Variations in the histological patterns of the lesions of coal workers’ pneumoconiosis in Britain and their relationship to lung dust content

The lungs of 490 British coal miners were examined for comparisons of the lesions of coal workers’ pneumoconiosis with lung dust content and dust exposure. Variations were found in histological appearances that formed a range, the extremes of which indicated two separate patterns of disease. In men from high rank collieries, whose lung dust had a high carbon content and little ash, most of the nodules of simple pneumoconiosis were evenly pigmented with dust, and where progressive massive fibrosis (lesions > 1 cm in diameter) had developed, this appeared to be by the enlargement of a single lesion. In men from low rank collieries where the ash content of lung dust was high, the centers of the nodules were often free of dust particles and in extreme cases these lesions were very similar to silicotic nodules. If PMF developed in these cases, it often appeared to be by the fusion of closely spaced groups of smaller nodules. While there appeared to be little difference between the lung dust composition of men from high rank collieries and the dust to which they had been exposed, in men from low rank collieries the proportion of the noncoal minerals in the lungs was usually higher than it had been in the mine dust. This indicated some form of differential retention of these components, which was progressively more marked in men with the more serious grades of pneumoconiosis.