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.

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
Cough
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
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Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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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:

Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Chest CT scan
Chest CT scan
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Lung function tests
Lung function tests
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
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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 treating and managing coal worker's pneumoconiosis. Information can be found at the American Lung Association: Treating and Managing Coal Worker's Pneumoconiosis website: www.lung.org/lung-health-diseases/lung-disease-lookup/black-lung/treating-and-managing.

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
Bronchitis
Acute bronchitis is swelling and inflamed tissue in the bronchi, the main passages that carry air to the lungs. This swelling narrows the airways, w...
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Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe. There are two main forms of COPD:Chroni...
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Cor pulmonale (failure of the right side of the heart)
Cor pulmonale
Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the pulmonary arteries of the lung an...
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Respiratory failure
Respiratory failure
Respiratory acidosis is a condition that occurs when your lungs can’t remove all of the carbon dioxide produced by your body. This causes the blood ...
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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.

Open References

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.

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 - 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 - illustration
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.
Coal workers pneumoconiosis - stage II
illustration
Coal workers pneumoconiosis - stage II - 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
illustration
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 - 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
illustration
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration

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 - 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 - illustration
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.
Coal workers pneumoconiosis - stage II
illustration
Coal workers pneumoconiosis - stage II - 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
illustration
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 - 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
illustration
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: 5/3/2023

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.

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Health Library

Coal worker's pneumoconiosis

Causes

Rheumatoid arthritis

Caplan syndrome

Symptoms

Cough

Shortness of breath

Exams and Tests

Chest x-ray

Chest CT scan

Lung function tests

Treatment

Support Groups

Outlook (Prognosis)

Possible Complications

Bronchitis

Chronic obstructive pulmonary disease

Cor pulmonale

Respiratory failure

When to Contact a Medical Professional

Prevention

References

Lungs - illustration

Lungs

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

Coal worker's lungs - chest x-ray

Coal workers pneumoconiosis - stage II - illustration

Coal workers pneumoconiosis - stage II

Coal workers pneumoconiosis - stage II - illustration

Coal workers pneumoconiosis - stage II

Coal workers pneumoconiosis, complicated - illustration

Coal workers pneumoconiosis, complicated

Coal workers pneumoconiosis, complicated - illustration

Coal workers pneumoconiosis, complicated

Respiratory system - illustration

Respiratory system

Lungs - illustration

Lungs

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

Coal worker's lungs - chest x-ray

Coal workers pneumoconiosis - stage II - illustration

Coal workers pneumoconiosis - stage II

Coal workers pneumoconiosis - stage II - illustration

Coal workers pneumoconiosis - stage II

Coal workers pneumoconiosis, complicated - illustration

Coal workers pneumoconiosis, complicated

Coal workers pneumoconiosis, complicated - illustration

Coal workers pneumoconiosis, complicated

Respiratory system - illustration

Respiratory system

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