More than 1,700 coal miners died from black lung between 2020 and 2023, according to an earlier NIOSH study. A Federal Silica Rule Still Not Being EnforcedThe regulatory backdrop is central to why researchers expect the numbers to worsen. Working underground miners are entitled to periodic chest X-ray screening at no cost through the federal Coal Workers' Health Surveillance Program. More than 26,000 miners or surviving dependents drew benefits from the federal black lung trust fund in 2024, according to a Labor Department report to Congress. Working underground miners can receive free periodic chest X-rays through the federal Coal Workers' Health Surveillance Program.