts to these health and safety programs. Their efforts include filing lawsuits, lobbying lawmakers and pleading with Trump officials to reverse course.

Sam Petsonk, a lawyer based in Oak Hill, West Virginia, has filed a lawsuit on behalf of hundreds of coal miners over the suspension of the black lung screening program. The suit accuses the Trump administration of violating the 1969 law that established the program, and it seeks the immediate reinstatement of the fired NIOSH employees. The case is pending before U.S. District Judge Irene C. Berger, who attracted national attention in 2016 for sentencing former coal baron Don Blankenship to a year in prison — the maximum for a misdemeanor — for an explosion that killed 29 workers at his company’s mine.

In the meantime, dozens of staff at black lung clinics across Appalachia traveled this month to Washington, D.C., to meet with lawmakers. While the trip occurs every year around this time, it happened to coincide with the cuts, said Brad Johnson of Stone Mountain Health Services in Southwest Virginia, prompting concern from lawmakers in both parties.

Yet the two Republican senators in West Virginia, the nation’s second-largest coal-producing state, have offered mixed reactions to the cuts.

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Sen. Jim Justice, whose family owns numerous coal companies, praised Kennedy for slashing the staff and budgets of U.S. health agencies. “I am in favor of cuts to waste across the federal government, and I’m sure Secretary Kennedy understands how important coal miner health programs run by the department are to West Virginia,” Justice said in a statement.

But Sen. Shelley Moore Capito said she expressed concerns about the layoffs during a phone call with Kennedy two days after the employees were fired. Kennedy committed to reviewing the layoffs on the call, a Capito spokeswoman said, although none of the terminated employees has since been reinstated.

In their own conversations with Trump officials, advocates have started making a new argument: These health and safety programs save taxpayers money in the long term. They note that while NIOSH’s black lung screening program had a budget last year of $466,000, the initiative prevented dozens of miners from seeking federal compensation for lung transplants, which can each cost more than $1 million.