A new report from the Center for Public Integrity finds that, after decades of decline, the incidence of black lung disease – a progressive, debilitating, scarring of the lungs that makes breathing difficult for its victims – is rising, particularly among young miners and those in central Appalachia.

The cause: inadequate standards regulating exposure to coal dust and inadequate enforcement. Earlier efforts by the Mine Safety and Health Administration (MSHA) to revise these standards were stymied by opposition from the mining industry. MSHA was expected to publish final rules reducing coal dust exposure limits and updating the techniques for measuring miner exposure in April 2012, but Republicans on Capitol Hill inserted language into the last appropriations bill barring it from doing so until after the Government Accountability Office (GAO) reviews the science behind the revisions. GAO is expected to publish its findings soon.