title: Lung disease and coal mining: what pulmonologists need to know.
abstract: OBJECTIVE
  Coal mine workers are at risk for a range of chronic respiratory diseases including coal workers' pneumoconiosis, diffuse dust-related fibrosis, and chronic obstructive pulmonary disease. The purpose of this review is to describe coal mining processes and associated exposures to inform the diagnostic evaluation of miners with respiratory symptoms.
  
  
  RESULTS
  Although rates of coal workers' pneumoconiosis declined after regulations were enacted in the 1970s, more recent data shows a reversal in this downward trend. Rapidly progressive pneumoconiosis with progressive massive fibrosis (complicated coal workers' pneumoconiosis) is being observed with increased frequency in United States coal miners, with histologic findings of silicosis and mixed-dust pneumoconiosis. There is increasing evidence of decline in lung function in individuals with pneumoconiosis. Multiple recent cohort studies suggest increased risk of lung cancer in coal miners.
  
  
  CONCLUSIONS
  A detailed understanding of coal mining methods and processes allows clinicians to better evaluate and confirm chronic lung diseases caused by inhalational hazards in the mine atmosphere.
authors.affiliation: aEnvironmental and Occupational Health Sciences Division, University of Illinois at Chicago School of Public Health, Chicago, Illinois bColorado School of Public Health, Aurora cDivision of Pulmonary Sciences and Critical Care Medicine, University of Colorado dDivision of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA.
authors.forename: Leonard H T
authors.initials: LH
authors.lastname: Go
authors.forename: Silpa D
authors.initials: SD
authors.lastname: Krefft
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cohen
authors.forename: Cecile S
authors.initials: CS
authors.lastname: Rose
mesh_terms: D002908:Chronic Disease; D003031:Coal / Q000633:toxicity*; D003032:Coal Mining; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D009784:Occupational Diseases; D016273:Occupational Exposure
chemical_list: D003031:Coal