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When I say ‘black lungs’, what do you think of? If you are like most people, you think of a smoker who has blackened his lungs after years of smoking.
And that’s a very appropriate assumption too. But there’s also something called pneumoconiosis , anthracosis, or coal worker’s black lung disease – all of these terms are synonymous.
Anthracosis is an exogenous pigmentation by carbon particles, which affects the skin or tongue.
It is a variety of pneumoconiosis produced by the inhalation of coal dust, which is deposited in the alveoli and the lung interstitium, and is sometimes accompanied by subpleural proliferation of connective tissue and secondary hyalinosis.
The massive deposit causes pulmonary fibrosis.
The word pneumoconiosis comes from ‘pneum / o-‘, which refers to the lungs, ‘-coni-‘, which means dust, and the suffix of ‘-osis’, which denotes a disease process.
Anthracosis is therefore a disease process of the lungs as a result of dust. Many types of dust can cause anthracosis, including asbestos particles ( asbestosis ), silica dust (silicosis), or, in the case of a coal worker, coal dust.
Coal has the prefix of ‘anthrac-‘, and that’s where anthracosis comes from. And because anthracosis actually causes the lungs to blacken, it is more colloquially called black lung disease.
Causes
Anthracosis is a disease caused by inhaling coal dust, usually in small amounts, over many years.
When too much coal dust is inhaled, the body cannot destroy or remove the particles. The accumulation of these particles ultimately causes thickening and scarring of the lungs, which in turn leads to inadequate oxygenation of a person’s blood.
Anthracosis occurs frequently with silicosis. Generally, an exposure of 15 years or more is required before symptoms appear.
Symptoms
People most likely to develop complications from pulmonary anthracosis are residents of large cities, who normally live exposed to highly polluted air, and coal miners.
In the case of miners, to avoid the development of anthracosis, it is recommended to use protective masks, which must be supplied by the company, to avoid injuries to the lung, in addition to washing hands, arms and face before leaving the work environment.
People with anthracosis experience all kinds of signs, symptoms, and sequelae that get worse as the disease progresses, including:
- Short of breath.
- Tos.
- Emphysema, a disease that damages the air sacs in your lungs where oxygen enters your blood.
- An abnormal enlargement of the right side of the heart.
The history of anthracosis
Evidence for anthracosis dates back to the 16th century, however, it was not until the 19th century that significant scientific steps were taken to understand it.
It was during this time that the doctors combined the medical records of the coal workers, including their length of work and pre-death symptoms, with the gross findings of the autopsies.
By gross findings, I mean something thick or large enough to be visible to the naked eye, such as black discoloration of the lung or the hard masses that develop in the lungs as a result of anthracosis.
Diagnostic procedures
A thorough medical history and physical examination revealing exposure to coal dust are essential and may reveal rales or crackles in the lungs, a rattle in the throat (rhonchi), and wheezing.
Chest x-rays, pulmonary function studies, and arterial blood gas analysis will confirm the diagnosis.
Treatment
No specific treatment is necessary for pulmonary anthracosis, being mostly recommended only the removal of the person from the activity and from places that have coal dust.
However, some treatments are strictly symptomatic and generally include the use of bronchodilators and corticosteroids.
Chest physiotherapy will help clear secretions and careful management of respiratory complications, such as tuberculosis or silicosis, which usually occurs in association with anthracosis, is important.
Forecast
The prognosis varies. Simple anthracosis is self-limiting. The complicated form is chronic, progressive, and worsens the prognosis. Complications can be disabling.
Prevention
Prevention of anthracosis involves avoiding charcoal dust.
