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Study Syllabus for Classification of Radiographs of Pneumoconioses						Print
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										Pathology OverviewPathology Basis of Occupational Lung DiseaseCoal Workers’ Pneumoconiosis
Associated Lesions: Emphysema and Diffuse Interstitial Fibrosis
Inhalation of coal mine dust has been determined to be an independent risk factor in the development of emphysema [Green and Vallyathan 1998; Cockroft et al. 1982; Ruckley et al. 1984b]. Progressive centrilobular emphysema constitutes an extension of focal emphysema associated with the coal macule. Panacinar emphysema represents a less common variant associated with coal dust exposure.
In a study that evaluated emphysema severity in whole-lung thick sections from autopsies of 616 US coal miners and 106 non-miners performed from 1957 to 1973, Kuempel et al found that emphysema was significantly elevated in coal miners compared with non-miners regardless of smoking history. Additionally the study reported that cumulative exposure to respirable coal mine dust and coal dust retained in the lungs were significant predictors of emphysema severity [Kuempel et al. 2009].
Pulmonary interstitial fibrosis documented at autopsy has been variably reported in the lungs of coal miners in as many as 33% of cases. Interstitial fibrosis may macroscopically resemble honeycomb lung. Histologically, black pigment and mineral deposition in the areas of interstitial fibrosis were noted in 53% of cases (Fig. 31). However, in the remaining 47%, interstitial fibrosis was nonpigmented, resembling the type of fibrosis seen in idiopathic pulmonary fibrosis [McConnochie et al. 1988]. Chronic interstitial pneumonia and fibrosis resembling usual interstitial pneumonia were also identified in a subset of French coal miners with clinical and radiologic evidence of interstitial lung disease with honeycombing [Brichet et al. 2002].COMPLICATED CWPPage 3 of 3ASBESTOS PLEUROPULMONARY DISEASE
							
					
							Last Reviewed:  April 26, 2023						Source: 	National Institute for Occupational Safety and Health
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        Syndicate homeStudy Syllabus for Classification of Radiographs of Pneumoconioses
Introductionplus icon
Preface
Appreciation to Contributors
Intent of the Self-study Syllbus
Getting Started
Clinical Overviewplus icon
Major Occupational Lung Diseasesplus icon
Pneumoconioses
Central Role of Diagnostic Imagingplus icon
Role of CT
Overview of Nonimaging Clinical Tools in Lung Disease Diagnosis
Appendix A
References
Pathology Overviewplus icon
Pulmonary Silicosis
Coal Workers’ Pneumoconiosis
Asbestos Pleuropulmonary Disease
Pathological-Clinical Correlations
References
Radiograph Classificationplus icon
SUBSET 1 – Radiograph Classification, #1 to #19plus icon
Introduction
Radiograph Identification
Section 1: Image Quality
Section 2: Parenchymal Abnormalities, #1 to #14
Section 3: Pleural Abnormalities, #15 to #19
Section 4: Any Other Abnormalities
Section 5
SUBSET 2 – Radiograph #20 to #27plus icon
Radiograph #20
Radiograph #21
Radiograph #22
Radiograph #23
Radiograph #24
Radiographs #25 to #27
SUBSET 3 – Radiograph #28 to #38plus icon
Radiographs #28 to #30
Radiographs #31 to #32
Radiographs #33 to #35
Radiographs #36 to #38
SUBSET 4 – Radiograph #39 to #46 (Small and Large Opacities)plus icon
Radiographs #39 to #40
Radiographs #41 to #42
Radiographs #43 to #44
Radiograph #45
Radiograph #46
SUBSET 5 – Classifications and Answer Keys, Radiographs #47 to #83
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