Coal Worker's Pneumoconiosis Treatment & Management
- Author: Farhan J Khan, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP more...
Treatment for both simple coal worker’s pneumoconiosis and complicated coal worker’s pneumoconiosis is symptomatic. Use oxygen as hypoxemia demands.
No evidence supports the hypothesis that removing the miner from the mining environment arrests the disease once progression to progressive massive fibrosis has begun. Therefore, serially monitoring the chest radiographs of miners in order to prevent the development of complicated coal worker’s pneumoconiosis is prudent. Advise workers who develop evidence of simple coal worker’s pneumoconiosis to transfer to jobs with low dust exposure.
Since smoking has an additive effect on coal worker’s pneumoconiosis, smoking cessation should be strongly recommended.
Caplan syndrome is treated similarly to progressive massive fibrosis. Oxygen and bronchodilators are administered as needed. The rheumatoid component is treated separately, per rheumatological protocol.
All patients should receive immunizations for influenzae and pneumococci.
One should strongly consider the possibility of superimposed mycobacterial infection in any patient with unexplained weight loss, chronic cough, fever, or night sweats.
A retrospective study noted good clinical outcomes after lung transplantation in a small group of patients with coal worker's pneumoconiosis. Removal of native lungs was not problematic, and no complications were found during the perioperative and postoperative periods. Furthermore, no pulmonary complications due to the native lung in patients who underwent single lung transplantation were reported.
Consultation with a pulmonary medicine specialist is required.
Morgan WK, Seaton A. Occupational Lung Diseases. Philadelphia, Pa: WB Saunders; 1975. 149-210.
Wade WA, Petsonk EL, Young B, Mogri I. Severe occupational pneumoconiosis among West Virginian coal miners: one hundred thirty-eight cases of progressive massive fibrosis compensated between 2000 and 2009. Chest. 2011 Jun. 139(6):1458-62. [Medline].
Kuempel ED, Wheeler MW, Smith RJ, Vallyathan V, Green FH. Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States. Am J Respir Crit Care Med. 2009 Aug 1. 180(3):257-64. [Medline].
Nemery B. Coal worker's lung: not only black, but also full of holes. Am J Respir Crit Care Med. 2009 Aug 1. 180(3):199-200. [Medline].
Haselton PS. Spencer's Pathology of the Lung. 5th ed. New York, NY: McGraw-Hill; 1996. 475-83.
Boitelle A, Gosset P, Copin MC, et al. MCP-1 secretion in lung from nonsmoking patients with coal worker's pneumoconiosis. Eur Respir J. 1997 Mar. 10(3):557-62. [Medline].
Nadif R, Oryszczyn MP, Fradier-Dusch M, et al. Cross sectional and longitudinal study on selenium, glutathione peroxidase, smoking, and occupational exposure in coal miners. Occup Environ Med. 2001 Apr. 58(4):239-45. [Medline].
Huang X, Li W, Attfield MD, Nadas A, Frenkel K, Finkelman RB. Mapping and prediction of coal workers' pneumoconiosis with bioavailable iron content in the bituminous coals. Environ Health Perspect. 2005 Aug. 113(8):964-8. [Medline].
McCunney RJ, Morfeld P, Payne S. What component of coal causes coal workers' pneumoconiosis?. J Occup Environ Med. 2009 Apr. 51(4):462-71. [Medline].
Borda MJ, Elsetinow AR, Schoonen MA, Strongin DR. Pyrite-induced hydrogen peroxide formation as a driving force in the evolution of photosynthetic organisms on an early earth. Astrobiology. 2001 Fall. 1(3):283-8. [Medline].
Cohn CA, Pak A, Schoonen MA, Strongin DR. Quantifying hydrogen peroxide in iron-containing solutions using leuco crystal violet. Geochem Trans. 2005. 6(3):47-52.
Cohn CA, Borda MJ, Schoonen MA. RNA decomposition by pyrite-induced radicals and possible role of lipids during the emergence of life. Earth Planet Sci Letters. 2004. 225(3-4):271-8.
Cohn CA, Mueller S, Wimmer E, et al. Pyrite-induced hydroxyl radical formation and its effect on nucleic acids. Geochem Trans. 2006 Apr 4. 7:3. [Medline].
Cohn CA, Laffers R, Simon SR, O'Riordan T, Schoonen MA. Role of pyrite in formation of hydroxyl radicals in coal: possible implications for human health. Part Fibre Toxicol. 2006 Dec 19. 3:16. [Medline].
Wang T, Ji X, Luo C, Fan J, Hou Z, Chen M. Polymorphisms in SELE gene and risk of coal workers' pneumoconiosis in Chinese: a case-control study. PLoS One. 2013. 8(9):e73254. [Medline].
Seaman DM, Meyer CA, Kanne JP. Occupational and environmental lung disease. Clin Chest Med. 2015 Jun. 36 (2):249-68, viii-ix. [Medline].
Laney AS, Weissman DN. Respiratory diseases caused by coal mine dust. J Occup Environ Med. 2014 Oct. 56 Suppl 10:S18-22. [Medline].
Baum GL, Crapo JD, Celli BR. Textbook of Pulmonary Diseases. Philadelphia, Pa: Lippincott-Raven; 1998. Vol 1: 683-92.
Centers for Disease Control and Prevention. Changing patterns of pneumoconiosis mortality--United States, 1968-2000. MMWR Morb Mortal Wkly Rep. 2004 Jul 23. 53(28):627-32. [Medline].
Advanced pneumoconiosis among working underground coal miners--Eastern Kentucky and Southwestern Virginia, 2006. MMWR Morb Mortal Wkly Rep. 2007 Jul 6. 56(26):652-5. [Medline].
Beggs JA, Slavova S, Bunn TL. Patterns of pneumoconiosis mortality in Kentucky: Analysis of death certificate data. Am J Ind Med. 2015 Oct. 58 (10):1075-82. [Medline].
Antao VC, Petsonk EL, Sokolow LZ, et al. Rapidly progressive coal workers' pneumoconiosis in the United States: geographic clustering and other factors. Occup Environ Med. 2005 Oct. 62(10):670-4. [Medline].
Centers for Disease Control and Prevention. Pneumoconiosis prevalence among working coal miners examined in federal chest radiograph surveillance programs--United States, 1996-2002. MMWR Morb Mortal Wkly Rep. 2003 Apr 18. 52(15):336-40. [Medline].
Petsonk EL, Rose C, Cohen R. Coal mine dust lung disease. New lessons from old exposure. Am J Respir Crit Care Med. 2013 Jun 1. 187(11):1178-85. [Medline].
Laney AS, Petsonk EL, Attfield MD. The Changing Epidemiology of Coal Workers' Pneumoconiosis in Appalachia - Investigating the Role of Silica Exposure. D42. OUTCOMES FROM OCCUPATIONAL FIBERS AND DUSTS 2009: A5900, 10.1164/ajrccm-conference.2009.179.1_MeetingAbstracts.A5900.
Shen HN, Jerng JS, Yu CJ, Yang PC. Outcome of coal worker's pneumoconiosis with acute respiratory failure. Chest. 2004 Mar. 125(3):1052-8. [Medline].
Reichert M, Bensadoun ES. PET imaging in patients with coal workers pneumoconiosis and suspected malignancy. J Thorac Oncol. 2009 May. 4(5):649-51. [Medline].
Bourgkard E, Bernadac P, Chau N, Bertrand JP, Teculescu D, Pham QT. Can the evolution to pneumoconiosis be suspected in coal miners? A longitudinal study. Am J Respir Crit Care Med. 1998 Aug. 158(2):504-9. [Medline].
Vallyathan V, Goins M, Lapp LN, et al. Changes in bronchoalveolar lavage indices associated with radiographic classification in coal miners. Am J Respir Crit Care Med. 2000 Sep. 162(3 Pt 1):958-65. [Medline].
Noh SR. Availability of the 6-min walk test in coal workers' pneumoconiosis evaluations. Chest. 2010 Jun. 137(6):1492-3. [Medline].
Hayes D Jr, Diaz-Guzman E, Davenport DL, Zwischenberger JB, Khosravi M, Absher KJ. Lung transplantation in patients with coal workers' pneumoconiosis. Clin Transplant. 2012 Jul-Aug. 26(4):629-34. [Medline].
Katabami M, Dosaka-Akita H, Honma K, et al. Pneumoconiosis-related lung cancers: preferential occurrence from diffuse interstitial fibrosis-type pneumoconiosis. Am J Respir Crit Care Med. 2000 Jul. 162(1):295-300. [Medline].