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Pathology of Coal Workers'  Pneumoconiosis

 Dr Sampurna Roy MD                          December 2015

Simple Coal Pneumoconiosis: 

Mild, predominantly distensive enlargement of respiratory bronchioles is associated with mild abnormalities of pulmonary function.

Radiologic examination shows small nodular opacities or linear opacities.          

Visit: Emphysema

Progressive Massive Fibrosis:

Progressive massive fibrosis was first adequately described in coal miners. 

The size and location of the lesions are similar to those in progressive massive fibrosis of  silicosis

The burden of silica in the lung may play a role in its pathogenesis.

The disorder is associated with significant functional disability, and there is usually an obstructive defect, which may or may not be associated with a restrictive defect.

Caplanís Syndrome:  

Caplanís syndrome was originally described in coal miners as the radiographic appearance of large lung masses together with rheumatoid arthritis.

The pulmonary lesions are large (1 cm to 10 cm in diameter), multiple, and bilateral.

Histologic examination shows them to be "rheumatoid nodules", but they differ from classic rheumatoid nodules in that the palisading of fibroblasts at the periphery is less apparent and there is necrosis with an acute inflammatory infiltrate.

Visit: Rheumatoid Nodule

Caplanís syndrome is not confined to coal miners and may occur in silicosis and asbestosis.

Pathogenesis of Coal Pneumoconiosis:

The role of silica in coal pneumoconiosis has long been controversial. Coal miners are often exposed to substantial amounts of silica, and the term antracosilicosis was widely used (Anthracite is a form of coal).

It was subsequently shown that those who worked only with coal (Example: Trimmers who loaded only coal) developed simple coal pneumoconiosis.

It has been suggested that the aggregates of coal particles in macrophages in the walls of respiratory bronchioles weaken the respiratory bronchiolar muscle, thus leading to dilatation.

It has recently been shown that the lesions in coal miners who have also been exposed to high levels of silica are different in that the silicotic nodules in the lung are heavily pigmented with coal.

In addition, progressive massive fibrosis in these subjects closely resembles conglomerate silicosis.

The frequency of coal pneumoconiosis has diminished significantly because of declines in dust levels in underground mines and the increase in strip mining.

                                                   

Further reading:

Rapidly progressive coal workers' pneumoconiosis in the United States: geographic clustering and other factors. .

Coal workers' pneumoconiosis: a study of prevalence in coal mines of eastern Madhya Pradesh and Orissa states of India.

Pneumoconiosis problem among the Vietnamese coal mine workers.

Temporal trends in coal workers' pneumoconiosis prevalence. Validating the National Coal Study results.

Radiographic and pathologic correlation of coal workers' pneumoconiosis.

Levels and clinic significance of serum soluble Fas and soluble Fas ligand in coal workers' pneumoconiosis

Wood charcoal and activated carbon dust pneumoconiosis in three workers.

Role of pyrite in formation of hydroxyl radicals in coal: possible implications for human health.

Mechanistically identified suitable biomarkers of exposure, effect, and susceptibility for silicosis and coal-worker's pneumoconiosis: a comprehensive review.

Evaluation of IL18 and IL18R1 polymorphisms: genetic susceptibility to knee osteoarthritis.

Apoptosis and Bax expression are increased by coal dust in the polycyclic aromatic hydrocarbon-exposed lung..

Changes of tumor necrosis factor, surfactant protein A, and phospholipids in bronchoalveolar lavage fluid in the development and progression of coal workers' pneumoconiosis.

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

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