Black Lung Disease

Black lung disease, commonly known as 'coal worker's pneumoconiosis' is a disease caused by the prolonged exposure to coal dust, which gradually accumulates in the lung. It is a type of pneumoconiosis, a chronic respiratory disease. Pneumoconiosis is generally of three types, namely silicosis, asbestosis and the coal workers' pneumoconiosis or black lung disease. Silicosis is caused by the accumulation of silica in the lungs, while asbestosis is caused by the accumulation of asbestos. Black lung disease causes black pigmentation of the lung, and also black saliva which was observed among the coal miners of Europe during 17th and 18th century.

Causes
The main cause of black lung disease is the inhalation of coal dust, graphite and any other man made carbon. It is mainly prevalent among the coal miners, and sometimes also among the workers associated with the production of graphite and carbon black. The disease is mainly caused by the silica and carbon present in the coal dust. The inhaled coal particles builds up in the lung and causes its discoloration. The accumulated coal dust gradually forms coal macule in the lung, which is nothing but a small patch of discolored skin. But eventually, this can develop into small coal lumps or nodules, which get enlarged with constant exposure to coal dust. These are generally found in pulmonary lymph nodes and connective tissues of the lungs, and can not be removed from the body. They can ultimately block the flow of air through the air passages of the lung. Smoking is not related to this disease, though it can contribute to the further damage of the lung, and thereby aggravate the situation.

Symptoms
Usual symptoms associated with the disease are shortness of breath, chronic cough and also obstruction of the air passages. However, sometimes the patients may not show any symptom. However, shortness of breath is not always a symptom of lung diseases and can also be experienced by people after exercise and any other strenuous activity.

Complications
Black lung disease can be classified into two forms, simple, or coal workers' pneumoconiosis (CWP) and the complicated, known as progressive massive fibrosis (PMF). In the initial stage of the disease, patients may not face much problem, and symptoms like cough or difficulty in breathing may or may not be present. But, gradually many complications develop, that can cause strain and enlargement of the right side of the heart, which may result in right-sided heart failure.

Diagnosis and Treatment
The diagnosis of the disease usually begins with the occupational history of the patients, as it is basically an occupational disease. X-ray of the chest, and pulmonary or lung function test can help in detecting the occurrence and severity of the disease.

There are no remedies or cure for the black lung disease. However, treatments are there for alleviating the symptoms and complications. The best way to deal with the disease is preventing further inhalation of coal dust, and also wearing masks while working in the coal mines or any other occupation that involves excessive exposure to carbon.

Black lung disease is a deadly disease that affects a large number of coal miners. Almost 14,000 coal miners died in United States during 1994 to 2004, i.e in the span of just 10 years. Recently, National Institute for Occupational Safety and Health in association with Mine Safety and Health Administration has undertaken a Mobile Heath Screening Program. Under this program, mobile units will visit the mining areas of United States, and would provide free health check-up to the participants once in every five years. This is indeed a very good step in this field, and more of such endeavors are required for the prevention of Black lung disease. Industrial bodies should also cooperate with government to ensure safety to their workers as well for improving their living standard.