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July 2009 Location of Retired and Current Miners Potentially Eligible for Services under the Black Lung Clinic Program

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I. LOCATION OF RETIRED MINERS Indicator Data: Black Lung Benefit recipients and applicants Reported cases of black lung disease Historic location of coal mines Historic coal mining employment Pension benefits Health benefits BLCP clinical services and outreach services provided to retired miners (limited to voluntary submissions)

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A. Black Lung Benefit Program 1. Federal Black Lung Program DOL Approved and Denied Applicants Data and Thematic Maps Black Lung Applicants, 2001-Feb. 2009. Black Lung Beneficiaries, Part B (prior to 2001) and Part C (2001-Feb 2009)

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2001- Feb. 2009 Applicants for the DOL Black Lung Program

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2001- Feb. 2009 Applicants for the DOL Black Lung Program (Cont.)

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DOL Black Lung (BL) Applicants 2001 to Feb 2009 STATE Denied/ Approved STATE Denied/ Approved STATE Denied/ Approved WV1,719 2,080WY 117 32OR7 5 PA5,739 1,955GA41 25WI 5 4 KY8,607 1,577CA23 22AK0 2 VA3,018 1098IA34 21DC1 2 OH1,036 339OK35 21LA4 2 TN917 210NM78 19MA1 2 IL1,080 128AR28 18MN2 AL 1801 123SC55 18MS10 2 FL184 112NY16 15ID5 1 IN371 96TX35 12KS11 1 CO91 84AZ54 11ME1 UT150 57DE10 4MT8 1 NC154 49MO43 9NH0 1 MD52 43CT1 9ND1 MI56 40WA8 7SD0 1 NJ37 10NV8 5NE2 0

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Cities with the Most Part C DOL Black Lung Program Beneficiaries BL BeneficiariesCityStateZip code 102BECKLEYWV25801 74GRUNDYVA24614 67PRINCETONWV24740 58PIKEVILLEKY41501 54CLINTWOODVA24228 51POTTSVILLEPA17901 43COEBURNVA24230 42WHITESBURGKY41858 40BLUEFIELDWV24701 40HONAKERVA24260 40CEDAR BLUFFVA24609 39WISEVA24293

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BLCP Current Grantees

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DOL Black Lung (BL) Approved Applicants

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DOL Black Lung Benefits Program All Living Beneficiaries and Denied Applicants (under Part C) 2001- Feb 2009 Applicant Miners by Residential Zip Codes

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Locations of BLCP Funded Sites Overlaid on Applicants to DOL Black Lung Program

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Proximity of Applicant Residences to BLCP Clinics

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Recently Closed Clinic

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Appalachia: East Coast

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Ohio, Indiana, Kentucky

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Mississippi, Alabama

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Florida

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B. Coal Workers Pneumoconiosis (CWP) Cases of CWP/Black Lung Disease 1. CDC Compressed Mortality Files Cause of Death ICD 9 500, ICD 10 J60 Charts and Thematic Maps Total Counts CWP as Cause of Death by State During 1999-2004, 1999-2005. Highest Counties for CWP Mortality

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Multiple Cause of Death, 1999-2004 CWP Mortality (J60) None

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1999-2005 CWP Mortality 2,002

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State CWP Mortality Counts 1999-2004 1.Pennsylvania2,002 2.West Virginia1,033 3.Virginia 520 4.Kentucky 461 5.Ohio 178 6.Tennessee 110 7.Illinois 86 8.Florida 80 9.Mississippi 76 10.Indiana 62 11.Alabama 49 12.Colorado 47 13.North Carolina 46 14.Texas 40 15.Utah 40 16.Michigan 36 17.California 32 18.New York 30 19.Arkansas 26 20.New Mexico 25 21.Maryland21 22.Arizona18 23.Louisiana18 24.Iowa17 25.Georgia15 26.New Jersey15 27.Oklahoma14 28.Missouri12 29.Wyoming11 30.South Carolina 8 31.Wisconsin 8 32.Washington 6 33.Connecticut 5 34.Kansas 4 35.Minnesota 4 36.Oregon 3 37.Montana 2 38.Nevada 2 39.New Hampshire 2

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CountyCount Crude Rate / 100,000 Total2,4010.1 Luzerne County, PA (42079) 27012.2 Schuylkill County, PA (42107) 25824.8 Raleigh County, WV (54081) 11220.2 Northumberland County, PA (42097) 8112.4 Buchanan County, VA (51027) 7742.3 Lackawanna County, PA (42069) 755.1 McDowell County, WV (54047) 5731.3 Fayette County, WV (54019) 5215.7 Tazewell County, VA (51185) 5116.4 Highest CWP Mortality by County: 1999-2005

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CountyCount Crude Rate / 100,000 Cambria County, PA (42021) 454.3 Mercer County, WV (54055) 399.0 Logan County, WV (54045) 3312.7 Pike County, KY (21195) 326.7 Carbon County, PA (42025) 307.1 Wise County, VA (51195) 2910.0 Wyoming County, WV (54109) 2916.5 Fayette County, PA (42051) 282.7 Somerset County, PA (42111) 274.8 Floyd County, KY (21071) 268.8 Mingo County, WV (54059) 2613.4 Harlan County, KY (21095) 2310.1 Kanawha County, WV (54039) 171.2 (Unreliable) CWP Mortality by County: 1999-2005 (Continued)

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CountyCount Crude Rate / 100,000 Perry County, KY (21193) 157.3 (Unreliable) Dickenson County, VA (51051) 1412.3 (Unreliable) Boone County, WV (54005) 147.8 (Unreliable) Franklin County, IL (17055) 134.7 (Unreliable) Clay County, KY (21051) 137.6 (Unreliable) Columbia County, PA (42037) 132.9 (Unreliable) Carbon County, UT (49007) 139.3 (Unreliable) Johnson County, KY (21115) 127.3 (Unreliable) Lee County, VA (51105) 127.3 (Unreliable) Westmoreland County, PA (42129) 110.4 (Unreliable) Martin County, KY (21159) 1011.5 (Unreliable) Colfax County, NM (35007) 1010.2 (Unreliable) Washington County, VA (51191) 102.8 (Unreliable) CWP Mortality by County: 1999-2005 (Continued)

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CWP (ICD 9 500) Nationwide Inpatient Sample Total number of discharges: 2005 2004 2003 2002 2001 10,084 8,819 12,387 14,067 10,865

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C. Historic Location of Mines Indicator Data: MSHA Title 30 Code of Federal Regulations, Part 50 Mining Address/Employment Data Files Thematic Maps a)Coal Mine Sites, by County, 1983-2006 in Relation to BLCP Funding b)Mines 1983-2006 - East Coast Detail

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Locations of Active (or Temporarily Closed) Coal Mines: 1983 2007

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Location of Active Mines: 1983 2007 East Coast Detail

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II. LOCATION OF CURRENT MINERS Indicator Data: Location of active coal mines Coal mining employment BLCP clinical services and outreach services provided to active miners

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A. Location of Active Mines 1.MSHA Title 30 Code of Federal Regulations, Part 50 Mining Address/Employment Data Files Thematic Maps a)Active Coal Mine Sites, by County, in 2007 in Relation to BLCP Funding

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Location of Active Mines: Current and Historic Comparisons

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Location of Active Mines: Current and Historic Comparisons

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B. Coal Mining Employment 1.MSHA Title 30 Code of Federal Regulations, Part 50 Mining Address/Employment Data Files Thematic Maps Total Number of Persons Working at Active Coal Mine Sites, by County, in 2007

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LOCATION OF CURRENT COAL MINERS (BY TYPE)

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State Underground Surface Mill Total West Virginia 11,716 5,968 2,150 19,834 Kentucky 8,663 4,542 1,799 15,004 Pennsylvania 4,363 2,423 602 7,388 Wyoming 205 6,179 6,384 Virginia 2,537 1,168 495 4,200 Alabama 2,413 1,338 68 3,819 Illinois 2,797 435 122 3,354 Indiana 1,160 1,652 34 2,846 Ohio 1,432 966 88 2,486 Texas 2,272 Colorado 1,725 508 5 2,238 Utah 1,647 11 141 1,799 New Mexico 358 865 1,223 Montana 20 972 992 North Dakota 975 Tennessee 146 331 44 521 Arizona 429 Maryland 85 253 52 390 Louisiana 239 Oklahoma 55 134 189 Mississippi 177 Alaska 100 Arkansas 86 2 88 Kansas 51 Missouri 14 States With Most Coal Employees 2007 States without BLCP clinic are in red

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COUNTYSTATE#EMPLOYEES CAMPBELLWY4,988 BOONEWV3,998 PIKEKY3,175 GREENEPA2,666 TUSCALOOSAAL1,941 PERRYKY1,866 WISEVA1,762 LOGANWV1,652 KANAWHAWV1,591 MINGOWV1,588 HARLANKY1,563 SALINEIL1,558 BUCHANANVA1,223 RALEIGHWV1,223 MONONGALIAWV1,214 KNOTTKY1,099 JEFFERSONAL1,083 HOPKINSKY1,066 MARSHALLWV1,004 MCDOWELLWV992 GIBSONIN923 LETCHERKY845 WYOMINGWV821 Counties With Most Coal Employees 2007

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Mine Employees 2007 Contrasted to 1983

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U.S. Mining Trends 1990-1999 Category199919981997199619951990 Percent Change 1998- 1999 Average Annual Percent Change 1995- 1999 1990- 1999 Number of Employees/Miners3 78,72385,41881,51683,46290,252131,310-7.8-3.3-5.5 Underground46,57151,32552,48753,79657,87984,154-9.3-5.3-6.4 Surface32,15234,09329,02929,66632,37347,156-5.7-0.2-4.2 Productivity Total2 6.616.26.045.695.383.836.65.36.3 Underground3.993.93.833.573.392.542.44.25.1 Surface10.399.589.469.058.485.948.45.26.4

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IndustryCode Percent Change 1997-2002 Total Coal mining2121-15.2 Bituminous coal & lignite surface mining212111-8.9 Bituminous coal underground mining212112-19.5 Anthracite mining212113-30.2 Estimated Change in Mining Employment* *(based on limited sampling)

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Average # Contractors 2007 38,865 Total - Nationally

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Number of Active or Temporarily Closed Mines 2007

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BLCP Grantee Clinics in Relation to 2007 Active Mines (by County)

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BLCP Grantee Clinics in Relation to 2007 Mine Employees (By County)

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Review of Summary Conclusions

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Distribution of Retired Miners (DOL Data) Since 2001 through February 2009 36,739 miners applied for DOL benefits from the DOL Black Lung Program of whom 8,309 were approved States with most applicants Kentucky West Virginia Virginia Pennsylvania Alabama Ohio, Illinois, Tennessee, Indiana, Florida, and North Carolina Cities with Most Applicants Major centers in West Virginia and Virginia Kentucky Pennsylvania Other Appalachian States Miners Seem to Migrating to: Neighboring communities Southern Retirement areas (FL, NC, SC, AZ, CA, etc.) East coast, mid-west, and western urbanized areas

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Distribution of Current Miners Nationally, In 2007 there were 77,021 miners working in active or temporarily closed mines States with most current miners West Virginia Kentucky Pennsylvania Wyoming Virginia Alabama Counties with most current miners Campbell, WV Boone, WV Pike, KY Greene, PA Tuscaloosa, AL Perry, KY Wise, VA

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Trends in Distribution of Employment Employment in coal mining has seen a general decline. Leading coal mining states have remained mostly the same overtime, with some shifts seen between states.

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Trends in Coal Workers Pneumoconiosis (CWP) Despite the decline in active miners, CWP cases remain steady over the last 5 years (10,865 discharges in 2001 and 10,084 in 2005) CWP mortality (1999-2004) more closely follows the areas of retired miners applying for benefits than active miners, concentrating in: Pennsylvania West Virginia Virginia Kentucky and Ohio Many cases appearing in retirement states, such as Florida (80).

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Emerging Areas / Gaps in Services Shifts in Active Mining Sites and Employment Major declines in mining employment Employment more concentrated in fewer mines Geographic distribution of mines and employment mostly stable overtime Some active mining and employment falls outside BLCP funded areas (including: Texas, North Dakota and others)

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Emerging Areas / Gaps in Services Retired miners migrating to mid-western metro areas and Southern/Western Retirement areas Mid-western, Mid-Atlantic and Southern States bordering Appalachian area Florida (6 th most DOL applicants) West coast communities, including California

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Distribution of Funding Distribution of BLCP funding on target from a geographic perspective Majority of funds distributed in Appalachia and Rocky Mountain states Large proportions of miners in Texas Majority of mines are lignite, surface mines that may not be as high priority. Need to explore how to expand BLCP impact to address emerging areas where retired miners are settling

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Service Area and Patient Origin Analysis: Sample Slides from Two Grantees

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Alabama Mines by Type (MSHA 2007)

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