- related to total coal dust exposure
- simple CWP characterised by small rounded opacities (<1.5mm) on chest X-ray, and is associated with emphysema. Asymptomatic
- Progressive massive fibrosis (PMF)
- development of larger opacities (>3mm)
- lesion usually in upper zone
- ANA and RF often positive
- mixed restrictive and obstructive lung defect with reduced transfer factor
- presents with melanoptysis
- Caplan syndrome = pneumoconiosis + rheumatoid arthritis
- manifest as multiple round pulmonary nodules
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