RATIONALE: Recent reports of progressive massive @entity82 and rapidly progressive @entity3673 in U.S. coal miners have raised concerns about excessive exposures to coal mine dust, despite reports of declining dust levels. OBJECTIVES: To evaluate the histologic abnormalities and retained dust particles in available coal miner lung pathology specimens, and to compare these findings with those derived from corresponding chest radiographs. METHODS: Miners with severe disease and available lung tissue were identified through investigator outreach. Demographic as well as smoking and work history information was obtained. Chest radiographs were interpreted according to the International Labor Organization classification scheme to determine if criteria for rapidly progressive @entity3673 were confirmed. Pathology slides were scored by three expert pulmonary pathologists using a standardized nomenclature and scoring system. MEASUREMENTS AND MAIN RESULTS: Thirteen cases were reviewed, many of which had features of accelerated @entity5636 and mixed dust lesions. Twelve had progressive massive @entity82 , and 11 had @entity5636 . Only four had classic lesions of simple @entity7864 . Four had diffuse @entity82 with @entity32 , and two had @entity5970 . Polarized light microscopy revealed large amounts of birefringent mineral dust particles consistent with @entity3440 and @entity7182 ; carbonaceous coal dust was less prominent. On the basis of chest imaging studies, specimens with features of @entity5636 were significantly associated (P   =   0.047) with rounded (type p, q, or r) opacities, whereas grade 3 @entity82 was associated (P   =   0.02) with the presence of irregular (type s, t, or u) opacities. CONCLUSIONS: Our findings suggest that rapidly progressive @entity3673 in these miners was associated with exposure to coal mine dust containing high concentrations of respirable @entity3440 and @entity7182 .

Lung Pathology in U.S. Coal Workers with Rapidly Progressive Pneumoconiosis Implicates @entity3440 and XXXX .

@entity32 :: ('MESH:D007249', 'Disease') :: ['chronic inflammation'] @entity7182 :: ('MESH:D017640', 'Chemical') :: ['silicates'] @entity82 :: ('MESH:D005355', 'Disease') :: ['interstitial fibrosis', 'fibrosis'] @entity7864 :: ('MESH:D055008', 'Disease') :: ["coal workers' pneumoconiosis"] @entity3673 :: ('MESH:D011009', 'Disease') :: ['pneumoconiosis'] @entity5636 :: ('MESH:D012829', 'Disease') :: ['silicosis'] @entity5970 :: ('MESH:D011649', 'Disease') :: ['focal alveolar proteinosis'] @entity3440 :: ('MESH:D012822', 'Chemical') :: ['silica']
@entity7182 :: (MESH:D017640,Chemical) :: ['Silicates']
