(Anthracosis; pneumoconiosis; coal worker’s pneumoconiosis)

Pneumoconiosis of coal miners (CWP) is caused by the inhalation of coal dust. The dust deposit results in the accumulation of dust-laden macrophages around the bronchioles (carbon stain), which occasionally leads to a local bronchiolar emphysema. The CWP usually causes no symptoms, but can become a progressive massive fibrosis (PMF) evolve with impaired lung function. The diagnosis is based on history and chest x-ray findings. Treatment is usually symptomatic.

Pneumoconiosis of coal miners (CWP) is caused by the inhalation of coal dust. The dust deposit results in the accumulation of dust-laden macrophages around the bronchioles (carbon stain), which occasionally leads to a local bronchiolar emphysema. The CWP usually causes no symptoms, but can become a progressive massive fibrosis (PMF) evolve with impaired lung function. The diagnosis is based on history and chest x-ray findings. Treatment is usually symptomatic. Etiology The CWP is caused by chronic inhalation of coal dust (anthracite and bituminous coal) and, rarely, graphite dust, typically about ? 20 years. Inhalation of coal contained in the silicon dioxide can also contribute to clinical disease. Pathophysiology alveolar macrophages engulf the dust, cytokines set free, which cause inflammation and accumulate in the interstitial space around bronchioles and alveoli (coal spots). By the accumulation of collagen, small coal nodules develop, and there is a local emphysema by weakening and expansion of Bronchiolenw√§nde. Fibrosis can occur, but is typically limited to the areas that are in the immediate vicinity of the carbon spots. Destruction of lung architecture, obstruction and functional limitations are mostly geringgradig, but can cause serious damage in some patients. Two forms of CWP are described below: Simple, with individual coal stains complexity, with fusion of spots and PMF patients with a simple CWP develop a PMF in about 1-2% / year. Recently, a rapid progression of CWP to PMF in young miners was v. a. observed in the eastern United States. In PMF the spots coalesce and form black, rubbery parenchymal lesions, which are normally in the upper posterior lung fields. The lesions can spread to blood vessels and airways, destroying them or lead to caverns. A PMF can even develop after termination of coal dust exposure and progress. Despite the similarity of coal-induced PMF and conglomerate silicosis developing a PMF in coal workers is not in proportion to the silica content of the coal. The compound of complications CWP with characteristics of rheumatoid arthritis (RA) has been described in detail. It is unclear whether that CWP coal miners predisposed to develop RA whether RA in CWP patient has a particular expression or whether an RA changed the responses of miners to coal dust. The occurrence of multiple rounded nodules in the lung within a relatively short period of time (Caplan’s syndrome) is a pathophysiological immune response that is related to rheumatoid diathesis. Histologically they resemble rheumatoid nodules, but have acute entz√ľndlicheren rim. Patients with CWP have a slightly increased risk of developing active TB and atypical mycobacterial infections. Weak associations have been described between CWP one hand and the progressive systemic sclerosis, and gastric carcinoma on the other. Symptoms and complaints The CWP normally causes no symptoms. Most chronic pulmonary symptoms in coal miners caused by other diseases such as industrial bronchitis due to coal dust or simultaneously vorliegendes Raucheremphysem. Coughing may be chronic and difficult to treat, even after sufferers have left their jobs. This is true even for Non smoking. The PMF causes progressive dyspnea. Occasionally coughing patient black sputum (Melanoptyse), which occurs when breaking through PMF lesions in the respiratory tract. The PMF often leads to pulmonary hypertension with right heart failure and respiratory failure. Diagnosis exposure history of coal dust chest CT or chest X-ray Diagnosis is based on history of exposure and the chest x-ray or chest CT findings. In patients with CWP show X-rays or CT scans diffuse, small rounded opacities or nodules. The finding of at least one opacity> 10 mm indicates PMF. The specificity of the chest x-ray for PMF is low, as up to a third of the lesions that are held for a PMF out, in the course of the cancer, scars or other diseases. A chest CT is for the detection of confluent nodes, PMF in the early stage and caverns sensitive and specific than an X-ray image. Pneumoconiosis STEVE ALLEN / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: ‘/-/media/manual/professional/images/m2400479-pneumoconiosis-science-photo-library-high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/m2400479-pneumoconiosis-science-photo-library-high_de.jpg?la=de&thn=0’, title: ‘pneumoconiosis’, description:’ u003Ca id = “v37893148 “class = ” anchor “” u003e u003c / a u003e u003cdiv class = “” para “” u003e u003cp u003eDie dark lung fields show a mottled appearance with pattern of white fibrous mass. u003c / p u003e u003c / div u003e ‘credits’ STEVE ALLEN / SCIENCE PHOTO LIBRARY’

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