AtoZ Diseases

What do Doctors call this Condition - Coal worker’s pneumoconiosis, coal miner’s disease, miner’s asthma, anthracosis, anthracosilicosis

What is this Condition?

A progressive lung disease, black lung occurs in two forms. Simple black lung is characterized by small opaque areas in the lung. In complicated black lung, also known as progressive massive fibrosis, masses of fibrous tissue occasionally develop in the lungs.

The risk of developing black lung depends on the duration of exposure to coal dust (usually 15 years or longer), the intensity of exposure (dust count, particle size), the location of the mine, the silica content of the coal (anthracite coal has the highest silica content), and the worker’s susceptibility. Incidence of black lung is highest among anthracite coal miners in the eastern United States.

The prognosis varies. Simple asymptomatic disease is self-limiting, although progression to complicated black lung is more likely if black lung begins after a relatively short period of exposure. Complicated black lung may be disabling, resulting in severe respiratory and heart failure .

What Causes it?

Black lung is caused by the inhalation and prolonged retention of coal dust particles. Simple black lung may cause focal emphysema (permanent dilation of small airways). Simple disease may progress to complicated black lung, involving one or both lungs. In this form of the disease, fibrous tissue masses enlarge and coalesce, causing gross destruction of structures in the lungs.

What are its Symptoms?

Simple black lung causes no symptoms, especially in nonsmokers. Symptoms appear if complicated black lung develops and include shortness of breath on exertion and a cough that occasionally produces inky-black sputum. Other features of black lung include increasing shortness of breath and a cough that produces milky, gray, clear, or coal-flecked sputum. Recurrent lung infections produce yellow, green, or thick sputum.

Complications include pulmonary hypertension, an enlarged heart, and tuberculosis. In cigarette smokers, chronic bronchitis and emphysema may also complicate the disease.

How is it Diagnosed?

The person’s history reveals exposure to coal dust. A physical exam shows a barrel chest, hyperresonant lungs with diminished breath sounds, wheezes, and other abnormal lung sounds. In simple black lung, chest X-rays show small opacities, which may be present in all lung zones but are more prominent in the upper lung zones; in complicated black lung, one or more large opaque areas are seen.

Pulmonary function studies help to evaluate the person’s breathing capacity. In addition, arterial blood gas studies provide information about the amount of oxygen and carbon dioxide in the blood.

How is it Treated?

The goal of treatment is to relieve respiratory symptoms, to manage oxygen deficiency, and to avoid respiratory tract irritants and infections. Treatment also includes careful observation for tuberculosis symptoms.

Respiratory symptoms may be relieved through therapy with drugs that widen the breathing passages (such as Theo-Dur or Aminophyllin), steroids (oral Orasone or an aerosol form), or Nasalcrom aerosol. Chest physical therapy techniques, such as controlled coughing, combined with chest percussion and vibration, help remove secretions.

Other measures include increased fluid intake (at least 3 quarts [liters] every day) and respiratory therapy techniques. In severe cases, it may be necessary to administer oxygen by mask if the person has chronic oxygen deprivation, or by mechanical ventilation. Respiratory infections require antibiotics.

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