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How can black lung disease progress to massive fibrosis and heart failure?

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Asbestosis — occupational disease The lung disease asbestosis is caused primarily by prolonged inhalation of asbestos fibers. It occurs mainly among workers whose occupations involve exposure to asbestos and people who live near mines, factories, and construction sites.

Black lung disease, or coal workers’ pneumoconiosis, begins when inhaled coal dust deposits in the terminal bronchioles, triggering a fibrotic reaction. While early stages often present little disability, the disease can progress to a more generalized form where large masses of fibrotic tissue develop within the lungs, a condition known as progressive massive fibrosis.1

This advanced fibrosis causes significant lung damage, which can lead to cor pulmonale—the enlargement of the heart's right ventricle. As the disease destroys the network of pulmonary capillaries, it increases pressure in the pulmonary artery, a condition called pulmonary hypertension. This creates back pressure on the right ventricle, forcing the heart to work harder to pump blood through the damaged lungs. Over time, this increased workload leads to heart enlargement and, if left uncorrected, results in heart failure.21

It is important to note that there is no curative treatment for black lung disease, emphasizing the critical need for workplace safety and dust exposure prevention.1