coal workers' pneumoconiosis

Epidemiology

coal workers

Pathology

• begins as anthracosis
• coal macules
  • < 4 mm in size
  • consists of macrophages, fibroblasts, reticulin & collagen fibers
• collections of coal macules around small airways cause bronchiolar dilatation & focal spongy emphysema
• no increased risk of malignancy or tuberculosis

History

• smoking

Clinical manifestations

• non-specific bronchitis may occur with inhalation of large amounts of coal dust
• melanoptysis (expectoration of black sputum)

Diagnostic procedures

• pulmonary function testing:
• generally normal unless the patient smokes
• slight decrease in FEV1 may be related to centrilobular emphysema
• distinguishes obstructive vs restrictive pattern if abnormal

Radiology

• chest X-ray
  • tiny nodular infiltrates in the upper lung zones
  • micronodules (< 7 mm in diameter)
  • macronodules (> 7 mm in diameter)

Management

• remove from exposure

More general terms

• occupational lung disease

More specific terms

• anthracosis
• hard metal pneumoconiosis; giant cell interstitial pneumonia; cobalt lung