“When you breathe in silica, it coats your lungs immediately,” said Bethel Brock, a 79-year-old retired coalminer in Wise, Virginia, who worked in mines for 32 years.

Brock has complicated black lung disease caused by inhalation of coal dust.

A report last year conducted by the AFL-CIO, the largest federation of unions in the US, Death on the Job: The Toll of Neglect, estimated that 95,000 workers die from occupational diseases in the US every year

Coalmining has historically been a leading job occupation where workers contract and suffer from respiratory diseases due to the dust they’re exposed to on the job.

Though reported black lung cases hit an all-time low at the end of the 20th century, high rates of black lung disease have emerged in recent years in coalminers and other industries.

Silicosis is an untreatable lung disease caused by the inhalation of silica dust that progressively scars the lungs. About 100 workers die every year in the US due to the disease.

Brock said that miners in Appalachia are being exposed to silica dust more often because the remaining coal is deeper in the earth, thus requiring more cutting to get to it, and unionized mines that once served to protect workers from excessive dust exposure no longer exist.

“The mines now have all this rock to cut. They have to take out a foot of rock to get clearance to walk and mine, and that brings on the problem of black lung worse because silica is a lot worse than coal dust. Your lungs can’t deal with it,” he said. “With black lung, even with supplemental oxygen, you suffocate to death. It destroys the air sacs and inhibits oxygen to your blood supply. The first thing that goes is your legs, that’s my weakness now.”

Silica dust has been cited as a contributor to recent rises in black lung disease, particularly in central Appalachia, despite initial progress in nearly eradicating the disease among miners. In 2018, black lung disease in miners hit a 25-year high. In Appalachia, cases of black lung rose to levels unseen since the 1970s, when modern coal dust regulations were implemented.

For coalminers, the silica dust they’re exposed to while mining is 20 times more toxic than the dust from coal, and new, mechanical methods of mining coal are probably exposing miners to greater amounts of silica dust in the process.

“It’s really tragic we are seeing cases of silicosis in the 21st century and cases of a disease that are entirely preventable,” said Dr Robert Cohen, a professor of medicine and director of occupational lung disease at Northwestern University.

He said anytime workers are drilling, mining or carving stone or rock, respirable crystalline silica, a very toxic dust, is likely being liberated in the process. Without protection and proper dust controls, workers inhale this toxic dust.

“The dust is never removed from the lungs, so even after people are exposed it can continue to cause problems. It’s unfortunate this disease can progress without any further exposure,” Cohen added.

The United Mine Workers of America has called on the Mining Safety and Health Administration to enact stricter standards to regulate respirable silica dust in the wake of resurging black lung cases. A spokesperson for the Mining Safety and Health Administration said the agency is currently reviewing public comments before proceeding on any changes to regulations.

Countertop workers

Coalminers are not the only workers experiencing a surge in reported cases of silicosis in the United States. In September 2019, the Centers for Disease Control and Prevention published a report that cases of silicosis in the US are beginning to surface among countertop fabrication workers, with 18 cases and two deaths reported so far.

Jose Martinez, 37, is one of the kitchen stone countertop workers in the US with a confirmed diagnosis of silicosis. He worked for 15 years at a polishing and counter company in California that sold engineered stone, which has significantly higher rates of silica than granite or marble.

“Everywhere you went in the shop, there was dust,” said Martinez. “Once you know you have this, everyday it gets worse. The symptoms, you feel dizzy, tired, weak. Sometimes when I’m eating, it’s hard for me to breathe. When I go to sleep, I can’t sleep. My biggest fear is when I go to work thinking if I’ll come back home, because something can happen to me during work or driving.”

Martinez is currently suing his former employer over denial of workers’ compensation and refusal to assume liability for his occupational injury.

Alan Gurvey, one of Martinez’s attorneys in the case, said: “When an employer denies coverage under the workers’ compensation system, a worker is left with nothing, without the indemnity benefits he should be getting and without medical treatment. Without medical treatment, things can become extremely difficult for the injured worker and his family. That is not what the workers’ compensation system intended.

“Corporations are trading profits for people’s lives and their wellbeing. There are so many industries where employers are not taking responsibility for what they should and not treating their employees like human beings. That’s the fight we’re going to pursue in the court so this company will be held responsible under these very unfortunate circumstances.”

The Guardian could not reach Martinez’s former firm to request a comment on the lawsuit.

Researchers at the Centers for Disease Control and Prevention (CDC) noted that many US cases of silicosis likely have yet to be identified, given screening and surveillance of at risk US workers has been limited, and other countries such as Australia have reported outbreaks in the stone fabrication industry.

“The first deaths reported by CDC of workers disabled, and in some cases dying of silicosis, is clearly the tip of the iceberg,” said Dr David Michaels, the assistant secretary of labor for the Occupational Safety and Health Administration (Osha) from 2009 to 2017 and currently a professor at George Washington University.

“Based on the studies from Australia, there could easily be thousands of additional cases among countertop workers that have not been diagnosed.”

At Osha, Michaels issued a new standard strengthening regulations for silica exposure to workers, but the rule wasn’t set to go into effect until 2017 to give employers time to adjust for compliance. The Trump administration abandoned enforcing those new standards.

“Osha’s decision to abandon its enforcement program aimed at workplaces where workers are exposed to deadly silica dust is sentencing hundreds and possibly thousands of workers to disease, disability and in some cases, premature death,” Michaels added. “This is especially true for workers employed making artificial stone countertops, but also holds for workers exposed to silica on construction sites.”