Pneumoconiosis

What is pneumoconiosis?

Pneumoconiosis is a term for lung diseases caused by breathing in certain types of dust. This dust settles deep in the lungs. It can cause an inflammatory reaction and damage the lung tissue.   

The disease has different forms, depending on the type of dust you breathe in. One of the most common forms is coal worker’s pneumoconiosis (CWP). This is also called black lung disease. It’s caused by breathing in coal dust. Another form is brown lung, which comes from working around dust from cotton or other fibers. Other types of dusts that can cause pneumoconiosis include silica and asbestos. Diacetyl, the compound used to give movie popcorn its buttery flavor, can also lead to the disease. This form is called popcorn lung.

Pneumoconiosis can be simple or complicated. Simple pneumoconiosis causes a small amount of scar tissue. The tissue may appear on an X-ray as round, thickened areas called nodules. Complicated pneumoconiosis is known as progressive massive fibrosis (PMF). Fibrosis means that there is a lot of scarring in the lungs.

For both simple and complicated pneumoconiosis, the damage causes the loss of blood vessels and air sacs in your lungs. The tissues that surround your air sacs and air passages become thick and stiff from scarring. Breathing becomes harder. This condition is called interstitial lung disease.

You are likely to be exposed to these dusts only in the workplace. So pneumoconiosis is called a work-related lung disease.

What causes pneumoconiosis?

Pneumoconiosis is caused by breathing in large amounts of certain types of dust over a long time. Your lungs can't get rid of all these dust particles. So they cause inflammation in your lungs. Over time this can lead to scar tissue. Pneumoconiosis often takes years to develop.

Who is at risk for pneumoconiosis?

Being exposed to dust that can cause pneumoconiosis, in an everyday setting, is not enough to cause the disease. But you could be at risk if you've worked around or directly with these dusts. Studies show that coal miners may over time develop interstitial fibrosis from coal dust. Other dust exposures that may put you at risk include working with asbestos fibers or silica dust. Your risk may also be increased by:

• Smoking

• Being exposed to a high level of dust

• Being exposed for a long time

What are the symptoms of pneumoconiosis?

Symptoms often depend on how severe the disease is. Simple pneumoconiosis may have few symptoms and show up only on an X-ray. Complicated pneumoconiosis or PMF may cause mild to severe trouble breathing. Symptoms may include:

• Cough

• Lots of phlegm

• Shortness of breath

• Severe tiredness (fatigue)

• Fever

How is pneumoconiosis diagnosed?

You may be diagnosed with pneumoconiosis if you have symptoms and a history of working around coal, asbestos, or silica. You may also be diagnosed by having a routine X-ray during the time you are working. The Federal Mine Safety and Health Acts require that all underground coal miners be offered a chest X-ray after 3 years and then at 5-year periods to look for the disease. Your healthcare provider may use any of these to help make a diagnosis:

• Past history of work exposure and physical symptoms

• Physical exam

• Chest X-ray to look for lung nodules

• CT scan of the chest

• Pulmonary function studies

How is pneumoconiosis treated?

Pneumoconiosis can’t be cured. Once the disease has been diagnosed, treatment is aimed at keeping it from getting worse and controlling your symptoms. A treatment plan may include:

• Not smoking

• Not being exposed to dust

• Using oxygen

• Taking medicines called bronchodilators that open lung passages

• Vaccination against the flu and pneumococcus

• A lung transplant may be an option in rare cases.

What are the possible complications of pneumoconiosis? 

The main complication is when simple pneumoconiosis progresses to PMF. These are other possible complications:

• Progressive respiratory failure

• Lung cancer

• Tuberculosis

• Heart failure caused by pressure inside the lungs

Can pneumoconiosis be prevented?

Prevention is important because the disease can't be treated or reversed. The Occupational Safety and Health Administration sets standard prevention rules for workers at risk for pneumoconiosis. These are common prevention measures:

• Wearing a mask

• Washing areas of skin that come in contact with dust

• Safe removal of dust from clothing

• Washing your face and hands thoroughly before eating, drinking, or taking any medicines

• Not smoking

• Letting your healthcare provider and your employer know about any symptoms of pneumoconiosis

• Getting regular chest X-rays and physical exams

• Getting a yearly flu shot. The flu is a common cause of pneumonia. Because of that, getting a flu shot every year can help prevent both the flu and pneumonia.

• Getting the pneumococcal pneumonia vaccine. Pneumococcal pneumonia is caused by bacteria that is spread from person to person. It can cause minor problems, such as ear infections. But it can also develop into life-threatening illnesses of the lungs (pneumonia), the covering of the brain and spinal cord (meningitis), and the blood (bacteremia). This vaccine has prevented pneumococcal pneumonia in both adults and children. But as with all vaccines, some people should not get it. Ask your healthcare provider if you should have this vaccine.

Living with pneumoconiosis

Pneumoconiosis is a long-term (chronic) lung disease. Learn as much as you can about your illness and work closely with your healthcare team. Involve close family members in your care and help them learn about the diseases. These tips can help you better manage your health:

• Always call your healthcare provider if you have shortness of breath, a lasting cough, a cough that produces lots of phlegm, or worsening symptoms.

• Get a flu shot every year to help protect your lungs. Ask your provider about getting the pneumonia vaccine.

• Stop smoking and stay away from secondhand smoke. Ask your provider for help quitting.

• Ask your provider if a pulmonary rehab program could help you.

• Try to get regular exercise and plenty of sleep.

• Eat a well-balanced diet. Try frequent, smaller meals if a full stomach makes it harder to breathe.

• Struggling to breathe can make you feel anxious and stressed. Talk about your feelings and seek help from a mental health professional if needed.

• Think about joining a support group. The American Lung Association has Better Breathers Clubs all around the country that can help.

Key points about pneumoconiosis

• Pneumoconiosis is a general term for lung diseases caused by breathing in certain types of dust.

• The disease has different forms, depending on the type of dust you breathe in.

• One of the most common forms is coal worker’s pneumoconiosis. This is also called black lung disease. It’s caused by breathing in coal dust.

• Prevention is important because the disease can't be treated or reversed.

• Prevention includes wearing a mask, not smoking, washing skin that comes in contact with dust, and safely removing dust from clothing.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is advised and what the results could mean.

• Know what to expect if you don't take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions, especially after office hours and on weekends and holidays.