When it comes to black lung disease, here’s the good news: Most people don’t have to worry about it. It isn’t genetic and it isn’t contagious. But the millions of people who work (or used to work) in coal mines around the world may be at risk.
Causes
Black lung disease is considered a job-related illness. You get it when you inhale coal dust over a long period of time. Because it mainly affects coal miners, it’s also known as coal workers’ pneumoconiosis (CWP).
As you breathe in coal dust, particles settle into your airways and lungs. After they land, healthy lung tissue may try to get rid of them.
As your immune system tries to fight and remove the particles, you can get inflammation. Over time, the inflammation can cause scarring, which is also known as fibrosis.
The extent of the disease depends on how much dust has been inhaled and for how long.
There are two types of black lung disease: simple and complicated. Simple CWP means the lung has spots or scar tissue from the dust particles. Complicated CWP is called progressive massive fibrosis (PMF). People with PMF have a lot of scarring on their lungs.
Symptoms
Just because you work in the coal industry doesn’t mean you’ll get black lung disease. Estimates say around 16% of coal miners in the United States eventually may have lung issues from coal dust.
It can take years or decades for the disease to develop. Some people don’t have symptoms until they retire. (Most of the people diagnosed with the disease are over age 50.)
But when symptoms begin to appear, they’re likely to include:
- Cough, with or without black sputum
- Shortness of breath
- Chest tightness
Diagnosis
Doctors will use several pieces of information to diagnose black lung disease. They’ll look at your medical history and ask you details about your exposure to coal dust.
Your doctor likely will order a chest X-ray, CT scan, or both to see if there are any spots or masses on your lungs or signs of inflammation.
A pulmonary function test, which shows how well your lungs work, may also be used.
Treatment
There is no cure. Treatments generally aim to ease symptoms, prevent further damage to your lungs, and improve your quality of life.
Your doctor may prescribe medication to keep airways open, such as inhalers, especially if you have asthma symptoms. Oxygen may be prescribed if your oxygen levels are low, especially when you’re active or sleeping.
If you smoke, your doctor will urge you to quit. Smoking can lead to further lung damage and can make symptoms worse.
Your doctor may recommend a pulmonary rehabilitation program to help you find ways to breathe better.
In very rare cases, your doctor may recommend a lung transplant. You’ll have lots of testing to make sure that you’re healthy enough for the operation and that it will improve your long-term quality of life.
Lastly, your doctor may tell you to avoid all exposure to dust.
Prevention
Black lung disease is a disease related to work, but it is avoidable and preventable.
The Occupational Safety and Health Administration has safety standards for workers at risk for CWP. When they’re on the job, coal workers should:
- Wear a mask.
- Wash dust off exposed skin.
- Wash their face and hands before eating, drinking, or taking medicine.
- Not smoke.
- Get regular chest X-rays.
Federal regulations limit how much coal dust should be in the air. Mines are supposed to follow methods to control the amount of dust. Make sure your employer is following the safety rules.
Also, stay up to date with vaccines to keep your lungs healthy. Since the flu is a leading cause of pneumonia (a lung infection), getting a yearly flu shot is a good idea. And ask your doctor about the pneumonia vaccine.
Prognosis
The number of cases may be on the rise, especially in central Appalachia. This region, which includes parts of Kentucky, Virginia, and West Virginia, is prime coal mine territory.
CWP is different for every person. For patients with simple CWP, the outlook is generally positive. The disease may be stable and not get worse over time.
For people with complicated CWP, or PMF, the disease could get worse over time.
No matter which type you have, expect to have regular visits with your doctor.
Complications
If you have black lung disease, you may get these complications with your lungs:
- Chronic bronchitis, or long-term inflammation of the breathing tubes
- Chronic obstructive pulmonary disease (COPD), an inflammatory disease that blocks airflow from the lungs
- Lung cancer
