NPR and the Center for Public Integrity did a two-part repot on the resurgence of black lung disease in the coal mines of West Virginia and Kentucky.

It wasn’t supposed to happen to coal miners in Mark McCowan’s generation. It wasn’t supposed to strike so early and so hard. At age 47 and just seven years after his first diagnosis, McCowan shouldn’t have a chest X-ray that looks this bad.

“I’m seeing more definition in the mass,” McCowan says, pausing for deep breaths as he holds the X-ray film up to the light of his living room window in Pounding Mill, Va.

“The mass is larger and more defined in the right upper lobe,” he continues, clinically describing the solid streak that shows up white on the X-ray of his lungs. “If you know white is bad and black is good, I’m in a lot of trouble.”

McCowan went from a clean X-ray at age 35 to progressive massive fibrosis — an advanced stage of coal workers’ pneumoconiosis, or black lung — in just five years.

“You go from being normal to where … one day you try to do something you used to do, and you can’t do it and you’re just heaving to catch your breath,” McCowan says. “And you say this is crazy. It can’t be this bad. And then you realize a couple months down the road that it can be. And you realize a year down the road after that that you ain’t seen nothing yet.”

Regulations were put in place over 40 years ago to regulate coal mines and eliminate the disease. And for a while it did; cases dropped off to almost nothing. But as the report shows, they’ve been on the rise since 1995.

Round up the usual suspects: lax enforcement, longer hours, and the occasional fraudulent reporting by both the mining companies and the regulators.

From the very beginning, miners reported “irregularities” in controlling coal mine dust, says Donald Rasmussen, 84, a pulmonologist in Beckley, W.Va. Rasmussen says he’s tested 40,000 coal miners for black lung in the last 50 years.

“So many miners will say, ‘If you think the dust is controlled you’re crazy,’ ” he says.

Measuring coal mine dust is key to preventing overexposure. Excess dust can trigger citations, fines and even slowdowns in coal production. Mining companies enforce their own compliance by taking and reporting mine dust samples. Federal mine inspectors also test for excessive dust.

But NPR and CPI have found widespread and persistent gaming of the system designed to measure and control exposure.

Now comes the hard part: getting the mining companies to come clean, so to speak, and save the lives of their workers.

In a companion story to the NPR/CPI investigation, veteran coal industry reporter Ken Ward Jr. of The Charleston Gazette reviews 40 years of attempts to strengthen protection for miners.

Ward quotes former MSHA official Celeste Monforton, a worker safety advocate now at George Washington University: “We can’t get a regulation out to save our souls.” And, as Ward reports, “miners are left with the same system that experts have agreed hasn’t worked for decades.”

Since 1970, when mine dust controls began, black lung contributed to the deaths of more than 70,000 miners. The federal government and the industry spent $45 billion compensating the victims, including McCowan, and their families.

“Now it feels like I’ve got a heavy wet sack on each lung,” McCowan says, between long, deep breaths. “Breathing has become a conscious effort. … It seems like I give up a little bit of my world each day, that it gets smaller and smaller.”

NPR and the Center for Public Integrity did a two-part repot on the resurgence of black lung disease in the coal mines of West Virginia and Kentucky.

It wasn’t supposed to happen to coal miners in Mark McCowan’s generation. It wasn’t supposed to strike so early and so hard. At age 47 and just seven years after his first diagnosis, McCowan shouldn’t have a chest X-ray that looks this bad.

“I’m seeing more definition in the mass,” McCowan says, pausing for deep breaths as he holds the X-ray film up to the light of his living room window in Pounding Mill, Va.

“The mass is larger and more defined in the right upper lobe,” he continues, clinically describing the solid streak that shows up white on the X-ray of his lungs. “If you know white is bad and black is good, I’m in a lot of trouble.”

McCowan went from a clean X-ray at age 35 to progressive massive fibrosis — an advanced stage of coal workers’ pneumoconiosis, or black lung — in just five years.

“You go from being normal to where … one day you try to do something you used to do, and you can’t do it and you’re just heaving to catch your breath,” McCowan says. “And you say this is crazy. It can’t be this bad. And then you realize a couple months down the road that it can be. And you realize a year down the road after that that you ain’t seen nothing yet.”

Regulations were put in place over 40 years ago to regulate coal mines and eliminate the disease. And for a while it did; cases dropped off to almost nothing. But as the report shows, they’ve been on the rise since 1995.

Round up the usual suspects: lax enforcement, longer hours, and the occasional fraudulent reporting by both the mining companies and the regulators.

From the very beginning, miners reported “irregularities” in controlling coal mine dust, says Donald Rasmussen, 84, a pulmonologist in Beckley, W.Va. Rasmussen says he’s tested 40,000 coal miners for black lung in the last 50 years.

“So many miners will say, ‘If you think the dust is controlled you’re crazy,’ ” he says.

Measuring coal mine dust is key to preventing overexposure. Excess dust can trigger citations, fines and even slowdowns in coal production. Mining companies enforce their own compliance by taking and reporting mine dust samples. Federal mine inspectors also test for excessive dust.

But NPR and CPI have found widespread and persistent gaming of the system designed to measure and control exposure.

Now comes the hard part: getting the mining companies to come clean, so to speak, and save the lives of their workers.

In a companion story to the NPR/CPI investigation, veteran coal industry reporter Ken Ward Jr. of The Charleston Gazette reviews 40 years of attempts to strengthen protection for miners.

Ward quotes former MSHA official Celeste Monforton, a worker safety advocate now at George Washington University: “We can’t get a regulation out to save our souls.” And, as Ward reports, “miners are left with the same system that experts have agreed hasn’t worked for decades.”

Since 1970, when mine dust controls began, black lung contributed to the deaths of more than 70,000 miners. The federal government and the industry spent $45 billion compensating the victims, including McCowan, and their families.

“Now it feels like I’ve got a heavy wet sack on each lung,” McCowan says, between long, deep breaths. “Breathing has become a conscious effort. … It seems like I give up a little bit of my world each day, that it gets smaller and smaller.”