Dr. Donald Rasmussen, a Career-Long Campaigner Against Black Lung Disease, Says the New Budget Gives Miners the Shaft
The miners who come to Dr. Donald Rasmussen's clinic in Beckley, W.Va. have only one question to ask him: Have I got black lung disease?
One of the most widely suffered occupational maladies in the U.S., black lung is actually an all-embracing term for a number of ailments all believed to be caused by breathing coal dust. It was first diagnosed in Great Britain in 1813, yet in all the years since, no cure has been found for the disease that kills 4,000 U.S. miners every year. An estimated 70 percent of underground coal miners will be afflicted with some form of black lung during their lives.
To Rasmussen, a tall, gaunt 53-year-old pulmonary specialist who has spent two decades battling the disease, it is still a terrifying puzzle. "There's no sense to it," he laments. "Some miners can work 50 years in the dustiest conditions and not develop any difficulty. Others can work 10 years or less and suffer significant loss of lung function."
The symptoms are severe shortness of breath, a racking cough and a near-suffocating buildup of mucus. Oxygen and medication are prescribed to relieve the periodic attacks of suffocation. Other than that, all Rasmussen can do is to tell the miner to hang his head and chest over the side of his bed while someone pounds on his sides to decongest his lungs.
Federal law mandates that coal dust inside the mines not exceed two milligrams per cubic meter of air, but Rasmussen claims the safety standards are not maintained and, in any case, miners often refuse to wear their company-issue masks because they are uncomfortable.
The federal government would like to wipe out black lung, and not just for humanitarian reasons. In 1981 it will pay out $824 million in black lung benefits to miners, widows and dependents, a third of which comes from a tax on mining firms. Washington must make up the deficit, however, and this rankles the budget cutters in the Reagan administration. They point to a 1980 U.S. General Accounting Office study indicating that 88 percent of all applicants for these benefits offer conflicting medical diagnosis—a blood-gas test might prove positive and X-rays negative on black lung. Dr. Keith W. Morgan, a chest disease specialist at University Hospital in London, Ont., argues that the ailment is really just chronic bronchitis and emphysema caused by smoking. But Rasmussen maintains that up to 10 percent of the miners diagnosed as having black lung (or pneumoconiosis, as it is officially termed) are nonsmokers.
For starters, the Reaganauts intend to tighten qualifications for benefits, which are now so liberal anyone who has worked in a mine for 10 years is "presumed" a black lung victim and may receive up to $559 per month. Last March 170,000 members of the United Mine Workers walked off their jobs to protest the proposed restrictions, and at least 5,000 miners marched on Washington. The current UMW strike is not directly related to black lung, but it has heightened the tension because coal companies believe, under the Reagan plan, they will have to provide a bigger share of benefit funds.
Dr. Rasmussen insists prevention is the best weapon against the disease. A tireless speaker before miners' groups, legislatures and congressional hearings, he has urged better health standards for miners who, as one puts it, "crawl around and breath in dust like rats." Rasmussen, who has conducted more than 100,000 black lung exams since 1963, oversees a staff of eight technicians at his cluttered, informally run clinic. "He is worshiped by miners all over Appalachia," says a colleague. "He was the first really qualified pulmonary physician to take black lung seriously, and they've never forgotten."
The son of a Colorado farmer who later became a veterinarian, Rasmussen became enthralled with physiology, took premed at Utah State, and earned his M.D. at the University of Utah in Salt Lake City. He didn't specialize in lung problems, but when he received his degree in 1962, the only job that interested him was on the staff of Beckley's Miners Memorial Hospital (now Appalachian Regional Hospital). "Once I got here," he says, "and confronted all these chest diseases, I sort of got stuck in it." His first wife divorced him in 1975 after 12 years, apparently because of his total dedication to black lung. His second wife, Jane, a medical technician, says, "My husband is just what he appears to be. He really cares about people and he feels badly when he can't help them."
While Rasmussen has worked closely with the UMW (ex-president Arnold Miller is a black-lung patient), he prefers to avoid politics but insists he has no choice now. The current Reagan proposals, he charges, are "a heartless and hard-nosed way to hurt a lot of people."
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