Pneumoconiosis is a group of lung diseases caused by inhaling certain types of dust, primarily in occupational settings. It is often caused by exposure to mineral dust, such as asbestos, silica, or coal dust. Common symptoms include cough, shortness of breath, and chest pain. There is no cure, but treatment focuses on relieving symptoms, slowing disease progression and preventing further exposure to harmful dust. For more detailed information you can refer to sources like the Centers for Disease Control and Prevention (CDC) and the National Institute for Occupational Safety and Health (NIOSH).
A diagnosis of pneumoconiosis is usually suggested to a GP on the radiology report.
The relevant occupational exposures need to be discussed. Diagnoses to consider include coal workers pneumoconiosis, silicosis and asbestosis. See also Asbestos Related Diseases – RefHelp
Coal workers Pneumoconiosis
The effects of the inhalation of coal dust on the lung can result in the development of:
- simple coal workers pneumoconiosis (SCWP),
- progressive massive fibrosis (PMF: a radiological definition)
- silicosis (certain collieries mined coal with a high silica content).
Inhalation of substantial quantities of coal dust also predisposes to the development and progression of COPD.
D.M & L.N – 11-8-26
Who can refer:
Any primary or secondary care clinician can refer.
Who to refer:
- Simple coal workers pneumoconiosis (SCWP) is not normally associated with respiratory symptoms or abnormal lung function. Therefore if patients are experiencing persistent breathlessness, cough or wheeze, please refer for further assessment.
- Refer cases of progressive massive fibrosis (PMF) as this may be associated with both symptoms and abnormal lung function.
- It is important to consider a co-existing diagnosis of COPD in all cases of pneumoconiosis. If COPD is confirmed on spirometry, inhaled bronchodilator therapies should be commenced.
Who not to refer:
- Cases of asymptomatic SCWP
- Symptomatic patients with SCWP and spirometry in keeping with COPD. These patients should first be trialled on treatment with appropriate inhaled therapies as this may relieve symptoms and therefore referral to secondary care may not be required.
How to refer:
- Spirometry is not essential prior to referral but it can be useful as often these patients will have co-existing COPD and will benefit from inhaled bronchodilator therapy.
- All referrals should be made using Sci-Gateway – RIE or WGH or SJH > Respiratory medicine > LI Basic Sign Referral. (Put reason for referral in presenting complaint and this will be triaged appropriately). These patients will all be reviewed within the Interstitial Lung Disease Service.
- A CXR should always be performed prior to referral. A normal CXR virtually excludes pneumoconiosis.
Please arrange spirometry as often these patients have co-existing COPD which will require treatment with inhaled bronchodilator therapy.
- Please discuss the relevant environmental exposures and advise regarding the importance of wearing appropriate personal protective equipment (PPE) whilst at work to ensure there is no further exposure to harmful dusts . Please signpost patients to the Coal Workers Health Surveillance Programme guidelines for further information on this: Coal Workers’ Health Surveillance Program | CWHSP | CDC
- Pneumoconiosis: Causes, Symptoms, Treatment, Prevention & More
- Pneumoconioses | Pneumoconioses Disease | CDC
- Chronic Obstructive Pulmonary Disease – RefHelp
- What is pneumoconiosis? | Action for Pulmonary Fibrosis
- HSE: Information about health and safety at work
- Coal Workers’ Health Surveillance Program | CWHSP | CDC
- Mining – HSE
