In Appalachia, a Father Got Black Lung. Then His Son Did, Too.

Denver Brock and his son Aundra used to spend early mornings hunting rabbits in the wooded highlands of Harlan County, Ky. But they don’t get out there much these days. They both get too breathless trying to follow the baying hounds.

Instead, they tend a large garden alongside Denver Brock’s home. Even that can prove difficult, requiring them to work slowly and take frequent breaks.

“You get so dizzy,” Denver Brock said, “you can’t hardly stand up.”

The Brocks followed a long family tradition when they became Appalachian coal miners. For it, they both now have coal workers’ pneumoconiosis, a debilitating disease characterized by masses and scarred tissue in the chest, and better known by its colloquial name: black lung.

Mr. Brock, 73, wasn’t all that surprised when he was diagnosed in his mid-60s. In coal mining communities, black lung has long been considered an “old man’s disease,” one to be almost expected after enough years underground.

But his son was diagnosed much younger, at just 41. Like his father, he has progressive massive fibrosis, the most severe form of the disease. And today, at 48, he’s even sicker.

When he followed his father into mining, he thought he was entering a safer industry than the one prior generations had worked in. By the 1990s, safety standards and miner protections had nearly consigned the disease to history.