ATHENS — Josh Wilson walked up the small metal steps in his heavy, paint-spattered work boots.

The Pomeroy native has been a coal miner for a decade, but he hasn’t worked for the past four months. He is only 38 but coughs like an old man — the hacking shakes his whole body. His kidneys recently failed, landing him in the hospital. And now he’s having trouble breathing.

"Especially at night," Wilson said.

So at the insistence of his wife, he is here getting screened for coal workers’ pneumoconiosis, also known as black lung.

The National Institute for Occupational Safety and Health’s mobile occupational safety and health unit — a cross between an RV and a moving van with five different testing stations inside — rolled up to the Walmart in Athens bright and early Friday. NIOSH is the arm of the Centers for Disease Control and Prevention that deals with worker safety.

The mobile testing unit made stops in Ohio, Kentucky, Virginia and West Virginia. Other Ohio locations were Harrison, Guernsey, Monroe, Muskingum, Perry and Tuscarawas counties. Athens was the last stop on the tour.

The screenings include a workplace questionnaire, chest X-ray and spirometry testing. They are free and confidential. Participants get results mailed to their homes within 10 weeks.

Wilson was among many coal miners screened for black lung in the NIOSH mobile testing unit.

Coal miners are especially vulnerable to black lung because they work in an environment where coal dust is always in the air. Symptoms include a persistent cough and shortness of breath. For some miners, the disease doesn’t progress and they continue about their normal lives. For others, if not caught early on, the disease can be deadly.

Many tested Friday had been coal miners for decades. Their fathers had been coal miners and their fathers’ fathers had been coal miners. Many of their sons are coal miners.

The Federal Mine Safety and Health Act of 1977 allows miners who can prove they have developed black lung to get transferred to a position with no dust exposure. Many miners, however, do not take advantage of this option, said Anita Wolfe, a public health analyst for the CDC.

"They don’t want to be labeled as sick," Wolfe said.

Since 2000, cases of the disease have surged, according to NIOSH data. Wolfe said more coal miners have been screened this year than in the past.

One-tenth of coal miners who have worked underground for at least 25 years have black lung, according to a NIOSH report released last month. For that same population of miners in Kentucky and West Virginia, one in five has black lung. Fewer than 10 Ohio miners screened from 2005 to 2014 had black lung, according to data from the CDC.

New mining practices in central Appalachia might be causing more exposure to hazardous dust, the CDC said. But because black lung takes years to develop, the exact cause of the uptick in cases of black lung is unknown.

The organization alerts miners in the area about the screenings via a letter mailed to their homes. Past participants also get a letter.

Gregory Hatfield has been retired from coal mining for five years. Hatfield said he was never afraid of being underground, but he is afraid he might have black lung. So the 67-year-old gets screened.

When he was younger, working in the Meigs No. 2 mine, Hatfield said he saw safety gear like earplugs and face masks as a hindrance to his work and did not wear them. "Macho stupid stuff," he said.

Now, if his health issues clear up and he can get back to work, Hatfield said he would follow all of the safety precautions.

He said he wants to be around to raise his two children, who start back to school next week.

For Wilson, Hatfield and the other miners screened Friday, the threat of black lung is very much present.

"You only get one life. You gotta take care of it," Wilson said. "You don’t want to go along thinking everything is fine and then fall over dead one day."

bmeibers@dispatch.com

@BMeibers