Silicosis is one of the oldest workplace hazards and public health experts have known for decades how to prevent it. Yet a new wave of workers, from Appalachian coalminers to Latino countertop fabrication workers, are developing and dying from the disease as industry fights new protections and regulators fail to defend the rules that could protect them.

John Robinson’s grandfather developed black lung back when coalminers could spend decades in the mines before being diagnosed with the disease, often dying in their 60s, 70s and 80s. But Robinson, who mined for coal in south-west Virginia, was diagnosed when he was 47. He’s part of a trend that has grown over the past two decades in central Appalachia, where more coalminers are developing black lung disease at younger ages.