DIAGNOSIS AND TREATMENT OF PNEUMOCONIOSES
A doctor may diagnose CWP or silicosis based on the combination of an appropriate history of exposure to coal mine dust or silica, compatible changes in chest imaging or lung pathology, and absence of plausible alternative diagnoses. A chest radiograph is often sufficient for diagnosis, but in some cases a computed tomography (CT) scan of the chest can be helpful. Lung biopsy, a procedure where a sample of lung tissue is taken for lab examination, is not usually required if a compatible exposure history and findings on chest imaging are present. Pulmonary function tests and blood tests to measure the amounts of oxygen and carbon dioxide in the blood (arterial blood gases) can help in objectively assessing the level of impairment caused by CWP or silicosis.
Epidemiologic studies of gold miners in South Africa, granite quarry workers in Hong Kong, metal miners in Colorado, and coal miners in Scotland have shown that chronic silicosis may develop or progress even after occupational exposure to silica has been discontinued [Hessel et al. 1988; Hnizdo and Sluis-Cremer 1993; Ng et al. 1987; Kreiss and Zhen 1996; Miller et al. 1998]. Therefore, removing a worker from exposure after diagnosis does not guarantee that silicosis or silica-related disease will stop progressing or that an impaired worker’s condition will stabilize.
Treatment of CWP or silicosis may include use of bronchodilators (medications to open the airways) or supplemental oxygen use. Once disease is detected, it is important to protect the lungs against respiratory infections. Thus, a doctor may recommend vaccinations to prevent influenza and pneumonia. In some cases of severe disease, a lung transplant may be recommended. Prognosis depends on the specific type of pneumoconiosis and the duration and level of dust exposure.
There is no cure for these lung diseases, and they cannot be reversed. Effective control technologies must be implemented and continually maintained to prevent the development of the disease.