A new federal study published this week in the American Journal of Respiratory and Critical Care Medicine found that 1 in 3 veteran underground coal miners in central Appalachia now has black lung disease — the highest rate since 1978. The disease was nearly beaten: the rate hit a low of 7% in 1999, a generation after Congress tightened dust exposure limits. It has since quadrupled. More than 1,700 coal miners died from black lung between 2020 and 2023.

The cause is silica dust. As the biggest coal seams played out, mining companies moved to thinner seams that require cutting through surrounding rock. That rock is laced with quartz, and the silica it releases is 20 times more toxic than coal dust alone.

In 2024, the Biden administration issued a new silica dust regulation, making the exposure limit twice as restrictive and creating, for the first time, a direct enforcement mechanism for overexposure. The mining industry sued. Federal courts issued an indefinite delay in enforcement. The Trump administration declined to fight the delay, putting the rule on hold.

Meanwhile, the same administration announced close to $700 million in federal spending to sustain coal-burning power plants and boost coal exports. "Coal's a great business," President Trump said in June. "In terms of power, there's nothing like it."

"If you imagine one out of every three school teachers were getting an incurable lung disease because of something they were exposed to at work, the whole country would put their hands up screaming," said Dr. Drew Harris, medical director at Stone Mountain Health Services in Virginia, which has diagnosed 2,400 new black lung cases in the past five years alone. "This is largely impacting rural Appalachian folks that don't have a voice, that don't have a country to unite behind them."

These miners just went to work. Sign to demand the Trump administration enforce the silica dust rule that could stop this disease from taking any more of them.