The nation's coal miners have lost an advocate — a pulmonologist who helped create a national movement in the 1960's that focused national attention on the deadly coal miners' disease known as black lung.

Dr. Donald Rasmussen died July 23 at age 87 in Beckley, W.V., where he spent close to 50 years assessing, studying and treating coal miners — more than 40,000 of them, by his account. His work documenting the occurrence of black lung helped trigger a statewide miners strike in West Virginia in 1969.

Congress responded with landmark legislation limiting miners' exposure to coal dust and providing compensation for miners stricken with the disease.

"There were those people who said, 'Well there's no point in doing anything about it.' After all, only four or five percent of coal miners are going to develop lung disease and die," Rasmussen recalled in a 2012 NPR interview.

"That's still quite a few," Rasmussen said, adding that the public health response should be "For heaven's sake, this is a terrible thing."

Rasmussen championed the use of breath tests to measure impaired lung function, an indicator of what is formally known as coal miner's pneumoconiosis. Other physicians and mining companies, lawmakers and state and federal regulators had relied on x-rays to determine the extent of black lung among miners.

"The x-ray's imperfect and the x-ray could fail to reveal a fair amount of pneumoconiosis," Rasmussen said. "It's not at all uncommon to have a miner who, at autopsy, will have quite a bit of pneumoconiosis that didn't show up on an x-ray."

Rasmussen's tests and studies showed that black lung was more widespread and more serious than previously believed.

"Without his curiosity about what was going on with the miners he was seeing, it would have been very difficult for the black lung movement to achieve what it eventually did," said John Cline, a lawyer for miners and widows seeking black lung benefits.

Sickened miners and the families of miners killed by the disease have received more than 40 billion dollars in compensation since the 1969 law was enacted. The money comes from the federal government and from mining companies.

Black lung diagnoses plunged for a while but Rasmussen and others charted a resurgence beginning in the late 1990's. That kept him working in his clinic until recently, when strokes and a fall left him hospitalized. Dr. Donald Rasmussen leaves behind an extended family, and thousands of miners and widows he tried to help.

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Transcript

AUDIE CORNISH, HOST:

The nation's coal miners have lost an advocate - a pulmonologist. His treatment of miners for nearly 50 years led to a national movement aimed at the deadly disease known as black lung. In the 1960s in West Virginia, Dr. Donald Rasmussen diagnosed and studied the disease. His work led to a massive miners strike and landmark legislation and compensation. Dr. Rasmussen died last month at age 87. Here's NPR's Howard Berkes.

HOWARD BERKES, BYLINE: Age and illness didn't stop Donald Rasmussen from studying and diagnosing coal miners at his black lung clinic in Beckley, W. Va. He was 84 when we visited him there three years ago. He'd assessed more than 40,000 coal miners, he told us, in 45 years on the job. And he had more in his waiting and treatment rooms.

(SOUNDBITE OF ARCHIVED BROADCAST)

UNIDENTIFIED NURSE: Suck in real deep - blast.

UNIDENTIFIED MAN: (Wheezing).

UNIDENTIFIED NURSE: Keep blowing. Keep pushing.

BERKES: A retired miner struggled to follow the nurse's instructions...

(SOUNDBITE OF ARCHIVED BROADCAST)

UNIDENTIFIED NURSE: Keep blowing. Keep blowing.

BERKES: ...As he exhaled hard into a tube.

(SOUNDBITE OF ARCHIVED BROADCAST)

UNIDENTIFIED NURSE: Big, deep breath in.

BERKES: Rasmussen stood by taking notes. This breath test is common now for diagnosing black lung, a disease that strips miners of the ability to breathe. Black lung killed more than 70,000 miners in the last 40 years, but there wasn't much concern about it when Rasmussen arrived in West Virginia in 1962.

(SOUNDBITE OF ARCHIVED BROADCAST)

DONALD RASMUSSEN: There were those people who said well, there's no point in doing anything about it. After all, only about 4 or 5 percent of coal miners are going to develop lung disease and die. Well, to me, 4 or 5 people out of 100 - that's still quite a few. And I think any public health measure would say, for heaven's sakes, this is a terrible thing.

BERKES: Still, state and federal regulators and politicians didn't respond. They pointed to x-rays which didn't always show diseased lungs even when miners coughed and struggled for breath. Rasmussen used breath tests instead, which measured impaired lung function, an indicator of what is formally known as coal miner's pneumoconiosis.

(SOUNDBITE OF ARCHIVED BROADCAST)

RASMUSSEN: The x-ray's imperfect, and the x-ray could fail to reveal a fair amount of pneumoconiosis. It's not at all uncommon to have a miner who will - at autopsy, will have quite a bit of pneumoconiosis that didn't show up on an x-ray.

BERKES: Rasmussen shared his tests and studies, but lawmakers balked. In 1969, 40,000 coal miners in West Virginia walked off the job, demanding controls on coal dust and payments for sickened miners. Rasmussen became an activist, spoke with every reporter who would listen and helped trigger raucous black lung rallies like this one, featuring then-congressman Ken Hechler.

(SOUNDBITE OF ARCHIVED RECORDING)

KEN HECHLER: The greatest heroes are you, the coal miners.

UNIDENTIFIED MAN: That's right.

HECHLER: You've taken the future - your future - in your hands, and you've proclaimed no longer are we going to live and work and die like animals. We're free men.

(APPLAUSE)

BERKES: By the end of the year, Congress enacted a tough new mining law. It included limits on exposure to coal dust and compensation for miners and their families. John Cline is a lawyer for miners seeking black lung benefits.

JOHN CLINE: Without his curiosity about what was going on with the miners he was seeing, it would have been very difficult for the black lung movement to achieve what it eventually did.

BERKES: So far, sickened miners and black lung widows have received more than $40 billion in compensation. Black lung diagnoses plunged for a while, but Rasmussen and others charted a resurgence beginning in the late 1990s. That kept him working in his clinic until recently when strokes and a fall left him hospitalized. Donald Rasmussen leaves behind an extended family and thousands of miners and widows he tried to help. Howard Berkes, NPR News. Transcript provided by NPR, Copyright NPR.

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