“It’s time to put the ‘H’ for ‘Health’ back in ‘MSHA,’” Dr. Greg Wagner recently told the annual meeting of the American Public Health Association. Wagner, the Deputy Assistant Secretary for Policy at the Mine Safety and Health Administration (MSHA), will not be alone in this pursuit. Newly confirmed Assistant Secretary of Mine Safety and Health Joseph P. Main has promised to “beef up the health part of MSHA,” through aggressive efforts to reduce miner exposures to coal mine dust and silica. While past rulemaking on these issues has been stagnant, Main and Wagner intend to accelerate them. More immediate is the expected increase in enforcement of existing rules.