In a symbolic celebration of coal’s comeback, President Donald Trump stood surrounded by helmeted miners in the White House East Room this April, promising a revival of a once-declining industry. As he touted “beautiful, clean coal,” his administration quietly pressed pause on crucial health protections for the very workers he claimed to champion.

At the heart of the controversy is a federal rule aimed at curbing exposure to silica dust — the leading cause behind the deadly resurgence of black lung disease among American coal miners. The rule, introduced under the Biden administration, would have halved the allowable silica dust limits in mines and introduced stricter oversight. But implementation was abruptly delayed, pending litigation and what officials described as “technical issues.”

Yet beyond the legal holdup lies a deeper concern: the ability of federal agencies to enforce the rule at all. The Department of Labor’s Mine Safety and Health Administration (MSHA), responsible for mine oversight, has been gutted by widespread office closures. Meanwhile, the National Institute for Occupational Safety and Health (NIOSH), which monitors miner health, saw nearly 900 staff terminated in April as part of sweeping budget cuts.

These decisions come amid a troubling resurgence in black lung cases, particularly in central Appalachia. By 2018, nearly 1 in 5 coal miners in the region showed signs of the disease. The most advanced form — progressive massive fibrosis — has seen a tenfold increase among long-time miners, with cases appearing in younger workers too.

The rise has been attributed to higher silica dust exposure as mining operations cut through more rock to reach thinner coal seams. The sharp, airborne particles scar lung tissue and can lead to irreversible and fatal conditions.

A Hard-Fought Rule Put on Hold

The delayed rule, years in the making, was hailed by labor advocates and health officials as a long-overdue safeguard. Acting Labor Secretary Julie Su previously called the lack of silica protections “unconscionable.”

However, in a single day this spring, miners not only lost progress on that rule, but also access to essential health surveillance. The shutdown of NIOSH’s mobile clinic program, which provided free lung screenings, left coal miners like Harry Wiley — who was diagnosed with early-stage black lung — without vital services. Wiley’s request to be transferred to a less dusty job went unanswered.

Following a class-action lawsuit filed by labor attorney Sam Petsonk, a federal judge ordered the immediate reinstatement of the surveillance program. A day later, Health and Human Services Secretary Robert F. Kennedy Jr. reversed the termination of over 300 NIOSH employees.

Still, doubts remain about the broader future of workplace protections. MSHA declined to comment on how or when the silica rule would be enforced, citing ongoing legal challenges.

Miner Advocates Warn of a Dangerous Precedent

Wes Addington, executive director of the Appalachian Citizens’ Law Center in Kentucky, sees the government’s actions as a threat not just to miners, but to worker safety nationwide.

“The silica rule wasn’t perfect,” Addington said, “but it was going to save lives.” His group has pushed for the rule for nearly two decades. With NIOSH’s work stalled and MSHA’s inspection capacity reduced, Addington warns that miners are now more likely to suffer injuries — or die — on the job.

A study by his group found that MSHA offices slated for closure were responsible for nearly 17,000 inspections over a 14-month period. Cutting those local presences, he says, weakens enforcement when it’s needed most.

Generational Struggles and Health Sacrifices

For coal families like the Fieldses of West Virginia, black lung disease is a personal legacy. Tilda Fields lost her father to the disease at age seven. Her husband Rex, a former miner, now lives with a severe form of it, struggling to breathe even during simple tasks.

Despite these challenges, the couple continues to advocate for miner rights and health protections. “You want better for your kids than what we had,” Tilda said. “And you surely want their safety.”

Their concerns are echoed by doctors working in mining communities. Dr. Drew Harris, who leads a black lung clinic in southwestern Virginia, has diagnosed 75 cases of advanced black lung in the past year alone. “This disease is entirely preventable,” Harris said, calling the rollback of protections and surveillance “disheartening.”

He also pushed back against the idea of transferring specialized tasks from NIOSH’s surveillance team to general staff. “You’re losing decades of expertise,” he warned. “This is not something you can easily replace.”

The Bigger Picture: A Shift in Worker Protections

The Trump administration’s actions are part of a broader effort to streamline — or dismantle, critics say — federal agencies through cost-cutting and restructuring. The Department of Government Efficiency, a new entity created by executive order, has led the closure of dozens of field offices and the reduction of nearly 10,000 jobs across various health and labor agencies.

In response to criticism, the Department of Labor maintains that mine inspections will continue as required by law and insists it remains committed to miner safety. However, for miners and their advocates, the message from Washington is clear: protections once fought for and won are now under serious threat.

“It’s a betrayal,” said Addington. “Miners gave their health to power this country, and now when the science and tools exist to protect them, we’re taking it all away.”

For families like the Fieldses, the fight continues — not just for safer mines, but for the lives and futures of those still working underground.