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William “Cotton” Jarrell(coal miner): “…call and tell us you’re disappointed [that you missed your screening appointment for black lung disease]… I guarantee you we will make the next [appointment].”


MedPage Today reports on a resurgence of black lung disease, as described in an analysis presented at the annual conference of the American Thoracic Society:

“The confirmation of an increase in progressive massive fibrosis (PMF) across the coal mining industry follows several reports of outbreaks in isolated coal mining regions, including a 2016 CDC report of 60 PMF cases identified at a single radiology clinic in eastern Kentucky.

“Earlier this year, the National Institute for Occupational Safety and Health reported more than 550 cases of PMF occurring in three clinics in southwestern Virginia since 2013 — the largest cluster of advanced black lung disease ever reported in the U.S.

“The newly reported analysis of U.S. Department of Labor data on coal miners collected since 1970 identified 4,679 cases of PMF, with half occurring among miners presenting for evaluation after 2000.

“The analysis was presented May 22 at ATS 2018, the annual international conference of the American Thoracic Society.

“We have known about the clusters of PMF cases, but this study represents the first systematic attempt to assess the burden of PMF in former miners,” the study’s lead researcher, Kirsten Almberg, PhD, of the University of Illinois at Chicago, told MedPage Today.”

Additional nuggets from the MedPage Today report:

“The change may also be influenced by changes in mining practices in recent decades, [Almberg] said. Current mining practices, such as surface mining, typically expose miner to high levels of rock dust, including crystalline silica dust. ‘Silica is much more toxic to the lung than coal dust. And it is now profitable to sort out coal from rock, so that is increasingly part of the process.’ ”

“…39% of miners who applied for black lung benefits had never participated in surveillance during their careers.”

“Also at the session, a fourth-generation coal miner, William “Cotton” Jarrell of Peabody Energy, a Fortune 500 coal company, who now works in mining safety, addressed the challenge of getting miners to seek medical attention: “We don’t want to know, so a lot of us just don’t go to doctors,” he said.

“You can help us by not letting us cancel appointments. Instead of having a receptionist do it, the doctor should pick up the phone and call us with a simple ‘Hey buddy, I need you to get in for this appointment.’ That would make a huge difference. And if that doesn’t work call our wife. She’ll get us in there. And as a last resort, call and tell us you’re disappointed. We hate to disappoint people. If you tell us you’re disappointed that we missed an appointment, I guarantee you we will make the next one.”

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