Howard Berkes at NPR: As Mine Protections Fail, Black Lung Cases Surge

“The mass is larger and more defined in the right upper lobe,” he continues, clinically describing the solid streak that shows up white on the X-ray of his lungs. “If you know white is bad and black is good, I’m in a lot of trouble.”

McCowan went from a clean X-ray at age 35 to progressive massive fibrosis — an advanced stage of coal workers’ pneumoconiosis, or black lung — in just five years.