Monday, April 23, 2018

The Coal Wars have not ended

Wilma Steele is one of the founders of the West Virginia Mine Wars Museum, located in Matewan. The region has a rich history of people banding together and pushing back against the industry, dating back to the West Virginia Mine Wars. The wars, which took place from 1910 to 1922—starting with the first official strike in 1912—involved more than 10,000 miners who went on strike repeatedly over low wages and deadly working conditions. The West Virginia Mine Wars Museum chronicles it all, from the Paint Creek-Cabin Creek strike of 1912-13 (one of the worst conflicts in American labor history) to the 1920 Battle of Matewan and the Battle of Blair Mountain with 10,000 miners on strike in the largest armed uprising of U.S. citizens outside of wartime, and federal troops were called in to break it up. 

 As immigrants came off the boats in New York, they were offered jobs at the mine, given places to live in their own area of Matewan, and assigned to a shift where they worked according to ethnicity of origin. Cultures were not shared and other languages were not learned, all of which was a tool of the mine owners to avoid unionization—when the miners didn’t know each other, they could resent each other and animosity could grow, which kept them from finding common ground for demanding fair wages and safe conditions. Ultimately, the groups did meet, talk and unionize.  Red bandannas were worn as a simple way to tell who was on their side. One origin of the word “redneck” derives from these bandannas: the term, which is now used with some amount of xenophobia to refer to small-minded people who typically live in rural Southern areas, in this sense is actually a symbol of diversity and working together for a common good.

“Today,” Steele explains “without the unions bringing people together, there is more bigotry. Just how they’ve always wanted it, keeping workers apart instead of fighting together.” 

“The mines used to own people by owning their homes, their stores, their churches, their schools,” Steele says. “Now, they don’t need to, because they own people’s minds. It’s much more psychological.” 

The coal companies donate money to the local schools, she says, so the teachers will endorse the industry. In response to reports of coal-based pollution and sick children, it was the teachers who wrote to the paper to discredit the accusations as liberal propaganda, Steele says, and it wasn’t until a reporter visited Marsh Fork Elementary School and with his finger wiped up a layer of coal dirt to show to the camera that the area finally started to take notice. Today’s workers are paid good wages and when they are fired, it’s blamed on the increasing government regulations that cost King Coal money in upkeep. But the regulations are necessary for the people to live, because they affect their own drinking water and air quality, their own children’s welfare. many miners blame the union and the government for the hard times miners are facing as interest in coal diminishes. From the union perspective, the main reason people are losing their jobs is that the mine owners didn’t want to lose money by keeping up with regulations when they could afford it.

When the victims from the Upper Big Branch explosion in 2010 when 29 miners died as the result of an explosion, were autopsied, it was revealed that 71 percent of them suffered from black lung, the deadly coal dust disease. The industry average is 3.2 percent.

In the neighbouring state of Kentucky a new law will prevent federally-certified radiologists from judging X-rays black lung compensation claims, leaving diagnoses of the disease mostly to physicians who typically work for coal companies. The legislation requires that only pulmonologists — doctors who specialize in the lungs and respiratory system — assess diagnostic black lung X-rays when state black lung claims are filed. Up until now, radiologists, who work in evaluating all types of X-rays and other diagnostic images, had been allowed to diagnose the disease as well. Just six pulmonologists in Kentucky have the federal certification to read black lung X-rays and four of them routinely are hired by coal companies or their insurers.  Those who work for coal companies tend to be conservative in assessing black lung because the coal companies or their insurers pay black lung benefits. The two remaining pulmonologists have generally assessed X-rays on behalf of coal miners but one is semi-retired and his federal certification expires June 1.

"It is curious to me that the legislators feel that the pulmonologist is more qualified to interpret a chest radiograph than a radiologist is," Dr. DePonte said. "This is primarily what radiologists do. It is radiologists who receive all the special training in reading X-rays and other imaging."

Dr. Edward Petsonk, a pulmonologist at West Virginia University with decades of experience and research focused on black lung, points to a 1999 report of pass-fail statistics for physicians taking the NIOSH B reader examination. Two-thirds of the radiologists passed, while the success rate for pulmonologists was 54 percent.

Among the radiologists excluded by the law is Dr. Brandon Crum, who helped expose the biggest clusters ever documented of complicated black lung, the advanced stage of the fatal disease that strikes coal miners. Dr. Crum is the most visible of the excluded radiologists. His clinic in Coal Run Village, Ky., was the focus of a 2016 study by epidemiologists from the National Institute for Occupational Safety and Health (NIOSH). They verified 60 cases of complicated black lung that had been diagnosed in a period of about 20 months in 2015 and 2016. NIOSH had previously reported 99 cases nationwide over a five-year period. At the same time, NPR and Ohio Valley ReSource reported nearly 1,000 cases across central Appalachia, prompting NIOSH epidemiologists to declare it the worst epidemic of complicated black lung they'd ever seen. Our ongoing survey of black lung clinics and law offices has the current count of advanced black lung diagnoses at more than 2,200 since 2010.

"Throughout the United States, I know of nowhere where radiologists are taken completely out of the evaluation for potential black lung disease," Dr. Crum said. "That's what we're primarily trained in."

Physicians who read chest X-rays for work-related diseases like black lung are known as "B readers" and are certified by NIOSH for both federal and state compensation claims. B readers do not specifically have to be pulmonologists or radiologists, though they can be both. Radiologists, on the other hand, focus entirely on reading multiple types of X-rays and other diagnostic images. The law also bars out-of-state radiologists who are both NIOSH-certified B readers and medically-licensed in Kentucky. That includes Dr. Kathleen DePonte, a radiologist in Norton, Va., who has read more than 100,000 black lung X-rays in the past 30 years.

 Rep. Adam Koenig, a Republican from Erlanger is the primary sponsor of the changes in the law and admitted  he "relied on the expertise of those who understand the issue — the industry, coal companies and attorneys."

"I do believe the coal industry is writing this bill to exclude certain doctors that they don't like," said Phillip Wheeler, an attorney in Pikeville, Ky., who represents coal miners seeking state black lung benefits.

 Evan Smith, an attorney at the Appalachian Citizens' Law Center in Whitesburg said the new state law "keeps Kentucky coal miners from using highly qualified and reliable experts to prove their state black lung claims [and] looks like just another step in the race to the bottom to gut worker protections."


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