Modern Occupational Diseases Diagnosis, Epidemiology, Management and Prevention

Coal Workers Pneumoconiosis

Author(s): Rafia Zulfikar* and John E. Parker

Pp: 74-103 (30)

DOI: 10.2174/9789815049138122010009

* (Excluding Mailing and Handling)

Abstract

Coal Worker’s Pneumoconiosis (CWP) was thought to be an archaic disease, but after an initial decline because of the Coal Mine Health and Safety Act in 1969, there has been a resurgence of this disease in the 21st century. For centuries, miners have been exposed to varied types and degrees of coal mine dust. Lung diseases in coal miners are caused by the inhalation, retention, and tissue reaction to the mixed constituents of this dust, which include carbon, silica, and silicates. Respirable dust particles of less than 5 microns are deposited in the proximal and distal airways and the smaller particles are deposited in the alveoli. The tissue reaction to these particles results in a variety of pathologic lesions, including coal macules, silicotic nodules, mixed dust pneumoconiosis, interstitial fibrosis, progressive massive fibrosis, bronchitis, and emphysema. These disorders are recognized primarily through occupational exposure history and characteristic radiographic imaging. With a latency of approximately 20 years, cumulative lifetime exposures appear to be most predictive of the disease severity. Prevention of these diseases should be the primary focus of the industry, the workforce, and the public health agencies. In the US, federal programs of screening and surveillance are in place and active. The treatment of these disorders as with other chronic respiratory conditions, is focused on vaccinations against respiratory infection, bronchodilator therapy when indicated, supplemental oxygen therapy when required, pulmonary rehabilitation programs, smoking cessation, vigilant observation for chronic respiratory infections, and if necessary, lung transplantation should be considered as the last resort.


Keywords: Antifibrotics, Black Lung, CMDLD, CWP, ILO, Lung transplantation, NIOSH, PMF, Pneumoconiosis, Prevention, Pulmonary rehabilitation, Resurgence, Sea coal, Vaccinations.

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