President Donald Trump has vowed to return America's declining coal industry to its glory days. But the only real revival of trying to put this polluting fuel back at its peak is its ability to destroy the health of its miners.

U.S. coal miners are suffering from the highest rate of lung disease since 1978 in the mining heartland of central Appalachia, even as U.S. coal production is less than half its all-time high in the late 2000s. If Trump were to somehow magically restore coal demand to full life, he would risk dooming new generations of workers to an incurable, agonizing sickness at an unprecedented scale.

Among all U.S. coal miners with 25 years or more of experience, the rate of pneumoconiosis, the broad class of diseases that includes black lung, a product of inhaling coal dust, was 19.6 percent on average in the five years through 2024, according to a recent report from the National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention.

That was the highest since 1990. The five-year average dipped below 19 percent last year, but the point remains: Nearly 1 in every 5 veteran coal miners in the U.S. today has an illness that seemed mostly tamed at the turn of the century.

The disease is strongest in the central Appalachian states of Kentucky, Virginia and West........

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