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Thursday, March 3, 2011

COAL WORKERS PNEUMOCONIOSIS

The disease follow prolonged inhalation of coal dust. The condition is subdivided in to simple pneumoconiosis and progressive massive fibrosis for clinical purposes and for certification
. It must be emphasised that for certification purposes in Britain the diagnosis rests at present on radiological and not clinical features.
Simple coal workers pneumoconiosis
This is categorised radiologically in to three grades, depending on the size and extent of the nodulation present. It does not progress if the miner leaves the industry.
Progressive massive fibrosis
In this form of the disease, large dense masses, single or multiple, occur mainly in the upper lobes. These may be irregular in shape and may cavitate. Tuberculosis may be a complication. The disease can be disabling, may shorten life-expectancy and progress even after the miner leaves the industry
Cough and sputum from associated chronic bronchitis are frequently present.The sputum may be black. Progressive breathlessness on exertion occurs in the later stages and respiratory and right ventricular failure supervene as terminal events. There may be no abnormal physical signs in the chest but where present they are those of chronic obstructive airways disease.
Antinuclear factor is present in the serum of about 15% of patients with coal workers pneumoconisis. Rheumatoid factor is present in some patients in whom rheumatoid arthritis coexists with rounded fibrotic nodules 0.5-5 cm in diameter. These are mainly in the periphery of the lung fields and the association is known as caplan's syndrome. This syndrome may also occur in other types of pneumoconiosis.

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