title: Emphysema and chronic obstructive pulmonary disease in coal miners.
abstract: OBJECTIVE
  Coal mining remains a major industry that has workers at risk for developing chronic lung disease. Aside from simple coal workers' pneumoconiosis and progressive massive fibrosis, the development of emphysema and obstructive lung disease independent of smoking may be underappreciated. This article reviews more recent studies that may help rectify this faulty view.
  
  
  RESULTS
  Cumulative exposure to coal dust is a significant risk factor for the development of emphysema and has an additive effect to smoking. Increased coal dust exposure is associated with increased risk of death from chronic obstructive pulmonary disease (COPD). In newly employed coal miners, bronchitic symptoms are associated with a rapid decline in lung function within 2 years after starting work. In evaluating impairment, the chest radiograph may be helpful as a marker of exposure but the diffusing capacity is most correlated with dyspnea, whereas the emphysema computed tomography score has good association with expiratory flow limitation.
  
  
  CONCLUSIONS
  Latest studies further support the association of emphysema and COPD with coal dust exposure. Increased cumulative exposure may also increase risk of death from these diseases.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. lsantot@mcw.edu
authors.forename: Linus H
authors.initials: LH
authors.lastname: Santo Tomas
mesh_terms: D001991:Bronchitis / Q000175:diagnosis / Q000209:etiology; D003031:Coal / Q000009:adverse effects*; D003032:Coal Mining; D004391:Dust; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D005541:Forced Expiratory Volume; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors
chemical_list: D003031:Coal; D004391:Dust