Imaging Pictorial EssayCoal Mine Dust Lung Disease (CMDLD) encompasses a spectrum of lung diseases caused by prolonged exposure to coal mine dust. CMDLD are often referred to as “black lung”.  Black lung is an oversimplification as Coal Mine Dust Lung Disease take on many different forms. In Queensland there has been a resurgence of CMDLD since 2015. Prior to this these diseases weren’t described since 1984.

Wesley Medical Imaging Research

Wesley Medical Imaging have been conducting research into Coal Mine Dust Lung Disease since the resurgence in 2015.  As a result of this work the Wesley Dust Disease Research Centre has been set up. The key aim of the research is to investigate confirmed cases of CMDLD and review how they have presented. Radiologically we review chest x-rays and CTs, and clinically, by reviewing medical history and respiratory symptoms. Once the radiological and medical review have been completed we obtain a detailed occupational history from the coal miner. By undertaking this research we hope to gain a better understanding of these long-forgotten diseases .

During the course of this research we noticed that there was no medical literature describing Coal Mine Dust Lung Disease and the radiological appearance of these diseases in Australian cases. Furthermore, internationally, medical literature describing CMDLD on high-resolution computed tomography (HRCT) is scarce. To fill this knowledge gap we decided to prepare a pictorial review presenting images from men diagnosed with a CMDLD since the resurgence of these diseases in Queensland in 2015.

Coal Mine Dust Lung Disease

This review presents coal worker’s pneumoconiosis (CWP), silicosis, mixed dust pneumoconiosis, progressive massive fibrosis and dust-related diffuse fibrosis. These are the fibrotic CMDLD diseases we have observed at our centre. Other CMDLD, which are not associated with fibrosis but rather with inflammation of the airways, include chronic bronchitis and emphysema. It can be difficult to determine the specific CMDLD diagnosis based on imaging as some CMDLD appear very similar, for example CWP and silicosis both present with nodular opacities. Understanding that each disease has unique characteristics, such as the size and density of nodules, helps a specialist chest radiologist determine which form of CMDLD is most likely present. The preventive and incurable nature of CMDLD means early diagnosis with recognition on imaging is of the utmost importance.

For more information about the appearance of these diseases on HRCT please refer to our pictorial review recently published in JMIRO.