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I'm just a layman spouting rumor, so please correct me if I'm wrong, but I've heard bad things about the MSHA. Things like how its regulations have been barely updated since the '70s, and how it hasn't actually decreased the rate of death and injury per capita, and how it's easy for those in charge to sidestep most of the regulations.

Here in West Virginia, we see less black lung, for example, but that's because there are fewer folks working in mines. We're actually seeing more PMF (progressive massive fibrosis, the end-stage of black lung) because the few guys still working in the mines are working more demanding hours without the proper PPE.

How many of my assumptions are wrong? What is actually involved in a safety inspection? Who conducts these inspections? And how often do red flags come up?