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Coal worker's pneumoconiosis

Black lung disease; Pneumoconiosis; Anthrosilicosis

Coal worker's pneumoconiosis (CWP) is a lung disease that results from breathing in dust from coal, graphite, or man-made carbon over a long time.

CWP is also known as black lung disease.

Causes

CWP occurs in two forms: simple and complicated (also called progressive massive fibrosis, or PMF).

Your risk for developing CWP depends on how long you have been around coal dust. Most people with this disease are older than 50. Smoking does not increase your risk of developing this disease, but it may have an added harmful effect on the lungs.

If CWP occurs with rheumatoid arthritis, it is called Caplan syndrome.

Symptoms

Symptoms of CWP include:

Exams and Tests

The health care provider will perform a physical examination and ask about your symptoms.

Tests that may be done include:

Treatment

 

Treatment may include any of the following, depending on how severe your symptoms are:

  • Medicines to keep the airways open and reduce mucus
  • Pulmonary rehabilitation to help you learn ways to breathe better
  • Oxygen therapy
You should also avoid further exposure to coal dust.

Support Groups

Ask your provider about Black Lung Clinics in your area. Information can be found at the National Coalition of Black Lung and Respiratory Disease Clinics website: blacklungcoalition.org/clinics.

Outlook (Prognosis)

Outcome for the simple form is usually good. It rarely causes disability or death. The complicated form may cause shortness of breath that worsens over time.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your provider right away if you develop a cough, shortness of breath, fever, or other signs of a lung infection, especially if you think you have the flu. Since your lungs are already damaged, it's very important to have the infection treated right away. This will prevent breathing problems from becoming severe, as well as further damage to your lungs.

Prevention

Wear a protective mask when working around coal, graphite, or man-made carbon. Companies should enforce the maximum permitted dust levels. Avoid smoking.

References

Cowie RL, Becklake MR. Pneumoconioses. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 73.

Tarlo SM. Occupational lung disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 93.

    • Lungs

      Lungs - illustration

      The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

      Lungs

      illustration

    • Coal worker's lungs - chest X-ray

      Coal worker's lungs - chest X-ray - illustration

      This chest x-ray shows coal worker's lungs. There are diffuse, small, light areas on both sides (1 to 3 mm) in all parts of the lungs. Diseases that may result in an x-ray like this include: simple coal workers pneumoconiosis (CWP) - stage I, simple silicosis, miliary tuberculosis, histiocytosis X (eosinophilic granuloma), and other diffuse infiltrate pulmonary diseases.

      Coal worker's lungs - chest X-ray

      illustration

    • Coal workers pneumoconiosis - stage II

      Coal workers pneumoconiosis - stage II - illustration

      This chest x-ray shows stage II coal worker's pneumoconiosis (CWP). There are diffuse, small light areas on both sides of the lungs. Other diseases that may explain these x-ray findings include simple silicosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse, infiltrative pulmonary diseases.

      Coal workers pneumoconiosis - stage II

      illustration

    • Coal workers pneumoconiosis - stage II #2

      Coal workers pneumoconiosis - stage II #2 - illustration

      This chest x-ray shows coal workers pneumoconiosis - stage II. There are diffuse, small (2 to 4 mm each), light areas throughout both lungs. In the right upper lung (seen on the left side of the picture), there is a light area (measuring approximately 2 cm by 4 cm) with poorly defined borders, representing coalescence (merging together) of previously distinct light areas. Diseases which may explain these x-ray findings include simple coal workers pneumoconiosis (CWP) - stage II, silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

      Coal workers pneumoconiosis - stage II #2

      illustration

    • Coal workers pneumoconiosis, complicated

      Coal workers pneumoconiosis, complicated - illustration

      This picture shows complicated coal workers pneumoconiosis. There are diffuse, small, light areas (3 to 5 mm) in all areas on both sides of the lungs. There are large light areas which run together with poorly defined borders in the upper areas on both sides of the lungs. Diseases which may explain these X-ray findings include complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

      Coal workers pneumoconiosis, complicated

      illustration

    • Coal workers pneumoconiosis, complicated #2

      Coal workers pneumoconiosis, complicated #2 - illustration

      This picture shows complicated coal workers pneumoconiosis. There are diffuse, massive light areas that run together in the upper and middle parts of both lungs. These are superimposed on a background of small and poorly distinguishable light areas that are diffuse and located in both lungs. Diseases which may explain these x-ray findings include, but are not limited to: complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, and metastatic lung cancer.

      Coal workers pneumoconiosis, complicated #2

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

      • Lungs

        Lungs - illustration

        The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

        Lungs

        illustration

      • Coal worker's lungs - chest X-ray

        Coal worker's lungs - chest X-ray - illustration

        This chest x-ray shows coal worker's lungs. There are diffuse, small, light areas on both sides (1 to 3 mm) in all parts of the lungs. Diseases that may result in an x-ray like this include: simple coal workers pneumoconiosis (CWP) - stage I, simple silicosis, miliary tuberculosis, histiocytosis X (eosinophilic granuloma), and other diffuse infiltrate pulmonary diseases.

        Coal worker's lungs - chest X-ray

        illustration

      • Coal workers pneumoconiosis - stage II

        Coal workers pneumoconiosis - stage II - illustration

        This chest x-ray shows stage II coal worker's pneumoconiosis (CWP). There are diffuse, small light areas on both sides of the lungs. Other diseases that may explain these x-ray findings include simple silicosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse, infiltrative pulmonary diseases.

        Coal workers pneumoconiosis - stage II

        illustration

      • Coal workers pneumoconiosis - stage II #2

        Coal workers pneumoconiosis - stage II #2 - illustration

        This chest x-ray shows coal workers pneumoconiosis - stage II. There are diffuse, small (2 to 4 mm each), light areas throughout both lungs. In the right upper lung (seen on the left side of the picture), there is a light area (measuring approximately 2 cm by 4 cm) with poorly defined borders, representing coalescence (merging together) of previously distinct light areas. Diseases which may explain these x-ray findings include simple coal workers pneumoconiosis (CWP) - stage II, silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

        Coal workers pneumoconiosis - stage II #2

        illustration

      • Coal workers pneumoconiosis, complicated

        Coal workers pneumoconiosis, complicated - illustration

        This picture shows complicated coal workers pneumoconiosis. There are diffuse, small, light areas (3 to 5 mm) in all areas on both sides of the lungs. There are large light areas which run together with poorly defined borders in the upper areas on both sides of the lungs. Diseases which may explain these X-ray findings include complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

        Coal workers pneumoconiosis, complicated

        illustration

      • Coal workers pneumoconiosis, complicated #2

        Coal workers pneumoconiosis, complicated #2 - illustration

        This picture shows complicated coal workers pneumoconiosis. There are diffuse, massive light areas that run together in the upper and middle parts of both lungs. These are superimposed on a background of small and poorly distinguishable light areas that are diffuse and located in both lungs. Diseases which may explain these x-ray findings include, but are not limited to: complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, and metastatic lung cancer.

        Coal workers pneumoconiosis, complicated #2

        illustration

      • Respiratory system

        Respiratory system - illustration

        Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

        Respiratory system

        illustration

      Review Date: 5/21/2017

      Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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