coal worker's pneumoconiosis

Coal worker's pneumoconiosis, often called black lung, is the lung disease that develops from breathing coal mine dust over many years. As the fine black dust settles in the lungs and the body tries to wall it off, the affected tissue literally darkens — hence the name — and small scarred spots accumulate where the dust has lodged.

Macrophages engulf the inhaled coal particles and gather around the small airways, forming coal macules and nodules visible as small spots on imaging. In the simple form, lung function may be near-normal despite these deposits. In complicated disease, the nodules enlarge and merge into large fibrous masses — progressive massive fibrosis — that destroy lung architecture and cause serious, progressive breathlessness.

The disease is dose-related, developing after years of exposure, and there is no cure: damage is permanent and management is supportive (oxygen, rehabilitation, vaccination, and stopping further exposure). Coal dust often contains silica, which adds to the harm. Once thought to be declining, black lung has resurged among miners — including younger workers and those cutting into silica-rich rock — underscoring that dust control at the source remains essential.