Everyone understands what causes black lung and how to prevent it by controlling dust in mines.
Coal operators have an incentive to prevent the debilitating and deadly illness because the industry must fund benefits for its victims.
Yet black lung is roaring back.
The Obama administration's mine safety and health chief, Joe Main, has put that question at the top of his agenda. He promises an intensive initiative to end black lung once and for all.
If that sounds like something you've heard before, it's because you have. The Clinton administration introduced a program to end black lung in 15 years.
The Bush administration had other priorities, however. Elaine Chao's Labor Department once supported a plan that would have quadrupled the amount of dust allowed in mines.
Black lung, a term that encompasses several respiratory diseases, had been in retreat for 20 years, declining 90 percent from the early 1970s among long-term miners.
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