"There's drilling, blasting, dumping of rock, dumping of coal," he said. "People have had the idea that you're working outdoors in open air, you're not exposed to dust. But you are."
Sanders said companies often wet roads or use vacuums on equipment to control dust.
About half the mines in Eastern Kentucky are surface operations, said Bill Bissett, president of the Kentucky Coal Association.
"It is concerning, because if someone has a case of black lung, we want to know this and do everything we can to prevent the disease," he said. "Why we're seeing more in Appalachian states is a good question."
He said he'll share the study with his members.