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	The Impact of Vocational Rehabilitationists on Employment in the Mining Industry Edwin S. Watson, CRC, CDMS, LPC, Linda Dougherty, MS, CRC Harold Eugene Nelson, RN, CRRN, Michael W. Davis, CBIS-CE The Rehabilitation Professional, April/May/June, 2006

	Introduction Recent tragic events have once again brought the nation’s attention to the hazards of employment in the mining industry. This article includes data from several government Internet sites and information found in a number of recent newspaper articles. The reader is introduced to the importance of coal and a few facts about the industry, the most common hazards associated with mining, particularly underground, as well as the most common types of injuries. We then briefly cover some of the attributes often found in coal miner populations and factors that should be considered when planning services for injured coal miners. Finally, strategies to promote successful vocational rehabilitation outcomes are discussed. The authors recognize we are speaking based on our own experiences and certain issues raised here may or may not apply outside the Appalachian coal fields and West Virginia specifically. It is worth noting the authors include a CRC who is married to a coal miner and a CRRN who worked in the mines for 15 years before becoming a nurse. Statistics If you are familiar with terms such as “shooting coal,” “gob pile,” “rock dusting,” “shoveling belt,” “pinning top” and “running a miner,” you probably have experience working with coal miners. That should not be too surprising since coal is mined in 26 States with Wyoming and West Virginia leading the way in tonnage. Coal is critical to the national economy as over 50% of electricity produced in the United States is coal-generated. (Petrauskis, C. &Pierce, 2003) According to the US Department of Energy (n.d.), 72,000 coal miners were employed by surface and underground mines in 2004 and of that total, nearly 42,000 worked at underground mines. Just 21,000 worked at union operations )United States Department of Energy, n.d.). According to the WV Department of Miners’ Safety and Health (2004, Employment), approximately 40,000 jobs in West Virginia arise out of the mining industry (miners, preparation plant workers, coal truck drivers, construction workers, service and supply firm employees and so forth). In 1978, nearly 63,000 miners were employed in West Virginia and 85 million tons of coal were extracted (West Virginia Office of Miners' Health, Safety and Training, n.d., 1863 - 2003). In 2004, only about 14,000 miners were employed, yet 152 million tons were extracted (West Virginia Department of Miners' Safety and health, 2004, Employment). This reflects the increased mechanization of the industry. Orientation and Training for Coal Miners The first step to becoming a coal miner is to complete an 80-hour mine safety class to secure a miner’s card. The class ensures that the new miner is aware of the dangers that may be encountered while working in the mine. All miners must also attend an 8-hour training class annually to review mine safety, first aid, escape routes, methane exposure and ventilation standards as well as to discuss any new laws that may have been enacted. The miner is also taught how to use new safety equipment. A miner with a new miner’s card works under the designation of “Red Hat” for 6 months. The “Red Hat” is not allowed to run machinery or work in the mine without an experienced worker monitoring him/her at all times. Some mines will not hire inexperienced miners. A miner might be hired by a contractor to work in the mine. The contractor is responsible for the new miner, not the coal company. Once the miner becomes experienced he can then apply for employment with the coal company. Safety Measures in Place By law, all miners are required to wear metatarsal boots and gloves, safety glasses, reflective safety vests, leg bands and hard hats. The mine company must also provide hearing protection and respirators to miners exposed to dust and noise. A certified person, usually a mine foreman often called a Fire Boss, must conduct an initial measurement 8 hours prior to the first shift and at 8 hour intervals during the week. The fire boss monitors the quantity and quality of air entering and leaving the mine and determines the concentrations of methane and oxygen. The fire boss must document all readings in a book which is kept on the surface to be monitored by the inspectors and supervisors. Union mines have a safety committee, a liaison between the company and the union. The committee will approach the company with safety concerns. They also conduct a monthly safety run and report violations and concerns to the company. Each mine foreman conducts a weekly safety class at the start of each shift to discuss recent accidents, prevention of accidents, general safety procedures, handling hazardous materials and self rescuer review. Each miner is reminded to be alert and aware of constant danger. Many mine companies emphasize safety and provide awards to miners who have worked over a period of time without a lost-time injury. Those companies always stress, Safety First. For all practical intents and purposes, all jobs in underground mines are Heavy. One must carefully consider what the Dictionary of Occupational Titles (1991) states regarding the physical demands of underground coal mining occupations. For instance, Continuous Miner Operator is classified as Medium and that may have been accurate when and if the worker simply “ran the miner.” In today’s reality, at union and non-union mines alike, when the Continuous Miner Operator is not actually operating his equipment he will be performing general labor (Heavy). Also, you might encounter two workers classified as Continuous Miner Operators working as a team and they trade off being the operator (Medium) and the helper (Heavy). Another example is Roof Bolter (classified as Medium). In low coal, the Roof Bolter job is Heavy because each and every bolt must be manually bent and straightened as it is placed. Machinery used in underground mining can be divided into different categories, each with different hazards. Machinery is used to mine the coal and to transport coal, supplies and miners. Machines are used in the working “face” of the section where the coal is mined and transported to a beltline to be sent out of the mine. With a few battery-powered exceptions, equipment is powered by AC power cables. Power cables are heavy and usually hung from the mine roof to prevent damage if run over by equipment. Power cables must be frequently moved by hand as the equipment is repositioned. Materials to be used in working sections of an underground coal mine are transported from the surface into the mine by underground rail or rubber-tired haulage machines. The supply cars are driven to the sections where workers unload the supplies, usually by hand, into the scoop, a car which transports the supplies to the working areas of the section. These materials are handled in adverse conditions – low ceiling height/ tight spaces, uneven terrain, muddy areas and poor lighting. These materials are usually heavy and miners are frequently unable to use proper body mechanics when handling materials and equipment. Materials used in mining include: - Wooden timbers and wedges - Concrete block - Steel Bolts (4 to 8 feet long) - Steel Plates - Bolting Resin - Hydraulic Oil (5 gal. cans) - Rock Dust (50 pound bags) - Ventilation Supplies - Conveyor Belt - Belt Structure/Belt Rollers - Electrical Cables - Machinery Parts - Rail & Ties - Tools & Roof Jacks Risks Hazards and environmental risk factors associated with coal mining include: - Lifting requirements (often with no opportunity for “good body mechanics”); - Difficult terrain (uneven, steep, rocky, muddy or wet surfaces); - Seam height (crawling and/or duck-walking required in low coal) - Roof falls/wall slips (highest risk in summer months); - Moving equipment; - Limited lighting; - Explosions and fires (highest methane explosion risk in winter months) - Electrocution (power cables); - Noise (from equipment and blasting; hinders verbal communication); and - Dust. Increased demand for coal has led to rapid price increases, from $31 per ton in 2003 to $58 per ton at present (United States Department of Energy, n.d.). Some extraction sites are now potentially profitable when they were not just 3 years ago. Production expectations may distract attention to safety. Increased demand for coal has led to the first increase in hiring for many years. A typical experienced coal miner is approximately 50 years old and has been employed in the mines for over 30 years. Some of those now hired are inexperienced; others may have not worked in the mines for a number of years following a layoff. Inexperience in a dangerous job increases risk for injury. An Internet search for “dangerous jobs” led to articles not listing coal miner as among the most dangerous based on percentage of fatalities of those employed in that occupation. That is likely to change for 2006. However, fatalities are just the beginning when addressing occupational injuries. Though injury numbers have declined and the 22 fatalities in 2005 (Miner Safety and Health Administration, 2006) were an all-time low for the nation, coal mining is still dangerous work. According to the National Institute of Occupational Safety & Health (NIOSH) branch of the Centers for Disease Control (n.d.), there were 6896 non-fatal, lost-time coal miner injuries in 1995 and 3132 non-fatal, lost-time coal miner injuries in 2004. For the period of 2000 through 2004, NIOSH (Centers for Disease Control, n.d.) broke down the accident classes for lost time underground mining injures: Handling materials....................33.3% Slip & fall of person.................16.5% Fall of ground from place..........15.9% Powered haulage......................11.6% Machinery................................10.8% Hand tools................................06.3% Other........................................05.7% In 2002 there were over 11,000 mining injuries according to the National Safety Council (2004). Though this includes all forms of mining, the percentages they related as shown below are not dissimilar from our own experience (except we believe we encounter a higher number of neck and head injuries in coal mining): Back..........................................24.0% Lower extremity other................09.1% Neck.........................................01.6% Knee.........................................07.9% Trunk other................................06.5% Foot..........................................03.2% Toe...........................................01.0% Finger........................................08.5% Multiple body parts....................09.7% Shoulder....................................05.8% Body systems............................01.4% Head.........................................03.3% Upper extremity other................05.7% Hand.........................................03.9% Eye............................................02.9% From 1986 through 1995, coal mining injuries were broken down as follows by the United States Department of Health & Human Services (2000): Sprains/Strains.........................40.4% Lacerations.............................16.4% Contusions..............................12.2% Fractures.................................10.3% Other ....................................20.7% (Including hernias, amputations, enucleations, burns, electrical shock, head injuries and others) Specific data on brain injury and spinal cord injury due to mining accidents is not readily available. Brain injury can be the result of toxicity from methane gas or carbon monoxide, falls, machinery malfunction and anoxia. Although critical spinal cord injury is diagnosed and treated accordingly, a brain injury which may accompany the spinal injury might be overlooked. Brain injury itself in particular often goes undiagnosed entirely. Therefore, the cognitive, behavioral, emotional and future medical consequences can be ignored completely. Although the devastation from either of these injuries can be catastrophic, neither injury is reflected in the National Safety Council data as it is currently recorded. A miner who experiences a laceration to the head resulting from a ‘fall of ground from place’ as categorized by NIOSH (Centers for Disease Control, n.d.), could easily return to work after a few days of rest or when the laceration is far enough into the healing process and it is no longer a health concern. The United States Department of Labor is responsible for enforcing the rules and regulations that all deep mines and strip mines must follow in the United States. The Mine Safety & Health Administration (MSHA) monitors all retraining and safety in the coal fields. The Federal and State mine inspectors monitor each mine to ensure all rules and regulations are enforced. Inspectors visit the mine on a regular basis and when a complaint has been filed. The mine inspector will issue citations for violations and request the violations be corrected within a certain period of time. Mine inspectors have the authority to close a mine or section of a mine if there is imminent danger. According to the United States Department of Labor (2005), 13.1% of citations issued in 2004 were related to accumulation of combustible materials; a figure over twice the next most frequent violation. Allegations of a poor safety enforcement record by Federal and State officials are longstanding. With a downward trend in injuries over the past several years, the number of Federal mine inspectors has recently declined. David G. Dye advised a United States Senate subcommittee that MSHA has an aggressive enforcement record and citations at coal mines increased by 18 percent from 2000 to 2005 (Ward K., January 24, 2006). Certain amendments to MSHA regulations may be affecting safety. For instance, according to Ken Ward (Belt that burned, January 22, 2006), allowing belt entries to be used as fresh air intakes may have contributed to 2 deaths in West Virginia this year and 13 in Alabama in 2001. Even when a significant fine is levied, appeal often results in a drastic reduction; other fines simply go unpaid. As described by Ward (January 24, 2006, Legislation passes), Wes Addington, a lawyer who represents miners claiming workplace discrimination after complaining about unsafe conditions, just released his own study of MSHA fines issued to Kentucky coal operators. He reported more than $4.1 million in unpaid fines for more than 18,000 citations since 1995; 14 mines have paid 10 to 35%, 30 mines have paid less than 10% and 53 mines have paid nothing. West Virginia lawmakers recently created a rapid response system with a 24-hour emergency hot line. (Ward, K., January 28, 2006). They passed new statutory requirements for immediate emergency notification to regulatory agencies, extra stores of oxygen throughout the mine and wireless emergency communication. Also, every individual underground must wear a State-approved, operator-issued wireless tracking device. It has been estimated implementation at the Sago Mine would cost about $100,000. Upon signing this law, Governor Joe Manchin announced a second round of proposed legislation is coming including a ban on using belt lines as fresh air intakes (ward, K., January 27, 2006). These new West Virginia laws focus on saving lives in entrapment situations. Similar laws are now being promoted at the Federal level and in several other States. Personal Emergency Devices that can penetrate several hundred meters of rock and text-message alerts to miners have been routinely used in Australian mines since the 1990s but in only 19 mines in the United States (Ward, K., January 29,2006) However, Bill Caylor of the Kentucky Coal Association and Don Blankenship of Massey Energy, assert the current technology for wireless communication and tracking does not work in a deep mine (Ward, K., January 28, 2006). Also, Mr. Dye of MSHA expressed doubts about the reliability of this technology (Ward, K., January 24, 2006). In any case, lost-time injuries are still likely to occur with considerable frequency. Why do they do it? So why do underground coal miners go deep into the earth each day despite formidable risks? Pay is certainly a major factor. Coal miners comment they have bills to pay and explain jobs paying less than $10 per hour simply will not pay those bills. Coal miners routinely make $50,000 per year and more (West Virginia Office of Miners' Health, Safety and Training, WV Coal Production, 2004). This is at least twice what they might find in nearly any other job in the Appalachian coal fields for which they are likely to qualify. The average annual wage in West Virginia is $30,383. In addition to holding a job that supports their families well, coal miners are proud to participate in an occupation that follows a family tradition and supports the nation’s economy. The coal miner will tell you, “Coal mining is all I know, it gets into your blood.” Though typically at least a high school graduate, few have skills that readily transfer to employment outside the mines. Many possess less than high school level academic abilities. West Virginians are reluctant to relocate to other areas for employment; those who do relocate return home as often as not. In the coal fields, most jobs that pay well are either in the mines or mine-related. Those jobs require significant physical capabilities or a high skill level or both. For an injured worker displaced from the mining industry by injury residuals, this lack of diversity might mean a long commute from a rural area to a more urban area needed to secure employment in another industry. An injured miner’s return to work in the mines, though admirable and consistent with “return-to-work hierarchies,” means it is very possible that coal miner will sustain more injuries or occupational disease. That can lead to multiple physical impairments resulting in several employment handicaps. This may well include occupational pneumoconiosis (Black Lung) or noise induced hearing loss. While claims for those conditions are most often filed near the end of the coal miner’s career, these conditions certainly might exist prior to such a filing and pose significant vocational rehabilitation obstacles. There is no “light duty” in underground coal mines and relatively little on the surface. This precludes some very practical transitional return to work possibilities. Ready access to timely, quality care is an issue for most living in Appalachian America and is exacerbated by the number of health care providers who will not accept workers compensation patients. This contributes to difficulty with implementation of a goal-oriented treatment plan. When specialists must be seen, long delays often occur. For example, it may take 2 months to see a neurosurgeon in some areas. To complicate matters, injured workers regularly describe feeling they are treated as “second class” patients because their treatment is covered workers compensation. A growing trend of hiring contract employees (essentially “temp” service hires) at mine sites is an issue since there is no traditional employer-employee relationship between the miner and the coal operator for whom the work is being performed. Further, there is no incentive for that coal operator to bring the injured worker back to their workplace upon work release. Aside from excellent adult education programs for GED preparation around much of West Virginia, retraining options for less physically demanding occupations are rather limited. Available facilities often start programs only once a year or are sometimes unable to offer all classes needed for a program underway due to budget issues. Limited local options means an injured worker who does attend school may face a daily commute of 100 miles or more. A long adversarial history between coal miners and coal operators has led to a tradition of mistrust . Circa 1900 immigrants to the Southern West Virginia coal fields worked in company mines using tools and equipment leased from the company. They lived in company housing and rent was deducted from their pay. The company stores charged inflated prices. Miners were paid with “scrip” that could be spent only at the company store. Miners, paid by weight of coal mined, were cheated through “cribbing” where coal cars were altered to hold extra coal. West Virginia fell far behind other major coal-producing states in regulating mining conditions. All this led to violent unionization attempts that culminated in the coal mine wars between armed miners and “guards” employed by coal operators. It ended, not well for the miners, in 1921’s Battle of Blair Mountain when the President ordered in Federal troops (West Virginia Archives and History, n.d.). Rehabilitation strategies Strategies for the rehabilitation professional working with injured coal miners are no different from work with other occupational injury population; early intervention is critical to successful vocational rehabilitation outcomes: Ø Involve everyone; immediate contact with the injured worker, their family, the employer and treating physician upon receipt of the referral; Ø Gain the injured worker’s trust (helps if you are “from around here”); provide full professional disclosure (preferably in writing); Ø Give the injured worker “someone to talk to” about issues faced; Ø Be assertive (but not aggressive) about “getting things moving” (when the injured worker sees such results, that improves trust); Ø Promote a goal-oriented, time-framed treatment plan; recognize when it is time to consider work conditioning/work hardening; Ø Encourage (re-establish if need be) communication between the injured worker and the employer; act as “communication hub” among all parties including the doctor, therapist and claims adjuster; Ø Help the injured worker recognize progress being made, to be an “informed consumer” of his own medical care and to accept responsibility for his/her own rehabilitation; Ø Ask the employer to consider some sort of transitional duty (reduced hours if not reduced physical activity); never mention “light duty.” Ø If return to work in the mines is questionable, make use of the medical recovery time frame: · Encourage the injured worker to begin exploring vocational options; perform or arrange vocational testing to assist the injured worker to identify suitable alternative vocational goals; · Suggest the injured worker participate in developmental classes as may be needed (ABE for a GED, computer classes, community college Math/English prerequisites, etc.); · Refer to other resources as needed; · If working with a coal miner whose spouse does not already work outside the home, some assistance might be offered to that spouse for a job search to supplement the family income that may drop. Conclusion Mining coal is a hazardous occupation with heavy physical demands. Coal miners are loathe to consider alternate occupations because of financial considerations, cultural attachments to the work, limited retraining opportunities and a narrow range of other local vocational choices. Rehabilitation professionals working with injured miners must focus their efforts on return to the pre-injury occupation. The alternatives generally are a problematic course of retraining for an occupation paying, at best, 50% less than the coal miner previously earned (or placement without training for an occupation paying even less) in a job requiring long commutes or relocation. Even so, the rehabilitation professional can be the catalyst needed to achieve a successful outcome. Edwin S. Watson, CRC, CDMS, LPC, is a self-employed rehabilitation counselor with 27 years experience working with injured workers in West Virginia. Linda Dougherty, MS, CRC, graduated from West Virginia University with a Masters Degree in Vocational Rehabilitation Counseling. Mrs. Dougherty is employed by Procura Management as a Case manager working with injured employees in West Virginia. Harold Eugene Nelson, RN, CRRN, is self-employed through Covenant Case Management as a Medical Vocational Nurse Case Manager working with West Virginia and Ohio injured workers since 1997. Mr. Nelson previously worked as an Underground Coal Miner for 15 years. Michael W. Davis, CBIS-CE, is a Certified Brain Injury Specialist and Senior Case Manager for Neurological Case Management Associates in Charleston, WV. Mr. Davis provides case management services to survivors of traumatic brain and spinal cord injuries, to their families and to the professionals who serve them. He primarily works with attorneys who represent these individuals and the injured person's guardians and conservators. References Centers for Disease Control. (n.d.) Distribution of loss-time injuries by accident class, underground mining operations 2000 - 2004. Retrieved on January 22, 2006 from www.cdc.gov/Niosh/mining/statistics/images/acis.gif Miner Safety and Health Administration. (2006). Metal and nonmetal fatal accident review CY 2005. Retrieved February 26, 2006 from http://www.msha.gov/stats/review/2005/mnm-2005fatalreview.pps National Safety Council. (2004). Injury Facts. Itasca, IL; Author Petrauskis, C. & Pierce, C. (2003). Research reports on electricity generation and use. Retrieved February 26, 2006 from www.inee.mu.edu/Capstone%202003/Research%Reports.htm United States Department of Energy, (n.d.) Average number of employees at underground and surface by state and union status. Retrieved January 22,2006 from www.eia.gov/cneaf/coal/page/acr/table20.html United States Department of Health and Human Services. (2000). Retrieved February 26, 2006 from http://cdc.gov/search.do? action=search&queryText=injuries2C=illnesses+and+hazardous+exposures+in+the+mining+industry +1986+-+1995&x=14&y=12 United States Department of Labor. (1991). Dictionary of occupational titles.(4th ed.). (Washington DC. Author). United States Department of Labor. (2005). Most frequently cited standards for 2004. Retrieved on January 22, 2006 from www.mhsa.gov/STATS/TOP20Viols/2004top20coal.asp Ward, K. (2006, January 22) Alma No. 1 belt that burned doubled as fresh air intake. Charleston Gazette. Retrieved on January 22, 2006 from www.wvgazette.com/section/News/20060122 Ward, K. (2006, January 24) Mine safety legislation passes. Charleston Gazette. Retrieved January 24, 2006 from www.wvgazette.com/section/News/20060127 Ward, K. (2006, January 24) U.S. senators query MSHA industry on safety. Charleston Gazette. Retrieved from www.wvgazette.com/section/News/20060124 Ward, K. (2006, January 27) Manchin seeks belt airway ban. Charleston Gazette. Retrieved from www.wvgazette.com/section/News/20060127 Ward, K. (2006, January 28) State following Manchin on new mine safety rules. Charleston Gazette. Retrieved from www.wvgazette.com/section/News/20060128 Ward, K. (2006, January 29) Bush MSHA cast aside text devices. Charleston Gazette. Retrieved January 29, 2006 from www.wvgazette.com/section/News/20060129 West Virginia Archives and History, (n.d.) West Virginia's mine wars. Retrieved on January 25, 2006 from www.wvculture.org/history/mine_wars.html West Virginia Office of Miners' Health, Safety and Training. Production of coal and coke in West Virginia, 1863 - 2003. Retrieved January 26, 2006 from http://www.wvminesafety.org/historicprod.htm West Virginia Office of Miners' Health, Safety and training, (2004). WV coal production and employment 2004. Retrieved January 18, 2006 from www.wvminesafety.org/month2004.htm