Learn About Coal Worker’s Pneumoconiosis

Key Facts

  • Coal worker’s pneumoconiosis, or black lung, is one of over 200 types of pulmonary fibrosis and is classified as an interstitial lung disease. Your doctor may refer to your disease by any of these terms.
    • Fibrosis - the development of fibrous connective tissue as a reparative response to injury or damage
    • Interstitial Lung Disease - Interstitial lung disease (ILD) is an umbrella term used for a large group of diseases that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs which makes it difficult to breathe and get oxygen to the bloodstream. Lung damage from ILDs is often irreversible and gets worse over time. 
  • An estimated 16% of coal workers are affected and after decades of improvement, the number of cases of black lung disease is on the rise again.
  • There is no cure for coal worker’s pneumoconiosis, but treatment can help manage symptoms and improve quality of life.
  • The Occupational Safety and Health Administration (OSHA) has safety standards to help workers employers and workers take steps to prevent black lung disease.

What Causes Coal Worker’s Pneumoconiosis?

Black lung disease can develop when coal dust is inhaled over a long period of time. Coal dust is made of dangerous carbon-containing particles that coal miners are at risk of inhaling, which is why it is mostly considered an occupational (workplace) disease. Coal miners may also be exposed to silica-containing dust because coal mining may involve some drilling into silica-containing rock.

However, not all workers will develop the disease. Recent studies have found that about 16% of coal miners in the U.S. will contract the disease. This number has been increasing in recent years, which may be linked to changes in mining technology that allow for higher volumes of coal to be extracted in a given time period and changes in the mineral content of the coal that make it more hazardous.

How It Affects Your Body

When the coal dust is inhaled, the particles can travel through the airways all the way into the alveoli (air sacs) that are deep in the lungs. After the dust particles land and settle in the lung, lung tissue may try to get rid of the dust particles, causing swelling as the body tries to fight the foreign particles. In some cases, the swelling is severe enough to cause scar tissue to form. The damaging effects of the inhaled coal dust may not show up for many years, and many patients don’t develop symptoms until long after their initial exposure.

For coal worker’s pneumoconiosis, the scarring can be separated into two types: simple or complicated. In simple pneumoconiosis, a chest X-ray or CT scan will reveal small amounts of scar tissue, seen as tiny, circular nodules on the lungs. Complicated pneumoconiosis, also called progressive massive fibrosis, involves more severe scarring over a larger area of the lung tissue. In both types, your breathing will be negatively affected.

Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.

Page last updated: July 26, 2023

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