Fibro-Anthracosis of the Lungs in Elderly Individuals in a Smoky City

¹ The Department of Pathology and the John C. Oliver Memorial Research Foundation, St. Margaret Memorial Hospital and the Department of Pathology, University of Pittsburgh School of Medicine.

Study of a series of 770 consecutive autopsies on elderly individuals with an average age of 60 years from the City of Pittsburgh shows an autopsy incidence of some degree of fibro-anthracosis in 97 subjects or 12.6 per cent. In six instances fibro-anthracosis was the sole cause of death and in two other instances the principal cause of death, a fatal incidence of 1.0 per cent. In two additional instances fibro-anthracosis was listed as a contributory cause of death. Analysis of the causes of death in the 97 subjects with fibro-anthracosis indicates that the presence of fibro-anthracosis in the lungs does not increase the incidence of or predispose to death from other lung diseases such as pneumonia, tuberculosis, and bronchogenic carcinoma.

Fibro-anthracosis was found in only seven females, and in each of the seven women lung damage was slight and had no effect on the patient's death. Most of the fatal cases of fibro-anthracosis occurred in coal miners. The mechanism of death was congestive heart failure. Right ventricular hypertrophy was marked in almost all of the fatal examples.

Study of this group of 770 residents of the City of Pittsburgh with an average age at autopsy of 60 years suggests that long continued exposure to a smoky atmosphere, while it may cause minimal scarring after many years, does not result in any appreciable degree of lung fibrosis. Fibro-anthracosis of the lungs, in the Pittsburgh district at least, is an occupational disease, predominantly if not entirely associated with coal mining.