Black lung disease is similar to silicosis, an illness caused by the build up of silica in the lungs. Asbestosis is a build up of asbestos fibers in the lungs, called white lung. Silica and asbestos are fibrogenic, but coal dust is not. The body cannot destroy or remove coal dust, so immune system cells, alveolar or interstitial macrophages, engulf the dust particles. Miners with black lung may have silicosis and asbestosis as well, from inhaling the rock dust. Asbestos was mixed with coal in Virginia, Kentucky, West Virginia, and Pennsylvania.
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