A person who has severe silicosis has to fight for every breath. A short walk that should take just 20 minutes can take an hour. Climbing stairs, carrying groceries, and normal recreational activities are distant memories.
Silicosis is typically caused by years of breathing in silica dust at work, and can worsen even after work exposures stop. In recent years, after decades of inaction, the federal government finally took several important steps to reduce the incidence of this ancient and debilitating disease. Under the Trump administration, all that progress is going away, in but one example of the widespread destruction now taking place across the federal government.
Silicosis first caught the attention of the federal government in the early 1930s, when hundreds of workers hired by the chemical company Union Carbide and its subsidiary to drill a tunnel through a mountain of almost pure silica died of silicosis. Most of the workers were Black, and many were buried in unmarked graves. President Franklin D. Roosevelt’s secretary of labor, Frances Perkins, issued a report on the widespread problem across factories and mines, informing businesses that control measures, “if conscientiously adopted and applied,” could prevent silicosis.
Perkins’s report went mostly unheeded. For all of the 20th century and the early part of the 21st century, the government’s silica-control standards failed to adequately protect workers and prevent workplace disease. Hundreds of workers employed in mines, foundries, and at construction sites developed silicosis, and some died from it. Many others died from lung cancer, also caused by silica exposure.
The 1970 law that established the Occupational Safety and Health Administration (OSHA) also launched a scientific-research agency, the National Institute for Occupational Safety and Health (NIOSH), whose job included providing OSHA with recommendations for health standards. In 1974, NIOSH provided OSHA with strong evidence that its silica-exposure standard needed to be more stringent—that too many workers were being exposed to too much silica, and suffering greatly as a result. (One of us, David, ran OSHA for more than seven years during the Obama administration. The other, Gregory, led the NIOSH Division of Respiratory Disease Studies for 15 years and served as deputy assistant secretary of labor in the Mine Safety and Health Administration [MSHA] for three years.)
OSHA’s process for setting this sort of health standard is not known for its speed. OSHA started working on a strengthened silica standard in 1997 and finally issued new rules for general industry and construction 19 years later (while David was running the agency)—but, significantly, the agency didn’t include mines and quarries, which are under the authority of MSHA, in the Department of Labor. Ever since, when workers face high levels of airborne silica, employers have been required to use engineering controls to reduce exposure; if airborne silica levels are still too high, employers must also provide workers with NIOSH-certified facemasks such as N95s (the N stands for “NIOSH”).
For many years, lung-disease experts employed in the congressionally mandated NIOSH Coal Workers Health Surveillance Program (CWHSP) provided medical testing and counseling to miners in an effort to identify workers who were showing early signs of lung disease, including silicosis. Under the Federal Mine Safety and Health Act, miners with a dust disease such as silicosis have the legal right to transfer to jobs with less dust exposure, and to have their exposure going forward monitored frequently. The chest X-ray readings of NIOSH’s trained and certified experts help sick miners move to safer work areas, which may improve their prognosis.
Despite OSHA’s new silica standard, MSHA’s standard remained outdated, and more miners were getting sick, particularly younger miners. Risk has been driven up by changes in mining practices, such as longer hours, the mining of seams that have less coal and more silica, and the use of new mining equipment that generates more dust. MSHA started working on a new silica standard during the Obama administration, but that work was halted when the first Trump administration came into power in 2017. The agency restarted work when Joe Biden took office and last year finally issued a strengthened silica standard.
In the few months since the second Trump administration began, the federal government’s efforts to control silicosis have been destroyed. Elon Musk’s DOGE fired the entire CWHSP team and most of the NIOSH engineers, staff, and other scientists who are doing research to make mining less dangerous. The White House made clear that virtually all of NIOSH’s functions are being permanently scrapped.
Additionally, in early April, the president signed four executive orders to promote the mining and use of coal. Then, days before MSHA’s rule could go into effect, the new leadership at the Department of Labor “paused” enforcement, claiming that employers would have difficulty complying because NIOSH no longer has staff to certify the respirators and measurement devices necessary for implementing the policy.
Although the Trump administration has not announced major personnel cuts to OSHA yet, the agency’s ability to prevent silicosis is under threat as well. DOGE has announced that 11 OSHA offices, along with 34 MSHA offices, will be closed, which will lead to fewer inspections, undoubtedly followed by more injuries and illnesses.
Even without these cuts, silicosis was already making a comeback, this time in a different industry: the fabrication and installation of artificial-stone kitchen countertops. In the Los Angeles area, more than 200 workers, almost all Latino immigrants, have developed silicosis; several have needed lung transplants. There are likely to be thousands more affected workers throughout the country, but the true number is unknown. Most of the workers in this industry are employed in small fabrication shops, and OSHA is so under-resourced and underpowered that it has had difficulty merely finding the shops where the work is being done.
Preventing silicosis is exactly the sort of essential public-health work that government employees perform with little or no recognition. When these policies work, lives are saved—invisibly, as no one can ever know who didn’t get silicosis because of good regulation and enforcement. But soon enough, if the Trump administration’s devastation of NIOSH, MSHA, and OSHA goes uncorrected, workers will certainly be getting silicosis because of inadequate public-health protections—and those losses will be quite visible, if not to the Trump administration then certainly to the people unfortunate enough to get sick.
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