Anthracosis is the term utilized to describe black lung disease before it has progressed to such an extent that symptoms of the disease are palpable. The condition most often develops gradually over the course of many years and is characterized by black spotting or marbling of the lungs.

The dark pigmentation associated with anthracosis primarily is caused by excessive exposure to carbonaceous material, which may stem from soot, diesel exhaust, coal, or other sources of carbon-containing dusts. Pollution and smoking are also known to contribute to anthracosis, and the condition is present to some extent in many residents of urban areas. Historically, however, anthracosis and its more severe manifestation, black lung disease, are best known as occupational illnesses that occur most commonly in coal miners.

Though anthracosis is often asymptomatic, when the disease is allowed to progress into black lung disease (sometimes referred to as coal worker’s pneumoconiosis), the effects may be significant. Shortness of breath and severe coughing are usually among the earliest symptoms of damage to the lungs, and labored breathing, phlegm production, and wheezing are also common. Over time, as carbonaceous dust particles increasingly overwhelm the lungs, scarring and thickening of the lung tissue can occur, which is sometimes followed by the development of progressive massive fibrosis, a particularly severe form of the disease that continues to progress even when exposure to carbon comes to an end. Other complications can include cor pulmonale (an increase in size of the right ventricle of the heart), emphysema, and chronic bronchitis.

Black lung disease was observed among coal workers as early as the seventeenth century, but the condition was not so-named until the 1830s. In earlier periods, the affliction was known by various other appellations, such as black spittle or miner’s asthma. Despite a long-time awareness that the condition was related to working in coal mines, little was done to stem the occurrence for many years. Some writers, such as the late nineteenth-century French naturalist Émile Zola, did attempt, however, to bring increased attention to the injurious effects of black lung disease on the mining population. Nevertheless, it was not until 1943 that individuals afflicted with the disease could gain disability compensation in England, and more than two decades would pass before similar benefits could be readily obtained in the United States.

Due to the adoption of regulatory measures by the United States Congress in 1969, working in the mining industry is not as hazardous today as it was formerly. The measures, which were a significant step forward for the cause of occupational safety, included new guidelines for average dust levels allowable in mining zones and a program to distribute disability benefits to individuals that acquired black lung disease through carbon exposure at work. Though most cases of the disease continue to occur among miners, morbidity and mortality related to carbonaceous dust particles has declined steadily over the last several decades.

Anthracosis at 40x Magnification - There is no cure for anthracosis or black lung disease, and treatment for the conditions generally involves providing symptomatic relief to the patient.

Anthracosis at 20x Magnification - In the early 1970s a federally administered radiography-screening program of active coal miners found evidence of black lung disease in more than 10 percent of the individuals tested.

Anthracosis at 10x Magnification - A black lung disease screening program carried out in the late 1990s discovered evidence of the disease in less than 2 percent of the active miners tested.