Coal-worker’s Pneumoconiosis

25/05/2013 by admin | Respiratory

Coal-worker’s Pneumoconiosis

Pneumoconiosis = accumulation of (‘inorganic’) dust in the lungs and the reaction of the tissue to its presence.

Simple pneumoconiosis:

  1. Reflects the deposition of coal dust in the lung.
  2. CXR = micronodular shadowing


Categories of simple pneumoconiosis:

  1. 1. Small round opacities definitely present but few in number
  2. 2. Small round opacities numerous but normal lung markings still visible
  3. 3. Small round opacities very numerous and normal lung markings partly or totally obscured


Simple pneumoconiosis may lead to the development of progressive massive fibrosis (PMF). PMF occurs in 7% of category 2 and 30% with category 3

Progressive massive fibrosis:

  1. Develop round fibrotic masses several centimetres in diameter
  2. Usually upper lobe
  3. Necrotic central cavities
  4. Antinuclear antibodies and rheumatoid factor present (ANA and RhF +ve) – pt may well have scleroderma/RA.


Apical destruction and disruption of the lung occurs in PMF = emphysematous change and:

  1. Dyspnoea
  2. Black sputum
  3. Cough
  4. Coal dust tattoos.


Caplan’s syndrome = Large fibrotic nodules in coal miners (pneumoconiosis) with rheumatoid arthritis 

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