Brad is 45 years old and has been working as a coal cutter in a mine for the last 25 years. He likes the job because it pays well and the same mine had employed his father. Like many of his colleagues, Brad has had problems with a chronic cough. He has avoided his annual checkups for fear that he will be told he has “black lung,” or coal worker’s pneumoconiosis. The disease causes fibrosis, decreased diffusing capacity, and permanent small airway dilation. In later stages, pulmonary capillaries, alveoli, and airways are destroyed.
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