Pneumoconiosis of shale miners.

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Abstract
Four patients were described in whom pneumoconiosis was diagnosed towards the end of a lifetime''s work in shale mines. All developed complicated pneumoconiosis, diagnosed in 2 cases at necropsy in 1 by lobectomy and in 1 radiologically. Two patients at necropsy also had peripheral squamous lung cancer. Clinical and histological features of the disease resembled the pneumoconioses of coal miners and kaolin workers, and the lungs of 3 patients contained dust composed predominantly of kaolinite, mica and silica. Shale miners'' complicated pneumoconiosis has not previously been described. Although the British [UK] shale industry is not defunct, oil production from shale is expanding in other countries, notably the USA. Control should be exercised over dust exposure levels in this industry and epidemiological studies should be carried out to quantify the risks of pneumoconiosis and bronchial carcinoma.