Mr. MICHELBACHER. I get along real well. I am O.K. financially. I am one of the lucky ones.

Senator WILLIAMS. Do you have anything else, gentlemen?

Senator SCHWEIKER. I have no further questions, Mr. Chairman. I would only like to commend these witnesses for their initiative and leadership in attacking the problems confronting the coal miner, and thank all four of these gentlemen for being with us today. They will be of very great assistance to our committee in its work on coal mine safety legislation.

Senator WILLIAMS. We are most grateful to all of you for coming here to be with us. It is very helpful to the deliberations to have people who are right where the disease happens that we are going to deal with as one of the aspects of bringing greater health to the people working in the mines.

Mr. CREANY. I don't know whether I made it clear to the subcommittee, but the mere fact that they get occupational disease payments does not automatically give them social security disability payments.

Senator WILLIAMS. That has to be established separately?

Mr. CREANY. Right.

Senator WILLIAMS. As a matter of total disability.

Mr. CREANY. Yes.

Senator WILLIAMS. As a compensation lawyer, did you ever win a case before the Pennsylvania statute on pneumoconiosis as an occupationally related disease?

Mr. CREANY. Before the statutes?

Senator WILLIAMS. Yes.

Mr. CREANY. No.

Senator WILLIAMS. Now, there are cancer cases that have been established as occupationally-related, yet there are no statutes that say the occupation did it.

Mr. CREANY. In the cancer case, the only example that I can think of is I can think of the name because it was the first one that went up to the Superior Court in Pennsylvania-is Rose Rebar. Her husband had died. We had established total disability as a result of silicosis during his lifetime. The pathologist was able to causally relate death, and there were no areas of cancer in any other organ except the lung.

In that case, we did win the continued benefits for the widow, but in no other case that I can think of.

Senator WILLIAMS. This was prior to the statute on pneumoconiosis? Mr. CREANY. Yes.

Senator RANDOLPH. Mr. Chairman, as we conclude the hearing today, I want to express my commendation to you for arranging hearings so that we will be hearing from the parties at issue.

These men and others who will come before us, the members of the medical profession, like Dr. Goldman, are important participants in the hearing, as are the union representatives and the industry representatives.

But I can assure those who are following that we shall be hearing from everyone who feels he can make a contribution to the passage of effective legislation. Thank you.

(The following material was subsequently supplied for the record:)

ENGLEHART, CREANY, ENGLEHART & LEAHEY,

Senator HARRISON A. WILLIAMS, Jr.,

Chairman, Subcommittee on Labor and Welfare,
Washington, D.C.

Ebensburg, Pa., March 5, 1969.

DEAR SENATOR WILLIAMS: I acknowledge receipt of your kind letter of February 28, 1969, and am appreciative again of the opportunity of appearing before the Committee and the kind consideration that was given to myself, Doctor Goldman, Mr. Curry and Mr. Michelbacher.

At the close of the session, Mr. Boyd had requested that I prepare a statement to submit to you as an informative measure following closely the testimony that I had presented.

I am therefore enclosing the same for your consideration and request the same be made part of the record in this matter.

Very truly yours, Enclosures.

EUGENE A. CREANY.

STATEMENT RELATING TO PNEUMOCONIOSIS (COAL WORKER'S PNEUMOCONIOSIS) AS A DISABLING FACTOR OF MEN EMPLOYED IN THE SOFT COAL INDUSTRY Over the years it had been accepted as a fact by the medical profession that individuals exposed to a silicon dioxide hazard acquired lung conditions which, upon continued exposure, evidenced itself in the eventual complete destruction of the pulmonary process because of a condition they described as silicosis. This was recognized in the quarries and later in the hard coal mining areas, and hence, the term "anthraco-silicosis".

In the State of Pennsylvania the Occupational Disease Act and the decisions of the Courts did not recognize as a hazard employment in the soft coal industry except in those instances where we were able to prove that a coal worker, while removing coal also during a considerable portion of his time would be removing rock or slate, and individuals working in transportation underground and using white sand, or silica sand, for traction, would likely be subject to the same hazards as workers in the hard coal regions.

The first Occupational Disease Act in Pennsylvania was enacted in 1937 as a supplement to the Workmen's Compansation Act. However, the coal industry rejected the Act and questioned its constitutionality and, because of this, a more acceptable Act was adopted in 1939 and this, too, was rejected by anthracite coal operators. In 1946 the United Mine Workers of America and its operator signatories entered into an amended Agreement which included the general acceptance of provisions of the Occupational Disease Act by the operators. Since that time the Act has been amended in various particulars and the Courts in liberally interpreting the effects of exposure, both in the hard coal and soft coal regions. have finally, by enactment of legislation, given the employees the benefit of the doubt by creating a presumption of exposure so long as they could show employment in the coal industry.

Recent cases have expanded on this to the point where we, in December of 1965, have amended the Act so that there would be no confusion to include pneumoconiosis as it applies to inhalation of coal dust as a definite hazard, and it is no longer necessary to show that silicon dioxide is required to cause the conditions which we find in the soft coal industry. The present Pennsylvania Act requires that a claimant, in order to avail himself of the payment of $12,750.00, which is the "basic" claim, must become totally disabled within four years of his last exposure.

As indicated by Doctor Goldman in his testimony, co-workers in the same area are not, or do not necessarily become affected at the same time or to the same extent. Therefore, the four year statute of limitations was in many cases a bar to recovery of any compensation by an affected coal miner.

With the advent of automation and the increased production of coal, the United Mine Workers, through its various agencies, found that more and more a younger man was disabled and coming to our office seeking assistance. Through the use of its facilities, the United Mine Workers of America were able to further amend the present Occupational Disease Act to obtain benefits for those individuals who could not qualify under the "basic" Act, that is, to become totally disabled within four years of their last exposure. This is an amendment designated as 301 (1) of the Occupational Disease Act. Under this section, although the employee does

not receive the weekly payments based on his earnings to the exhaustion of the initial award, that is, $12,750.00, he does receive presently, if he is totally disabled from this disease, $75.00 per month for the rest of his life. This was an accomplishment which the United Mine Workers felt was necessary to protect those individuals who, although having been exposed for many years, did not become totally disabled until some period beyond the statutory limit.

As the Subcommittee no doubt realizes, although we called pneumoconiosis a disease, this is not, in fact, so! Pneumoconiosis is a generic term applied to many types of lung conditions. As this relates to coal miners employed in the soft coal industry, it is called “coal workers' pneumoconiosis".

Again, as an elementary statement, the function of the lung, of course, is to aid in the process of exchange of gases by the lung method; that is, to inhale oxygen and exhale carbon dioxide. In this process there are small air sacs which take in oxygen and through the various capillaries related to the heart, supply oxygen to all parts of the body and then in the exhaling process remove the used gases in the form of carbon dioxide.

With the mechanization we have found an increase in coal dust in suspension at the face, or working area of the mines. The United Mine Workers as a service to its members, has set up clinics in various areas so as to periodically, by x-ray, check on the progression of the lung condition of the coal miner.

Doctor Goldman is associated with the clinic which is in the heart of District 2, United Mine Workers of America, located at Nanty Glo, and called the Ebandjieff Clinic. He will x-ray the worker periodically and when he moves from the second to the third or advanced stage, in most cases he advises the coal worker to remove himself from this hazard. We find, of course, that many of our members are reluctant to leave the coal mine because of their inability to obtain employment in other industries, particularly if the same requires a physical examination which includes x-rays. We also find that because of the notoriety given this lung condition, the younger men are not following in the footsteps of their father as they had done at the turn of the century.

As graphic demonstration we presented, and I am including in this report. four x-ray plates which were obtained from Professor J. Gough of The Welsh National School of Medicine, a school which has had extensive experience in the effects of coal dust per se on the lungs. We obtained this at a Seminar which was held at Pittsburgh.

The plates are sections of lungs taken at various stages of coal miners. Plate No. 57/466 indicates an early stage of deposits of coal dust. Plate No. 65/225 shows a more advanced stage where emphysema has developed in and around the coal foci. Plate No. 59/95 is a severe coal worker's emphysema with areas of fibrosis. Incidentally, when the coal miner's lung reaches this stage. he is already affected to the point where the lung is working harder to supply oxygen to the various body organs and tissues. Plate No. 66/610 is a characteristic example of progressive massive fibrosis which is the form which causes the greatest disability and is frequently the cause of death. At this point it has been our experience that the heart now has become taxed in its effort to supply the oxygen required by the body because of the inability of the lung to adequately furnish oxygen. The reason, of course, is obvious that instead of air sacs, we have now a condition existing in the lung whereby the air sacs are filled with dust thereby destroying the elasticity of the lung and breathing becomes heavy and taxed.

At this stage, that is the last stage, we also find the workers, through the assistance of the United Mine Workers, being supplied with tanks of oxygen in their homes so as to supply the necessary oxygen for survival. At this stage also we find that the coal worker has acquired what is known as a heart condition "cor pulmonale". This condition is a taxing of the right side of the heart as opposed to the left side where we find generally other heart conditions such as arteriosclerosis, etc. This indivilual, then, is in his last stages of life.

All through the history in Pennsylvania, both in Workmen's Compensation as the same relates to accidents as well as that relating to the health in the form of silicosis, or coal workers' pneumoconiosis, the United Mine Workers has spearheaded legislation toward effective dust control, or at least standards which would lengthen the productive life of the coal workers.

As testified to, the condition that we presented, although not as emotional or as catastrophic as an explosion, is nevertheless as dramatic in that it does produce a slow death, and the United Mine Workers have consistently by the efforts briefly described above spearheaded legislation to protect the worker. It is a sad commentary both to industry and to union that a major catastrophy

must occur before acknowledgment is given to conditions affecting both life and limb.

Mr. Curry, when he became totally disabled, was 58 years of age, and Mr. Michelbacher was 55 years of age. Both of these individuals at that age should have been at their highest productive life. As I had indicated, the process of determining total disability is not only by the Union-affiliated doctor, but also the result of a second examination by a Company selected doctor, and if there is a conflict, an impartial doctor is selected by the Workmen's Compensation Board. So that you can be sure that when this health problem exists to the point that an individual is declared totally disabled for employment in the coal industry, that his lung condition has in fact progressed to the point which we graphically have presented to you.

I trust that this brief excerpt of the condition and graphical examples of the lung will serve to benefit the Subcommittee in considering legislation toward effective dust control in the industry.

I can assure you that the National Office and all of its facilities will cooperate if and when a request is made.

Respectfully submitted.

EUGENE A. CREANY, Esq.