Black lung disease is a common name for any lung disease that develops from
inhaling coal dust. This name comes from the fact that those with the disease
have lungs that look black instead of pink. Medically, it is a type of
pneumoconiosis called coal workers' pneumoconiosis (CWP).
There are two forms: simple CWP
and complicated CWP, which also involves progressive massive fibrosis
"Fibrosis" is a term used to refer to scarring, so pulmonary fibrosis means scarring in the lungs. Pulmonary fibrosis can be caused by many conditions, including chronic inflammatory processes (like sarcoidosis or Wegener's granulomatosis), infections, environmental agents (asbestos, silica, exposure to certain gases), exposure to ionizing radiation (such as radiation therapy to treat tumors of the chest), chronic conditions (lupus, rheumatoid arthritis), and certain drugs, such as nitrofurantoin...
The inhalation and accumulation of coal dust causes coal workers'
pneumoconiosis (CWP). This stems from working in a coal mine, coal trimming
(loading and stowing coal for storage), mining or milling graphite, and
manufacturing carbon electrodes (used in certain types of large furnaces) and
carbon black (a compound used in many items, such as tires and other rubber
goods). Because CWP is a reaction to accumulated dust in the lungs, it may
appear and get worse during your exposure to the dust or after your exposure
The severity of CWP depends on the type of coal dust, how much dust was in the air, and how long you have been exposed to it.
Is CWP the same thing as chronic obstructive pulmonary disease (COPD)?
No. Although CWP may share many of the symptoms of
emphysema and/or chronic bronchitis (which are also known as
COPD), CWP is not COPD and is not treated like
What is the course of CWP?
CWP starts with the inhalation and accumulation of coal dust in the
lungs. For many, there are no symptoms or noticeable effect on quality of life.
There may be a cough and sputum (mucus) from inhalation of coal dust, but this
may be more a matter of dust-induced bronchitis. As CWP progresses and is complicated by
PMF, a cough and shortness of breath develop, along with sputum and moderate to
severe airway obstruction. Quality of life decreases. Complications of CWP
Smoking does not increase
the prevalence of CWP, nor does it affect the development of CWP. But it may
add to lung damage and contribute to the development of COPD. Coal workers who
smoke are at much greater risk of developing COPD than nonsmoking coal
How does CWP affect your lungs?
When coal dust accumulates in the lungs, a coal
macule may form. A coal macule is a combination of coal dust and
macrophages. As the disease progresses, macules can
develop into a coal nodule, an abnormality of the lung tissue. In time, a type
of emphysema and fibrosis may develop.
Lung nodules wider than
1 cm (0.4 in.) have been
accepted as evidence of progressive massive fibrosis (PMF), although some
organizations say a minimum width of
2 cm (0.8 in.) is necessary.
Nodules may grow to a large size and hinder or stop the airflow in the lungs'