Grim symptoms the price of exposure to coal dust

COAL workers’ pneumoconiosis and chronic obstructive pulmonary disease are a direct result of exposure to coal dust by people who have worked underground in coal mines and even those who have worked in opencast mines.

“They generally will affect mineworkers . . . it has not been documented on people living adjacent or near the coal mines,” said Rajen Naidoo, associate professor of occupational medicine and head of discipline for occupational and environmental health at the University of KwaZulu-Natal.

Naidoo said it could take more than 10 years before an infected person realised they had one of the diseases.

Their longevity depended on how much dust they had been exposed to, and for how long.

“Generally, the disease will progress after the exposure has stopped,” he said.

The diseases were similar to silicosis — the only difference was that silicosis arose from inhaling silica dust in gold mines, he said.

In court papers, lawyer Richard Spoor suggested that coal workers’ pneumoconiosis was characterised by the formation of dust-laden cells in response to coal dust lodged in the bronchioles of the lungs.

This could lead to focal emphysema and the formation of fibrous tissue which was visible as nodules on X-rays, he said.

The nodules distorted the lung architecture and led to air-flow obstruction and the functional impairment of the lung, which might lead to respiratory symptoms such as a persistent, unproductive coughing and shortness of breath.

“As a consequence, the patient’s ability to perform physical tasks is impaired.”

Chronic obstructive pulmonary disease, on the other hand, was a partly reversible air-flow limitation caused by the inhalation of toxins including coal dust, Spoor said.

“The condition is characterised by productive cough and breathlessness and results in the functional impairment of the lung. Common signs include decreased breath sounds, prolonged expiratory phase of expiration and wheezing.”

Severe cases might be complicated by weight loss, collapsed lungs, frequent “decompensation” episodes, right-heart failure and acute or chronic respiratory failure.

Spoor said people suffering from the disease were at significantly greater risk than healthy people of contracting tuberculosis and other opportunistic lung infections, and such infections were likely to be more severe than in healthy people.