PNEUMOCONIOSIS

Miner’s Asthma or Black Lung Disease

Pneumoconiosis, also known as “coal worker’s pneumoconiosis” is a lung condition caused by the inhalation of dust, characterized by formation of nodular fibrotic changes in the lung tissue. These changes may be in the form of industrial bronchitis, a condition which abates 3-6 months following the cessation of exposure, or permanent changes in the lung parenchyma, taking the form of macules, micronodules, macro-nodules, or progressive massive fibrosis. The changes may be exhibited on chest x-rays or CT scans of the chest.

Rarely does simple pneumoconiosis cause significant pulmonary problems. Coal miners with simple coal worker’s pneumoconiosis with obstructive airways dysfunction usually have been or are tobacco smokers. Many substances can cause pneumoconiosis including asbestos, talc, coal mine dust, kaolinite and other metal compounds.

Depending on the type of dust, variants of the disease are considered. For example, there are silicosis, also known as grinder’s disease; and pneumosilicosis, which is caused by the inhalation of the dust of stone, sand, or flint containing silica. Many common minerals contain silica, resulting in different types of silicosis.

What Is It?

Pneumoconiosis is a lung condition that is caused by inhaling particles of mineral dust, usually while working in a high-risk, mineral-related industry. At first, irritating mineral dust can trigger lung inflammation, which causes areas of the lungs to be temporarily damaged. Over time, these areas can progress to form tough, fibrous tissue deposits. This stage of pneumoconiosis is called fibrosis. Fibrosis stiffens the lungs and interferes with the lung’s normal exchange of oxygen and carbon dioxide.

There are several different types of pneumoconiosis. The most common include:

• Asbestosis-This is a general term for a family of irritating fibrous minerals that are mined from underground deposits and used in the manufacture of home insulation, fireproof materials, tiles for floors and ceilings, automobile brake linings and other products. Workers with the highest asbestos exposure include miners, construction workers, demolition workers, shipbuilders and auto mechanics who work with brakes. Asbestos exposure also can affect those who live or work in buildings where asbestos-containing building products are deteriorating. In most cases, signs of asbestos do not develop for 20+ years after a person is first exposed to asbestos dust.

• Silicosis-This form of pneumoconiosis affects people who work with silica, usually in the form of quartz that is found in sand, sandstone, slate, some clays, granite and other ores. Workers with the highest exposure to silica include sandblasters, miners, tunnel builders, silica miners, quarry workers, foundry workers and those who make ceramics or glass. Silicosis can cause progressive fibrosis in the lung with significant decrease in lung function, especially in cigarette smokers.

• Coal worker’s pneumoconiosis-This type is caused by inhaling carbon particles from coal, graphite, lamp black or carbon black (a finely powdered black soot used as a pigment material in paints, enamels and printing inks). It most often affects people who mine, process or ship coal; graphite miners; and workers who manufacture synthetic graphite, lamp black or carbon black products. Like silicosis, coal worker’s pneumoconiosis can cause significant fibrosis, primarily in miners who have worked for decades without protective equipment.

Signs and Symptoms

Pneumoconiosis sometimes does not cause any symptoms, however, when symptoms do develop, they can include:

• Cough (with or without mucus)

• Wheezing

• Shortness of Breath, especially during exercise

If pneumoconiosis causes severe lung fibrosis, breathing can become extremely difficult. When this happens, the patient’s lips and fingernails may have a bluish tinge. In very advanced disease, there may also be signs of leg swelling caused by too much strain on the heart.

Diagnosis

Your doctor will ask about your exposure to mineral dusts, the number of years you were exposed, and whether you used protective clothing and equipment. Your doctor will examine you paying close attention to your chest; this will be followed by a chest x-ray, which will be compared to a set of standard x-rays published by the International Labor Office for the evaluation of pneumoconiosis. Pulmonary Function breathing tests may be ordered. In some cases, a more detailed evaluation of the chest will be necessary resulting in a CT scan. Less often, a doctor will order a test called a bronchoscopy with a lung biopsy. In this test, a flexible tube is inserted into a lung and a small piece of lung tissue is removed to be examined in a laboratory setting.

Prevention

Pneumoconiosis almost always can be prevented. Recommendations to reduce the risk are:

• Limit work-related exposure to mineral dusts

        Workers who routinely deal with mineral dusts should always use protective equipment and clothing to limit their                  exposure and keep from bringing mineral dust home on their own clothing. If a mask or respirator is worn as a                        protection against dust, it must fit properly and be used according to the manufacturer’s directions.

• Prevent Exposure to asbestos at home

       Check your house, especially older homes, for areas of exposed asbestos-containing insulation or deteriorating                     asbestos. If discovered, these areas must be removed or safely sealed away (encapsulated) by a professional.

• Avoid cigarette smoking, e-cigarettes and tobacco use

       E-cigarettes (battery-operated) are modelled after regular cigarettes. They were invented in 2003 as an alternative           to conventional smoking. They are composed of a battery component, an atomizer and a cartridge containing either         nicotine or a non-nicotine liquid solution. When the device is operated, the battery heats the liquid in the cartridge and         the atomizer vaporizes the liquid, thereby emitting a mist that the user inhales. This practice is commonly described             as vaping and is used in reference to include vape pens and e-hookahs.

       In 2019 a dramatic rise in lung disease has been associated with vaping and has raised safety concerns. Research                 published has suggested that e-cigarette use is linked to hard-metal pneumoconiosis, a rare lung disease caused by           the inhalation of toxic materials, such as cobalt, tungsten, nickel and titanium. Metal workers and those who sharpen           tools or polish diamonds are at an increased risk of the condition. It has been shown to cause fibrosis of the lungs and           falls into the same category as others increasing the risk of developing pneumoconiosis over time.

       All types of smoking worsen the harmful effects of pneumoconiosis. If you smoke, consult with your doctor on proven           ways to quit.