Senator WILLIAMS. Will you be back with your experts?

Mr. DUNN. I will certainly be back to hear them, although I do not intend to testify.

Senator WILLIAMS. We want to move along as rapidly as we can to the conclusion of these hearings. Would the end of next week be too early to contemplate their arrival?

Mr. DUNN. I think that would be all right, Senator.

Senator WILLIAMS. We will work that out with you.

Mr. DUNN. Yes. They are scheduled to appear on the House side on March 19, but our witnesses will be available at your pleasure.

Senator WILLIAMS. We can be contacting you in Washington. Senator RANDOLPH (presiding pro tempore). Senator Schweiker, you are a member of the subcommittee, and are intensely interested. as you indicated earlier, in effective legislation in the area of coal mine health and safety. You referred to the people who will now appear, those coming from the Commonwealth of Pennsylvania.

It would be appropriate if you would present these men who will testify.

Will you do that, sir?

Senator SCHWEIKER. Thank you very much, Mr. Chairman.

I want to say that I am delighted to have the privilege to do this, because several of these men have done a great deal of outstanding work in this field, and I would like to introduce them at this time.

Mr. Creany, who is an attorney from Ebensburg, Cambria County, who has examined very closely the problems of the miners in an attempt to solve the health and safety problems; Dr. Goldman, expert in medicine, and who works out of the Johnstown area medical office of the United Mine Workers of America. He has brought along two of the disabled miners, a Mr. Curry and Mr. Michelbacher.

The third one who was scheduled to be here, frankly, is too ill to come today.

I am delighted to have them here. I feel it is extremely helpful to the subcommittee to have this kind of firsthand experience as to what is happening in our coal mines.

I think the story they have to tell will be educational and beneficial to the committee, and I know will guide us very intelligently in our legislative work.

Thank you, Mr. Chairman.

STATEMENT OF EUGENE A. CREANY, ATTORNEY, EBENSBURG, PA.

Mr. CREANY. Senator Randolph and members of the subcommittee, first of all I would like to briefly outline the program which the United Mine Workers have, particularly within the last 10 years, undertaken in our area, which comprises the central area of Pennsylvania, dealing with the coal miners in the soft or bituminous coal field as far north as St. Mary's in Elk County, which borders the State of New York, and as far south as Somerset, which borders the State of Maryland and West Virginia, as far west as New Kensington and Armstrong Coun ty, which again go down to your State, and as far east as over in Clarion, or near Harrisburg.

We have recognized-when I say "we," the United Mine Workers of America have recognized that, contrary to previous medical con

cepts, that soft coal workers were exposed to the same deleterious conditions related to lungs as the anthracite workers, who were exposed to a greater concentrated silicone dioxide hazard.

We have, and I am proud that Senator Schweiker and I are both from the State of Pennsylvania, I believe one of the best occupational disease acts presently, and this has been over many, many years.

The most recent amendment to the act was that on December 1, 1965, which has taken care of a lot of the old coal miners, which prior to that date had not had the benefits of compensation, because of the fact that our act requires, or required prior to that time, that any individual exposed to coal or silica particles had to become totally disabled within 4 years of the date of his last exposure.

Immediately, this has been shown to be practically impossible, since not everyone working in a coal mine, because of his physical ability to withstand the effects of the concentration, becomes totally disabled within this period.

We did find that with the mechanization of the coal industry, there were greater and greater concentrations of coal dust, and the individuals themselves becoming totally disabled and seriously affected with what you have been referring to here in the hearing as black lung.

We have by statute defined it in Pennsylvania as pneumoconiosis, which is a generic term: Coal miner asthma, coal miner's pneumoconiosis, to distinguish from pneumoconiosis which comes from smoking, from inhalation of other deleterious particles.

When the act went into effect on December 1, as a service to all coal miners, and with the permission of President Boyle and the officials of the United Mine Workers, and in an effort to be of service not only to the members of the United Mine Workers, but any prior employees or any aged coal miners who were either not members or had been at some time in the past, for some reason or other no longer members of the United Mine Workers, we filed in our district alone 13,000 claims in the period of 90 days, all of which now either have been decided or are in the process of being decided.

Our process is that initially we have our doctor-when I say “our doctor," I mean a participating doctor of the United Mine Workers Union-examine the individual.

I have today with me Doctor Goldman, whom I brought along as probably the person who might be able to be most expert in this matter, since through the efforts of the United Mine Workers, we have a participating clinic which we call the Ebandjieff Clinic, which services an area comprising perhaps a hundred miles in radius.

He also services and participates in the clinic, which is not maintained but financially supported by the United Mine Workers at Centerville, which is on the West Virginia border, as Senator Randolph knows.

Dr. Goldman has, and has a practice in order to be of service to these individuals, that is, the employees and members of our union particularly at this time, periodically checked these miners from time to

time.

When we find that an individual has progressed-and I am sure that Dr. Goldman will explain to you that this is not a type of disease, it is a condition which occurs as a result of the inhalation of these particles, it is progressive in nature—and when the man's lung condi

tion by X-ray or by ventilation study or exercise tolerance test, reaches a point where physical exertion begins to tell on him, we then advise the man to get out of the mine, and we try to have him apply for benefits.

Unfortunately, some of these individuals are getting younger and younger. They are not able to receive the benefits of the United Mine Workers insofar as pensions yet.

The pension term has been set down to 55, and a lot of them will, of necessity, work until they just cannot go any further.

I would like at this time first to have Dr. Goldman explain to you the progressiveness of this disease.

STATEMENT OF DR. JOEL GOLDMAN, JOHNSTOWN, PA.

Dr. GOLDMAN. Senator Williams and members of the subcommittee, coal worker's pneumoconiosis and silicosis is a progressive disease. The moment the worker is exposed in a mine until the end of his life, his condition will continue to progress, and finally deteriorate. Now, this does not mean that all coal workers, miners, cannot go through a full lifetime of working in mines, but it does mean that healthwise they will continue to show ill effects of being a coal miner. Many of them will go through their time in the mines until they retire, and perhaps go into their 80's and even 90's, in spite of their pneumoconiosis. The presence of pneumoconiosis of course is there.

In working with large numbers of these men, one cannot help but be impressed at the slow, gradual deterioration, healthwise, in a large percentage of them.

The type of mined coal is such that it is almost impossible, at least up to this point, not to have some dust. Of course this is inhaled. Now I will show you first some pictures of actual lungs from the autopsy table, that is, sections of them.

The first picture in the upper row to my left is a healthy lung. This person probably was not ever a coal miner, or perhaps was one of the fortunate ones early in the game.

Senator RANDOLPH. Or he did not smoke cigarettes. Is that right? Dr. GOLDMAN. Cigarette smoking would not give you dust. It will give you emphysema, and don't feel so smug. You should not smoke cigarettes.

The second picture in the top row, to my right, shows the dark discoloration of the tissue, which is of course, coal dust.

Once more, this does not of necessity prevent him from mining coal, but the dust is there.

In the second row, below, we see an advanced stage of the pneumoconiosis, and in the fourth picture we show that the entire upper half of the lung has been replaced by scar tissue with coal dust in it.

This is not a reversible process. Once it starts, it does not stop, and it cannot be removed by any manner that we know.

Now, as a corollary, I will show you what it looks like on X-ray. Mr. CREANY. Before you do that, Doctor, will you please explain the effect on the breathing, or ability of the man to perform in the various stages of his development?

Dr. GOLDMAN. Of course, above, in the first row to the left, he should breathe normally, because it is normal lung. The second one on the

left, once more, he may breathe normally, because the lung does not appear to be breaking down.

But in the second row, the bottom row, I see numerous areas where the air sacs have become so inelastic with coal dust and scar tissue that they have broken and have joined, and they are starting to form what we call emphysema blebs, or just emphysema. So here we have a lung that is becoming rigid with dust and scar tissue and not as much space left to properly cleanse the blood as it goes through the lung.

Now this, of course, will make more work on the heart, so here comes the heart entering the picture, and it is very prevalent that heart disease will accompany the lung disease.

In the last picture in the second row there, we have destruction of at least a third of the lung, and the breathing is extremely difficult, and the heart action is extremely difficult, and this patient is truly an invalid.

I say "patient," because now he is sick and should not be working at all.

Senator BELLMON. Dr. Goldman, assuming a patient is in the condition you show in the upper right-hand photograph, if he were to leave the coal mine at that point, would this condition continue to deteriorate?

Dr. GOLDMAN. This will continue to progress, perhaps not as rapidly, since he is not in a dusty atmosphere, but it will progress until he dies. It cannot be undone.

Senator SCHWEIKER. Doctor, about what length of time? I guess it depends on the exposure. In what length of time does that triggering mechanism begin?

I guess that is pretty hard to define.

Dr. GOLDMAN. That, of course, is impossible to answer. It varies with the individual. Two men can work in adjacent chambers with the same concentration of dust, both coal and silica, and one will be far advanced and one will have very little.

There are many things that have not been explained. I think ventilation may be a factor.

Senator SCHWEIKER. If he left the coal mine in the second stage, as Senator Bellmon asked, could it eventually deteriorate to the last stage there?

Dr. GOLDMAN. It may, or may not, but if he were to get work in some other field, with good fortune it may go no further, with good fortune. Now I am going to show you a perfectly normal lung.

Mr. CREANY. This is by X-ray.

Dr. GOLDMAN. This lung has no dust. He is not a coal miner. There is nothing there but normal-appearing lung.

I will leave that on for a comparison.

This lung shows far advanced pneumoconiosis, with large lesions in the upper part of each lung, with overt span of the lung at the bottom, emphysema trying to take up the load.

This man, of course, is a pulmonary invalid as a result of his exposure to coal and silica dust.

This gentleman here has not nearly as much involvement on X-ray, yet he was too short of breath to continue working as a coal miner. So, you see, we have to add all factors together, exposure, breathing test, called pulmonary function, and an X-ray examination.

26-491-69-pt. 1- -32

The great tragedy is this, that lungs like these do not fight infection well. When they get pneumoconiosis, it is very common to all adults, especially the pneumonias, they have quite a problem.

This winter with the Hong Kong flu, so called, followed by pneumonia, lost so many of these men that I was extremely morbid, because I felt helpless.

So there are many facets to the whole problem.

These miners cannot continue to work, no one will hire them, because every industry has its own health service, including an X-ray of the chest, and once these changes are found, they don't have a chance to work. So actually, they are unemployed and unemployable. I will be glad to answer any questions.

Mr. CREANY. At this time, if the subcommittee would allow me, I would like to introduce the two gentlemen I brought with me.

The gentleman on the end is Elmer Curry. His employment record shows continued employment in the coal industry, bituminous coal industry, from 1921 to November 13, 1965. Originally, his early employment in the earlier years was that of a hand loader, and toward the end of his working career was in transportation, all of his employment being underground.

At the time of our initial interview with this man, he was 59 years of age, and was very reluctant-actually he was 57--we did not file until 2 years later, when Dr. Goldman insisted on his getting out of the mine-he wanted to continue to work. However, as another service of our office, again I speak of the United Mine Workers, the minute we get the report from our doctors that a man is on the borderline or on the brink of becoming totally disabled, as an additional service, at no cost to him, either of legal services or medical services, this is paid for by the United Mine Workers, we try to find and have him evaluated for rehabilitation purposes, to see if we could at this point get this man out of the coal mine and into some work that will best suit him, and he would still have a normal life expectancy, as normal as he possibly could.

In Elmer's case, we were unable. He also has been declared totally disabled for social security purposes. We have the progressive X-rays, and they will match those that Dr. Goldman has placed on the view box.

The other gentleman, next to me, is Carl Michelbacher. At the time of his case coming up, and he had spent from 1925 to 1964 as an underground coal miner, primarily as a rock driller, running a joy or a cutting machine, all of his employment was underground, we found the same condition progressively in his case.

The unfortunate part with this gentleman was that he had at the time of our hearing in March 1965, five children under 18 years of age. To take a man out of the industry at a point where economically he should be most productive for himself and his family is, as Dr. Goldman put it, very discouraging at times in our office.

However, because of the progressiveness again of the radiological evidence of his lung condition, we did implore upon him to get out of the coal mines. We filed his claim.

It is not merely our doctor's word that is taken for it. Under the Pennsylvania law, the company has its own doctor, and they examine him, also. If there is a disagreement between the doctors, then there is