Coal worker's pneumoconiosis

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 of CWP include:

• Cough
• Shortness of breath
• Coughing up of black sputum

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

Tests that may be done include:

• Chest x-ray
• Chest CT scan
• Lung function tests

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

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.

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.

Complications may include:

• Chronic bronchitis
• Chronic obstructive pulmonary disease (COPD)
• Cor pulmonale (failure of the right side of the heart)
• Respiratory failure

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.

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.

Black lung disease; Pneumoconiosis; Anthracosilicosis

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.

Updated 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.