Black lung diagnoses for coal miners have doubled in the last decade. A study by the Center for Public Integrity, Black Lung Surges Back In Coal Country, identifies two principal factors: (1) lax enforcement by regulators; and, (2) noncompliance by coal mine operators. The study also faults federal lawmakers, who have refused to pass any laws toughening what are clearly out-of-date and ineffective standards. Most troubling, younger miners are developing the most severe, fastest-progressing type of black lung disease.