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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