Radiologists in Kentucky are no longer allowed to read x-rays of miners who claim to have black lung disease under legislation signed into law last week. Instead, the law gives pulmonologists the exclusive right to interpret such studies, according to a March 31 report by NPR.
The law is widely seen as an effort to cut down on claims for black lung disease by passing the responsibility for interpreting the studies from radiologists, who tend to diagnose the disease more often, to pulmonologists, who are seen as being friendlier to the coal industry, according to the article. Previously, any physician certified by the federal government could interpret the studies, according to NPR. The program is colloquially known as the B-reader program.
Another problem with the new law is that only six pulmonologists in the state are certified to interpret black lung studies under the B-reader program, which is administered by the U.S. National Institute for Occupational Safety and Health (NIOSH).
In addition, of these six pulmonologists, four have histories of working for coal mining companies or their insurers, while one is semiretired and will lose his NIOSH certification on June 1. That leaves one pulmonologist who usually works for coal workers rather than companies, according to NPR.
If a miner is able to prove he or she has black lung disease, the benefits are paid by coal mining companies or their insurers. As a result, coal mining firms often challenge the findings of x-ray reports that are positive for black lung.
Fewer miners could qualify for benefits under the new Kentucky law. What's more, NPR quoted a recent study that found that radiologists generally were better than pulmonologists at passing the exam required to become certified under the B-reader program.
The NPR story featured Dr. Brandon Crum, a radiologist in Pikeville, KY, who alerted researchers to a resurgence of black lung disease in his community that occurred from 2015 to 2016. Crum encountered a cluster of 60 black lung cases at his practice, whereas the NIOSH program had previously recorded 99 cases of the disease across the entire U.S. over a five-year period, according to an article in the Week. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) documented their findings in a study published December 2016.
The legislator who wrote the new Kentucky law, Rep. Adam Koenig (R), said he drafted the law based on expertise of "those who understand the issue -- the industry, coal companies, and attorneys," according to NPR.
