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In approximately 18 months, miners executed one of the most important movements in the coal industry. This grassroots effort, called the black lung movement, shut down mining in West Virginia, the nation's largest coal producer. Its goals were compensation for disabled miners and prevention programs. The movement ultimately secured federal action.

Several terms refer to black lung disease (e.g., pneumoconiosis, miners' asthma), and because it involves a spectrum of problems, there is not a confirmatory medical test. Despite some compensation for silicosis, when workers could prove damage from “hard” particles confirmed via X-rays, bituminous miners faced a difficult situation, because soft coal dust harms the lungs differently.

Black lung disease results from coal dust particles clogging the lungs. Over time, the body's ability to intake oxygen lessens, leading to heart enlargement, which, in turn, often leads to heart failure. Victims experience shortness of breath and inability to perform basic tasks.

“Miners' asthma” appeared in medical reports by the mid-1800s. In the early 1940s, the United Kingdom began compensating workers. At most United Mine Workers of America (UMWA) conventions from the early 1940s to the late 1960s, miners demanded actions to prevent black lung disease and compensate those affected. However, the U.S. medical establishment, company owners, and the union resisted acknowledging black lung.

Early in 1968, miners requested UMWA priorities on black lung prevention and compensation, but the union took little action. Later, in November, an explosion at Consol Number 9, near Farmington, West Virginia, claimed 78 lives and highlighted mine safety as a national issue.

In late January 1969, displeased with union response and concerned about safety, more than 3,000 miners attended a Charleston meeting, with talks by miners, physicians, and politicians. From this meeting and similar ones across the state, the West Virginia Black Lung Association was formed.

During West Virginia's legislative session, several bills on black lung issues were introduced. Many miners attended; they were joined by members of the Association of Disabled Miners and Widows. Group members sometimes staged funerals for fallen coworkers or wore armbands listing mine deaths. When a promised bill was not delivered, disgruntlement increased.

On February 18, miners at the Winding Gulf Coal Company's East Gulf Mine in Raleigh County refused to work. By the next day, miners at nine sites were on strike. Within the week, the wildcat strike included more than 7,000 workers and garnered media attention, reinforcing worker concerns nationally.

Absences of more than 30,000 workers shut down production in West Virginia's southern mines and more than half of the northern mines by late February. Union attempts to compel miners to work and legal action by company owners failed. By March, with over 40,000 striking, West Virginia's mines were closed. On March 11, West Virginia Governor Moore signed the black lung bill. Then, on December 30, President Nixon signed the Federal Coal Mine Health and Safety Act of 1969, which included the Black Lung Benefit Program.

The movement, fueled by West Virginia, Kentucky, Ohio, and Pennsylvania miners, focused attention on occupational disease. The federal act was significant; however, costs were borne by taxpayers rather than by mining companies. In the 1970s, focus centered on alleviating compensation problems. In mid-1972, the Black Lung Benefits Act, more broadly defining the illness, was passed.

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