Coal worker's pneumoconiosis
Black lung disease; Pneumoconiosis; Anthracosilicosis
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.
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.
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.
This chest x-ray shows stage II coal workers 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.
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.
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.
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.
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
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 for 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:
- Cough
- Shortness of breath
- Coughing up of black sputum
Exams and Tests
Your 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
Support Groups
Ask your provider about treating and managing coal worker's pneumoconiosis. Information can be found at the American Lung Association: Treating and Managing Coal Worker's Pneumoconiosis website:
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:
- Chronic
bronchitis Chronic obstructive pulmonary disease (COPD)Cor pulmonale (failure of the right side of the heart)Respiratory failure
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. Follow directions to prevent high-level exposure. Companies should enforce the maximum permitted dust levels. Avoid smoking.
References
Go LHT, Cohen RA. Pneumoconioses. In: Broaddus VC, King TE, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 101.
Tarlo SM. Occupational lung disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 87.
Version Info
Last reviewed on: 5/3/2023
Reviewed by: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
