The black lung crisis deepens in Appalachia

Back in 2023, we brought you a story about the resurgence of black lung disease among coal minors. The doctor says my lungs start shutting down and said it's hard and dislike a lump of coal. It's bad when you walk outside

and I'll let her turn to get in the lungs. For instance, trying to take a bite of dry shower.

First steps and heels, I can walk on the driveway, check my about.

You get a pack and spit in black and blood. Call them to the point of almost throwing up. That episode coals deadly dust. Documents failed efforts to prevent this deadly disease. And what those failures have meant for minors, their families, and their communities.

We're going to die from it. There's no cure for it. There's a death sentence. And no one that that's coming to you. It's pretty hard to take.

Howard Berkis has been investigating the rise of black lung disease for more than a decade.

First has an NPR correspondent and now as a retired correspondent.

Howard Berkis is joining us again today to bring us a major update. He's still investigating. But first, let's go back three years to that original episode. And that interview with Howard back then. We talked about the revelations he reported over the years.

So Howard, first of all, welcome to the podcast. I really appreciate being with you. I just want to better understand this disease. So when I think of black lung disease,

“it's not something that I think of in associate with today.”

I'm thinking of the past, the industrial revolution. And you know, I'm not thinking 2023.

You know, it's actually still pretty common in cold country in Appalachia.

To hear about dads and grandfathers, uncles, friends who mind cold. And then suffered and died from black lung disease. It was typically an old minor's disease. And the deaths can be really horrific. The lungs slowly build up with fibritic tissue.

The affected portion of the lungs become hard. And eventually they no longer work. It's often death by suffocation. I mean, it sounds like a terrible way to die. It has the government done anything to address this.

Back in 1969, 40,000 coal miners in West Virginia staged a wildcat strike over black lung disease. And that prompted Congress to enact a new mine safety law. It put tough limits on exposure to cold dust. And it made a big difference. The rate of black lung disease plunged 90% in the next couple of decades.

Okay.

“So what prompted you to begin investigating black lung disease in 2011?”

Like when you got started with all this. Actually, the year before in 2010, there was this terrible coal mine explosion at the upper big branch mine in West Virginia. Twenty-nine coal miners were killed. It was catastrophic then.

Dozens of mine rescuers EMTs and ambulances were mobile lungs. This was the worst mine disaster in 40 years. A year later in 2011, a report about the disaster was released. And it contained a one-page sidebar. That sidebar said that the autopsy is on the miners who were killed in the explosion.

Revealed an extraordinarily high rate of black lung disease. One of the miners who died in the explosion was named Gary Wayne quarrels. He was just 33 years old at the time. And his father, who's also named Gary, and also was a coal miner. He told me this.

He had black lung. Ben in the mines for 13 to 15 years and already considered having black lung now days. It's unbelievable. And not only him, he's quite a few other younger guys. And being that young, that's uncalled for.

So the thing that is striking about this is because with black lung disease in the past, this was something that hit miners when they were in their 60s and 70s. Like, they're later years in life and that image that kind of comes to mind of older, retired miners.

“It hooked up to oxygen tanks after mining for 30 or 40 years, right?”

One of the shocking experiences we had right away was meeting coal miners who did not fit that description. They were far younger when they were diagnosed. And they got far sicker and were quickly.

He was only 40 years old when he was diagnosed.

“We went to his house in southwest Virginia.”

And he held up an x-ray of his lungs in the light of his living room window. You go from being normal to where all of a sudden 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. And you say this is crazy, it can't be this bad. And then you realize, couple months down the road that it can be.

And you realize that you're down the road after that. Anything nothing yet? What does Mark McCowen mean by that? Mark was 47 years old when we interviewed him.

He'd been living with the disease for seven years and it was getting worse and worse.

So one of the things that he described is something we heard over and over and over again, while interviewing dozens of coal miners with black lung disease. They talk about the simplest things that they can no longer do, like just being with their grandchildren. I say little buddy, I got to put you down for a few minutes. And he's going to run a little bit and he'll say run, pop all around.

He wants me to chase him and okay. I said give pop all men and I might be able to in a minute. And I face them every day. Sometimes I make it to the top and sometimes I don't. You were hearing at these heart-wrenching stories about how minors struggle with the disease.

“What did you do next? Like did you have a hunch that these individual stories pointed to a much bigger trend?”

I did have that hunch and so did the black lung experts who were as shocked as Gary Wayne quarrels father. There was also another reporter who was thinking the same thing. Chris Hanby at the Center for Public Integrity. We teamed up and he did an analysis of government data that helped prove a dramatic resurgence of the disease. We found that the downward trend had reversed.

That the rate of the disease had soared. And actually a more recent study found that one in five working coal minors who have been tested for black lung. And that's thousands of coal minors have signs of the disease. Now we also found one likely reason for this. In the decade since that law was passed in 1969, minors began working longer hours,

including lots of over time and six day weeks by the time I was 40 years old. I had more coal than most minors seen in a lifetime. And in fact, we found that on average coal minors were each working 600 more hours a year. And there was something else that Mark McCow and another minors talked about. The big coal seams were gone.

The thinner coal seams that remained were still valuable and they were embedded in rock. Sometimes the coal was reduced to a two inch thickness.

“And you have to stay with that two inches because you know that you're co-sing.”

But the rest of what you need to man may be solid or out. This is also something we heard repeatedly from the dozens of coal minors we interviewed. Everyone I worked, we could rock. But I worry you weren't you had rock. The last 20 years I've kept more rock and cut coal.

Because I wasn't hardly know solid seams of coal left. A little seam of coal probably. I need to stick. Rest of that was rock. Six and a half foot.

In Appalachia that rock contains quartz and when quartz is ground up by mining machines, it produces a dust that is easily inhaled and contains sharpened particles of silica, which is far more dangerous than coal dust alone. After the break, the silica does that made black lung worse. And the challenge for Howard and his reporting partners in determining how much worse.

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Howard, I want to ask you about your motivation for continuing the reporting.

You spent a year investigating that 2010 mind disaster in West Virginia. You spent another year investigating and documenting a dramatic resurgence of black-long. For a lot of reporters, I would have been enough. You had exposed what was going on. You had born witness to it.

You could have left it there and moved on to other stories. And that's what usually happens. Why did you keep thinking about this?

“The truth is, I did move on to other reporting, some of which also involved other aspects of coal mine safety.”

But, you know, I met a lot of sick and dying coal miners while I was working on coal mine safety. I met a lot of crippled workers in their families. I met a lot of loved ones of miners who were killed on the job. And I just came to believe that work should not be a death sentence. It's that coal miners and other workers deserve to go home every night whole and alive.

And here's the thing, they were supposed to be protected.

This was an era of tougher mind safety laws and a regulatory system that was supposed to protect them. But clearly, it wasn't working. There must have been something else going on. Now, before the break, you mentioned Cilita. This is a common mineral in rock.

Can you talk more about it? Like, what's the connection with this, you know, surge in black lawn, especially among young miners? All that rock that miners were cutting produced this Cilita dust, and Cilita is actually 20 times more toxic than coal dust alone.

“And because it's sharp, it can embed in lungs forever.”

Every miner we talked to had a story about Cilita dust. The more rock you had to cut the dust, it was. It's like being in a room full of smoke. Like you're sitting in a cloud, black walk me into a fog bank. You're in hell on that into your lungs as well. You know, that's just like fiberglass that cut you lunged out of your head.

It took your eyes to spit it up constantly. And we just couldn't keep the dust down, get enough. These Cilita particles are invaders in the lung. And the lung tissue fights back. It becomes thicker and harder as it tries to expel this foreign substance.

Fiberatic tissue builds up and builds up, and it makes it more and more difficult to breathe. nodules form. And when they get larger and more of them form, the disease becomes far more serious.

“This is known as progressive massify process,”

or simply it's called complicated black lawn. It's incurable, it's fatal, and it was once rare among younger miners like Mark McCallon. So now you're on to Cilita and you're looking at that. How did you begin this part of the investigation?

Of all things, it was a text message. In the summer of 2016, my cell phone buzzed. This was a text message from a very reliable source, and it simply said this. I've seen as many complicated black lung cases in the last month,

as I've seen in the last 30 years, guys are really that sick, something is up. Of course, I had to verify this. And I thought about two kinds of places that would be witnessing a monumental escalation in cases,

is such a thing was actually happening. One, there are law firms that represent coal miners who are seeking state or federal black lung benefits, they'd have an increase in business, and two, the medical clinics that diagnosed black lung

and treat symptoms. And I quickly found that both were swamped with cases, especially in Virginia, Kentucky, and West Virginia. One clinic in particular in eastern Kentucky had dozens of cases, including younger miners who were getting very sick, very fast.

I interviewed there, one of the sickest minors I've ever met. Mackie Brana, he was just 39 years old when diagnosed, and he compared his situation to his family's history of black lung. You can hear how hard it is for him to breathe.

I'd probably be the first one to be this bad in the family.

And what do you mean this bad? For it to actually be this progressive and in this bad of shape. I mean, don't get me wrong. That can't breathe. But I can still get up and walk around and do stuff.

I'm more a tout, I'm more a good out of breath. It's just a lot of pressure in my chest all the times.

I've never been scared of death.

He don't bother me a bit. It's just not seen my kids grow up. But if I had to do over, I would do it again.

“If that's what it took to provide for my family, this long as I have.”

Oh my goodness, that's difficult to even hear how hard he struggling just to talk.

But then he says he do it all over again.

I think that that will be hard for a lot of people to understand. You know, mining jobs have been the best jobs in the hills and hollers of Appalachia. The best pay, the best benefits, miners sometimes have the best houses. They sometimes have the newest pickup trucks. There isn't usually anything else that compares or even comes close to what mining can provide these workers.

So how many Mackie brand-arms were out there?

How many cases are out there like this? To begin to answer that question, I went to the clinic where Mackie brand-arms was diagnosed. A radiologist there named Branding Crum is specially trained to assess the chest X-rays of coal miners.

“I think the percentage of black lung that we're seeing now here in Central Appalachia is unprecedented in any recorded data that I can find anywhere.”

In this clinic where we're roughly around nine to ten percent complicated rate, which is around three times higher than even the highest reported numbers. Crum was so shocked he approached epidemiologists at the National Institute for Occupational Safety and Health, which tracks black lung disease. He spoke with Scott Laney when the nation's most prominent black lung researchers. He told us that he was seen a lot of it really advanced disease and it was concerning to him. And I guess my initial thoughts was that's probably not true.

Why was epidemiologists Scott Laney so skeptical? Because Laney's Federal Research Agency, which has tested tens of thousands of working coal miners for black lung for decades, had counted and reported just 99 cases of complicated black lung nationwide in the previous five years. Branding Crum had two thirds as many cases in less time at his small clinic in Kentucky. Laney wanted proof so he went to Crum's clinic.

And he agreed to show us some of the medical images and we sat there for an entire day, one after another, after another, looking at these chest X-rays, the worst I've ever seen. And I asked Laney how he reacted to what he was seeing. But he said he had more than 600 cases in just three years. I'm not an epidemiologist or a scientist or a doctor. I just see the results that comes through the doors and something is going on, something major is going on.

So how could this happen? Like how could the agency that is responsible for counting the cases of this disease miss so much? It turned out there was nothing really nefarious going on.

“Remember that I said that Laney's Agency, the National Institute for Occupational Safety and Health or NIOSH tested working miners for black lung disease.”

That's its legal mandate. But 50,000 coal miners have lost their jobs since 2011. That's because coal plants have shut down and mines have closed. Some of those miners went into black lung legal and medical clinics to see if they might qualify for black lung benefits. So the clinics were testing laid off and retired miners who NIOSH was not testing. We surveyed clinics in Virginia, Kentucky, West Virginia, Ohio and Pennsylvania.

I mean, that's a big difference. And I guess if they didn't really know how many people were sick,

“then they didn't even know to try to look for a cause of this rise, right?”

That's right. If the official count was so low, then there wasn't anything major to be alarmed about.

In fact, there was never direct regulation of silica dust and coal mines.

So at this point, you know and government officials are starting to learn that the official count is way off. And lots more miners have this complicated black lung than was previously known. And you suspect that the problem may be silica because miners, you know, these days are cutting through so much rock to get to the coal and they're encountering silica. But, but how did you prove that? We knew that the mine safety agency had been sampling for cold dust and silica dust.

And we knew that the agency analyzed those samples. So in 2017, I turned to two of my colleagues on the MPR Investigations team who are whizzed as analyzing complex sets of data. That's Robert Benincasa and Wodging Not. And they obtained 30 years of sampling data going back to 1986.

“Now, we cast a wider net and went to even more black lung clinics to get a more complete count of cases.”

We were trying to definitively show how many dangerous silica dust exposures had occurred. What caused them? What the mine safety agency did or not do in response? And how many more cases were out there? When we come back, what all that data revealed about the deadly conditions miners were facing?

Fifty years ago, Congress set out to protect coal miners from black lung disease. Today, it's back at rates not seen in half a century. These guys are being treated like disposable widgets, not human beings. On the Sunday Story, why coal miners and Appalachia are getting sicker faster?

Listen now to the Sunday Story from the up first podcast on the MPR app.

Oh, hey there, I'm Brittany Loose. And I don't know, maybe this is a little out of pocket to say,

“but I think you should listen to my podcast.”

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We're back with Howard Burke is talking about his decade long investigation into black lung disease among coal miners. Howard and his team analyzed 30 years of data to try to document the number of dangerous silica dust exposures. So Howard, what did you find? Okay, stick with me here for a minute because it's a lot of numbers.

But it shows how such important details were overlooked.

First, we documented another 1,000 cases of complicated black lung with a total

than of over 2,000 cases since 2010. Second, we documented 21,000 instances of over exposure to silica dust since 1986, exposures that exceeded the federal health standard. Third, we found that the agency's response to excessive silica dust exposures failed to lower the dust to safe levels close to 9,000 times.

Fourth, we obtained government documents that showed that the mind safety agency had identified a cluster of advanced lung disease and coal miners back in 1996. And officials at the time connected that cluster of disease to exposure to silica dust. They even sent out warnings to the mining industry. But nothing was done then or since to force protective action on silica dust.

So it sounds like you had a lot of smoking guns here. More cases of disease, more evidence of this hidden epidemic. Enough excessive exposures to maybe show the cause of the epidemic. And then a failure by regulators to protect miners even when they knew about the danger. What kind of reaction did you get to that?

More shock, more horror, and a rare acknowledgment by a former top official at the Mind Safety Agency. Celeste Montforten was a top aide in the agency during the Clinton administration in the 1990s. We failed. Had we taken action at that time? I really believe that we would not be seeing the disease that we're seeing now and having minors die.

I mean, I don't know how you can reach any other conclusion.

“I mean, this is such a gross and frank example of regulatory failure.”

Wow. I mean, that is quite an omission. And it's not normally what you would hear from a regulator or a former regulator.

She's basically saying it's undeniable.

The mind safety and health administration is supposed to be protecting miners. So how do you account for this failure? Like what were those officials doing instead? Well, for one thing they didn't look at their own data. They also ignored repeated recommendations by NIOSH going back to 1974,

which called for a silica exposure limit that was twice as tough. That was also recommended by a special labor department commission on black lung in 1996. Well, I wanted to ask you about how miners can be protected from dangerous deaths. Like the pandemic obviously taught us all about in 95 masks. I don't call miners use mask or respirators for protection.

This is a subject we could talk a lot about. I'll just give you the highlights. And it starts with a fundamental principle in workplace safety,

which is companies are supposed to provide first and foremost as safe working environment.

They're not supposed to be able to get away with having an unsafe environment, providing some kind of protection, supplemental protection, it's called. And in this case with coal miners we're talking about masks or respirators. There's also a fraught history with the masks minors were issued in the past, including hundreds of lawsuits with settlements and multimillion dollar verdicts.

And miners did not really like wearing these masks. They would clog up with dust, wet, and be it honest and ever could get enough iron. And then it feel like someone just sit there with their hand over you place. They're not going to stop a hundred percent. There's finer particles getting through them filters.

Some of the companies I worked for didn't have my novel. Period. Now there are respirators and helmets available today that are more effective at screening out dust. But miners complain that they can limit vision or hearing or both.

That's not good in a dangerous work environment where it's critical to clearly communicate with co-workers

and to see the movement of massive equipment around you. Okay, so masks are not a perfect solution.

“What else can mining companies do to protect miners from dangerous dust?”

So mines have massive fans that push through clean air that sweeps away coal and silica dust. This robust ventilation is one thing that works if it's done right. Mining machines also spray water as they cut into coal and rock that also tamps down dust if the spray is working right. The other thing mining companies can do is slow down the mining machines which can result in less dust. They could choose not to mine the thin seams with so much rock.

Of course both of those options involve mining less coal and making less money. So bring us up to date. We now know the government didn't bother to look at his own data and it had failed to act on recommendations for tougher limits on silica dust. But they're finally doing that right. Well the mind safety and health administration is finally proposing to make the silica dust exposure limit twice as restrictive.

It is proposing to directly regulate silica dust for the first time so that citations and fines are possible for exposing miners to dangerous levels of dust. But the proposal appears to be weak on oversight and enforcement on making sure that coal companies actually follow the regulations and actually protect miners.

“The agency does not include in this proposed regulation some of the key trends about complicated black lung that it has overlooked in the past.”

It's not citing the data that shows thousands of continuing over exposures to silica dust. It doesn't cite the actual numbers of miners who are sick and dying from the disease. These numbers are important because when agencies propose a new regulation they have to sell it. They have to sell it to the industry that's affected because they don't want to get sued and they don't want the industry to appeal to their friends and Congress to try to block it. And in fact a house Republican has already launched an attempt to block implementation of the new silica dust regulation even though there's not even a final version of the proposal.

The proposal predicts that the new regulation will save just 63 coal miners lives and prevent just 244 cases of disease over 60 years.

“Our latest survey of black lung clinics shows more than 4,000 cases of disease in the last decade.”

It has the mindset to agency responded to your recent reporting like did officials explain why they left out those compelling details. They responded, but they did not explain. Instead they said in a statement that they would now consider the actual number of disease and dying miners and they said officials there are deeply disturbed by that.

Now this is actually a work in progress. The proposal is now under review. A final regulation is likely months away and we'll see if it actually incorporates what we've reported.

Howard, so I know you could probably talk all day and probably longer about the details of the proposal and some of the other shortcomings. And listeners can find out more about that in your story on our website at mpr.org, but I want to get back to the miners who've interviewed over the years.

“Because that's what this is really about. I mean, their lives are at stake.”

And I know that even with coal plant shut down and mines closing, there will still be tens of thousands of workers mining coal for years to come.

So what have these miners left you with at all these hours you spent with them and all that you've learned in your reporting, what stays with you?

I keep thinking about a miner named Danny Smith, who was a lot like Mackie Branham, one of the youngest and sickest miners I've met. Danny only worked 12 years underground. He was diagnosed with complicated black lung at just age 39. And when we visited with him at his home in eastern Kentucky in 2018, he was just trying to do something simple, Moez Lawn, but he had a hacking fit that forced him to stop. He bent over, he started coughing so bad that he was spitting up what looked like crusted bits of black paper with red streaks.

“Later his respiratory therapist told us that that was dead lung tissue that he was coughing up.”

Danny was taking his plate very hard. It's he'd had me an 8 mad, I mean for at least the last two years that I don't want to dial over it. So it's hard-breaking, you know, not knowing where you're going to see having cranky in and you're going to ever see him. And I've all the things that could kill me while I did work or rockfiles and all that stuff, you know, and I live through all that. And I found out years later that I'm on dial over black lung and it's hard-breaking.

It was all young and strong and sty-out and I took a bandjups there for one of his either crippled or dead, you know. It was all young me and we were just kids. Danny Smith was 46 years old when we spoke with him in 2018 and he showed me then the burial plot that he'd picked out for himself and his family cemetery. Danny and I've been communicating since then, most recently by text message because he says he doesn't feel strong enough to get through a phone conversation. He's being assessed right now for a double lung transplant.

He has good days and bad days, in one text that he sent me recently, he said he'd rather be poor and homeless than suffer what he's been going through and knowing it will only get worse. But he also wrote that he was grateful for the good life mining made possible for him and his family. He has two daughters he's immensely proud of, one of pharmacists now, and the other studying to be a physician's assistant in emergency rooms. Both were inspired by Danny suffering from complicated block lung. And I want to leave you with this.

His older daughter's Sydney wrote and performed a song about her dad and his disease. And I'm back so he's been over and there he is. And then there's a scariest place I could bring in the phone black, but he's still waiting down.

A lot has happened in the world of coal mining and black lung since that episode three years ago.

“So we have Howard Berkis back with us to bring us up to date.”

Hi, Howard. Hi, Eisha. Thanks for having me back.

I wish I had better news for you this time, but it's always good to talk to you.

Well, you know, we we always appreciate it and let's get right to that news. As I understand it, this resurgence of black lung disease not only continues. What is getting worse like is that right? That's right. Sadly, it is getting worse. The federal research agency that tracks black lung disease. The National Institute for Occupational Safety and Health or NIOSH tests hundreds of coal miners every year.

And in their latest report, they find that one in three working career coal miners in Appalachia. That's miners there who've toiled underground for at least 25 years.

They have black lung disease, one in three, Aisha.

“My goodness. I mean, that's just terrible. Like, how did they come to that finding?”

Well, by testing working underground miners in Kentucky, Virginia and West Virginia, and they did that in the last five years. The last time that this group of miners had that rate of disease was 1978 nearly 50 years ago. What about younger miners? Are they also experiencing higher rates of black lung? They are. Even working coal miners in that same region, with as little as 15 to 20 years underground, have tested positive at a rate not seen in nearly 40 years.

So how do these latest findings compare to what was happening when we last heard from you in 2023?

Well, when we last spoke three years ago, the most recent report from NIOSH was from 2018.

And it found that the same group of career miners had black lung at a rate of 1 in 5 or a 20% chance of having the disease. So it went from 1 in 5 to 1 in 3. That's a 65% increase in the rate of the disease in less than 10 years. And here's another perspective. Back in the 1960s and 70s, so many coal miners were sick and dying. That 1000 staged a wildcat strike and marched on Washington.

That prompted Congress to pass new mine safety laws, including strict limits on exposure to the coal mine dust that causes black lung. And those laws were affected 20 years later, the rate of disease for these miners had plunged to just 7%. That's less than 1 in 10 miners. So when we say now that the disease has come running back, we're not exaggerating. I mean, that's a really shocking uptick, especially when we're talking about 2026, like you would think things would be safer and better. Even the black lung experts were shocked by this data.

I shared this news by the way with one pulmonologist who treats coal miners. Dr. Drew Harris is the medical director at the nation's largest black lung clinic. And he sees miners from across Appalachia. If you imagine one out of every three schoolteachers were getting an incurable lung disease because of something that they were exposed to at work, the whole country would put their hands up screaming and stop whatever this exposure was immediately.

And it's sad that this is largely impacting rural Appalachian folks that don't have a voice, that don't have a country to unite behind them. That's really why this is happening. And the episode we just heard you talked a lot about the increase in silica dust and coal mines. Does that also explain this new milestone?

“That's what the NIOSH researchers say and there's really nothing else that could explain it.”

They also know that this is a progressive incurable disease. Scott Laney is the NIOSH epidemiologist who led the study. This is not going to get better because of all of the disease that's already in the pipeline. You know, these guys are being treated like disposable widgets, not human beings. And we're watching them die right before our eyes.

In fact, another NIOSH study last year counted more than 1,700 deaths from black lung just from 2023-23. And there's other evidence of a black lung crisis and a blasting impact. That black lung clinic we mentioned earlier diagnosed 2400 new cases of disease in just the past five years.

This is for living in medical expenses.

That was at a cost of $175 million.

But you know, we just heard that the federal mind safety agency had adopted these tough new limits on exposure to silica dust.

“Will that make a difference at least for miners who aren't sick yet?”

Well, the mining industry sued and now federal courts and the Trump administration have put enforcement of that new silica dust regulation on hold indefinitely. So miners are still being exposed to silica dust, which is believed to be driving these new cases of disease. And basically the same regulatory system that failed to protect them in the past. And while these new protections for miners are on hold, the Trump administration is trying to prop up coal mining and coal burning power plants.

Trump has promised the industry close to $700 million in federal support.

And that prompted this from Celeste Montforten, a former federal mind and workplace safety regulator and a specialist in occupational health. When I hear the president or other people in the administration talk about coal, it's like they have this love affair with coal. They have a love affair with the black rock. And not a love affair or compassion or concern for coal miners.

“So what are the administration and the mining industry? What are they saying about this newly reported rate of black lung disease?”

How are it? Thank you for bringing us up to date and for your continued reporting, you know, a true reporter never stops reporting and even when they're retired.

Well, thanks for having me back, Aisha. I hope to get back to being retired soon. Howard's latest reporting of Coals Deadly Dust was for public health watch and independent nonprofit investigative newsroom and was done in collaboration with Justin Hicks of Kentucky Public Radio. This episode of the Sunday Story was produced by Andrew Mombo, the earlier episode featured today was produced by Justin Yan. Our editor is Jimmy Schmidt. Maggie Luther was the engineer for this episode. So music was provided by audio network, blue dot sessions and rom team Ira Blueie, the song, coal mining Kentucky was performed by Erica Coleman, Chris Preston, Tyler Ball and Sidney Caughtdale.

Leanna Simstrom is our supervising producer and Irene Negucci is our executive producer. We'd love to hear from you, send us an email at the sunday story at mpr.org.

“I'm Aisha Roscoe, up first is back tomorrow with all the news you need to start your week until then have a great rest of your weekend.”

Myelin seems like everything is being called a recession indicator these days. Yeah, like the box of hamburger helper in my pantry. Or the new Apple Neo book. Or the resurgence of press on nails or lipstick or no lipstick, I've lost track. There is only one way to know if these are actual economic warning signs though.

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