The National Institute for Occupational Safety and Health (NIOSH) is not a government agency with a high public profile. President Richard M. Nixon established NIOSH when he signed the Occupational Safety and Health Act of 1970. In response to the increase in silica-caused black lung disease, Joseph A. Following the 2016 election of President Donald J. Trump, Main was replaced by former coal mining executive David G. Zatezalo. “We haven’t seen this rate of black lung since before the early ’90s,” said Cara Halldin, an epidemiologist at NIOSH.