Clinical features and prognosis

Patients with significant amount of disease will have symptoms of shortness of breath, cough, chest tightness, and/or wheezing. Those with less significant disease will have no respiratory symptoms.

Simple/mild pneumoconiosis may have little significant affect on pulmonary function, and is a nodular interstitial lung disease that is graded according to CXR appearance, with the diagnosis being an incidental finding on CXR. There is debate as to its impact on lung function, but if present it does increase the risk of COPD, diminish forced expiratory volume in one second (FEV1) and have additive effects combined with smoking.

The significance of the condition is that there is a risk of subsequent development to progressive massive fibrosis.

The risk is highest with category 3 disease - about 30% - and less so with category 2 disease - about 7%.

There is virtually no chance of development of progressive massive fibrosis directly from category 1 disease.

Any disability claim usually requires the presence of at least category 2 disease before a claim can be made.

Patients with chronic end-stage lung disease due to severe pneumoconiosis have a high risk of death (>50%) within 2 years without lung transplant and a high likelihood of 5-year survival (>80%) following a lung transplant. (2)

Reference

1. Go LHT, Almberg KS, Rose CS, et al. Prevalence and severity of abnormal lung function among US former coal miners with and without radiographic coal workers' pneumoconiosis. Occup Environ Med. 2022 Aug;79(8):527-32.
2. Leard LE, Holm AM, Valapour M, et al. Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2021 Nov;40(11):1349-79.