There are three basic criteria for the diagnosis of CWP:

1. Chest radiography consistent with CWP

2. An exposure history to coal dust (typically underground coal mining) of sufficient amount and latency

3. Exclusion of alternative diagnoses (mimics of CWP)

Symptoms and pulmonary function testing relate to the degree of respiratory impairment but are not part of the diagnostic criteria. As noted above, the chest X-ray appearance for CWP can be virtually indistinguishable from silicosis. Chest CT, particularly high-resolution scanning (HRCT), are more sensitive than plain X-ray for detecting the small round opacities.

Coal ash, also known as coal combustion residuals (CCRs), is the particulate residue that remains from burning coal. Depending on the chemical composition of the coal burned, this residue may contain toxic substances and pose a health risk to workers in coal-fired power plants.

Positive indications on patient assessment:

- Shortness of breath

- Chest X-ray may show a characteristic patchy, subpleural, bibasilar interstitial infiltrates or small cystic radiolucencies called honeycombing.

Pneumoconiosis in combination with multiple pulmonary rheumatoid nodules in rheumatoid arthritis patients is known as Caplan's syndrome.

Health care professionals are at risk of occupational influenza exposure; during a pandemic influenza, anyone in a close environment is at risk, including those in an office environment.

In the United States, the only federal regulation regarding the disposal of coal ash is called “Disposal of Coal Combustion Residuals from Electric Utilities”, which was signed into law on December 19th, 2014. In addition, when coal ash is disposed into surface impoundments and landfills, coal ash is regulated as non-hazardous solid waste under the Resource Conservation and Recovery Act (RCRA). Thus, the requirements of the coal ash disposal law is regulated under subtitle D of the RCRA.

In order for this federal regulation to be effective, there are some major requirements that surface impoundments and landfill facilities must follow. This rule requires facilities to prevent and control coal ash dust from accumulating into the air. As a result, facilities must provide annual plans for coal ash dust control. Furthermore, there are location restrictions where new landfills and surface impoundments can be built. In addition, if regulations of coal ash dust control are not maintained, closure of the facility will occur under the federal law. The law also requires all coal ash waste facilities to create annual groundwater monitoring reports. Lastly, all coal ash waste surface impoundments and landfills must keep a written record of the federal regulations at the facility for five years. Ultimately, this recent federal regulation is trying to eliminate occupational health concerns and environmental health issues regarding coal ash toxicity.

Pesticides exposure cannot be studied in placebo controlled trials as this would be unethical. A definitive cause effect relationship therefore cannot be established. Consistent evidence can and has been gathered through other study designs. The precautionary principle is thus frequently used in environmental law such that absolute proof is not required before efforts to decrease exposure to potential toxins are enacted.

The American Medical Association recommend limiting exposure to pesticides. They came to this conclusion due to the fact that surveillance systems currently in place are inadequate to determine problems related to exposure. The utility of applicator certification and public notification programs are also of unknown value in their ability to prevent adverse outcomes.

Tuberculosis is a lung disease endemic in many parts of the world. Health care professionals and prison guards are at high risk for occupational exposure to tuberculosis, since they work with populations with high rates of the disease.

In 2013 CWP resulted in 25,000 deaths down from 29,000 deaths in 1990. Between 1970–1974, prevalence of CWP among US coal miners who had worked over 25 years was 32%; the same group saw a prevalence of 9% in 2005–2006.

Many studies have examined the effects of pesticide exposure on the risk of cancer. Associations have been found with: leukemia, lymphoma, brain, kidney, breast, prostate, pancreas, liver, lung, and skin cancers. This increased risk occurs with both residential and occupational exposures. Increased rates of cancer have been found among farm workers who apply these chemicals. A mother's occupational exposure to pesticides during pregnancy is associated with an increases in her child's risk of leukemia, Wilms' tumor, and brain cancer. Exposure to insecticides within the home and herbicides outside is associated with blood cancers in children.

Prevention measures include avoidance of the irritant through its removal from the workplace or through technical shielding by the use of potent irritants in closed systems or automation, irritant replacement or removal and personal protection of the workers.

In order to better prevent and control occupational disease, most countries revise and update their related laws, most of them greatly increasing the penalties in case of breaches of the occupational disease laws. Occupational disease prevention, in general legally regulated, is part of good supply chain management and enables companies to design and ensure supply chain social compliance schemes as well as monitor their implementation to identify and prevent occupational disease hazards.

Mold health issues are potentially harmful effects of molds.

Molds (US usage; British English "moulds") are ubiquitous in the biosphere, and mold spores are a common component of household and workplace dust. The United States Centers for Disease Control and Prevention reported in its June 2006 report, 'Mold Prevention Strategies and Possible Health Effects in the Aftermath of Hurricanes and Major Floods,' that "excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination." When mold spores are present in abnormally high quantities, they can present especially hazardous health risks to humans after prolonged exposure, including allergic reactions or poisoning by mycotoxins, or causing fungal infection (mycosis).

Chest radiography is usually the first test to detect interstitial lung diseases, but the chest radiograph can be normal in up to 10% of patients, especially early on the disease process.

High resolution CT of the chest is the preferred modality, and differs from routine CT of the chest. Conventional (regular) CT chest examines 7–10 mm slices obtained

at 10 mm intervals; high resolution CT examines 1-1.5 mm slices at 10 mm

intervals using a high spatial frequency reconstruction algorithm. The HRCT therefore provides approximately 10 times more resolution than the conventional CT chest, allowing the HRCT to elicit details that cannot otherwise be visualized.

Radiologic appearance alone however is not adequate and should be interpreted in the clinical context, keeping in mind the temporal profile of the disease process.

Interstitial lung diseases can be classified according to radiologic patterns.

Investigation is tailored towards the symptoms and signs. A proper and detailed history looking for the occupational exposures, and for signs of conditions listed above is the first and probably the most important part of the workup in patients with interstitial lung disease. Pulmonary function tests usually show a restrictive defect with decreased diffusion capacity (DLCO).

A lung biopsy is required if the clinical history and imaging are not clearly suggestive of a specific diagnosis or malignancy cannot otherwise be ruled out. In cases where a lung biopsy is indicated, a trans-bronchial biopsy is usually unhelpful, and a surgical lung biopsy is often required.

In 2013 pneumoconiosis resulted in 260,000 deaths up from 251,000 deaths in 1990. Of these deaths 46,000 were due to silicosis, 24,000 due to asbestosis and 25,000 due to coal workers pneumoconiosis.

Symptoms of mold exposure can include:

- Nasal and sinus congestion, runny nose

- Respiratory problems, such as wheezing and difficulty breathing, chest tightness

- Cough

- Throat irritation

- Sneezing / Sneezing fits

Diagnosis of elemental or inorganic mercury poisoning involves determining the history of exposure, physical findings, and an elevated body burden of mercury. Although whole-blood mercury concentrations are typically less than 6 μg/L, diets rich in fish can result in blood mercury concentrations higher than 200 μg/L; it is not that useful to measure these levels for suspected cases of elemental or inorganic poisoning because of mercury's short half-life in the blood. If the exposure is chronic, urine levels can be obtained; 24-hour collections are more reliable than spot collections. It is difficult or impossible to interpret urine samples of patients undergoing chelation therapy, as the therapy itself increases mercury levels in the samples.

Diagnosis of organic mercury poisoning differs in that whole-blood or hair analysis is more reliable than urinary mercury levels.

Mercury thermometers and mercury light bulbs are not as common as they used to be, and the amount of mercury they contain is unlikely to be a health concern if handled carefully. However, broken items still require careful cleanup, as mercury can be hard to collect and it is easy to accidentally create a much larger exposure problem.

A class action court case was brought against Showa Yokkaichi Oil and initially adjudicated in September 1970. The class was ruled to contain 544 individuals, but that number has increased over the ensuing years.

A 2008 study by researchers from the Mie University Graduate School of Medicine and the Hiroshima University Natural Science Center for Basic Research and Development indicated a 10 to 20-fold higher mortality rates as a result of COPD and asthma in the affected populations of Yokkaichi versus the general population of Mie Prefecture.

Initial attempts to alleviate the problem by raising the height of smokestacks to disperse the pollutants over a larger area proved ineffective. Eventually flue-gas desulfurization was implemented on a large scale, leading to an improvement in the health of local populace.

Yokkaichi asthma has been identified in rapidly industrializing areas in the rest of the world, including Mexico City and mainland China.

Education and counselling by physicians of children and adolescents has been found to be effective in decreasing the risk of tobacco use.

COPD may need to be differentiated from other causes of shortness of breath such as congestive heart failure, pulmonary embolism, pneumonia, or pneumothorax. Many people with COPD mistakenly think they have asthma. The distinction between asthma and COPD is made on the basis of the symptoms, smoking history, and whether airflow limitation is reversible with bronchodilators at spirometry. Tuberculosis may also present with a chronic cough and should be considered in locations where it is common. Less common conditions that may present similarly include bronchopulmonary dysplasia and obliterative bronchiolitis. Chronic bronchitis may occur with normal airflow and in this situation it is not classified as COPD.

Beginning shortly after the opening of the first complex in 1956, severe cases of chronic obstructive pulmonary disease, chronic bronchitis, pulmonary emphysema, and bronchial asthma rose quickly among the local inhabitants. Taller smokestacks were implemented, but these simply spread the pollution over a wider area and did not help alleviate the reported health issues.

Fish caught in Ise Bay developed a bad taste, causing local fishermen to petition the government for compensation for their unsaleable fish in 1960.

A chest X-ray and complete blood count may be useful to exclude other conditions at the time of diagnosis. Characteristic signs on X-ray are overexpanded lungs, a flattened diaphragm, increased retrosternal airspace, and bullae, while it can help exclude other lung diseases, such as pneumonia, pulmonary edema, or a pneumothorax. A high-resolution computed tomography scan of the chest may show the distribution of emphysema throughout the lungs and can also be useful to exclude other lung diseases. Unless surgery is planned, however, this rarely affects management. An analysis of arterial blood is used to determine the need for oxygen; this is recommended in those with an FEV less than 35% predicted, those with a peripheral oxygen saturation less than 92%, and those with symptoms of congestive heart failure. In areas of the world where alpha-1 antitrypsin deficiency is common, people with COPD (particularly those below the age of 45 and with emphysema affecting the lower parts of the lungs) should be considered for testing.

Dipping tobacco, commonly referred to as snuff, is also put in the mouth, but it is a flavored powder. it is placed between the cheek and gum. Dipping tobacco doesn't need to be chewed for the nicotine to be absorbed into your body. First-time users of these products often become nauseated and dizzy. Long-term effects include bad breath, yellowed teeth, and an increased risk of oral cancer.

Users of dipping tobacco are believed to face less risk of some cancers than smokers but are still at greater risk than people who do not use any tobacco products. They also have an equal risk of other health problems directly linked to nicotine such as increased rate of atherosclerosis.

Occupational lung diseases include asbestosis among asbestos miners and those who work with friable asbestos insulation, as well as black lung (coalworker's pneumoconiosis) among coal miners, silicosis among miners and quarrying and tunnel operators and byssinosis among workers in parts of the cotton textile industry.

Occupational asthma has a vast number of occupations at risk.

Bad indoor air quality may predispose for diseases in the lungs as well as in other parts of the body.

The diagnosis of RA was formerly based on detection of rheumatoid factor (RF). However, RF is also associated with other autoimmune diseases. The detection of anti-CCP is currently considered the most specific marker of RA. The diagnosis of rheumatoid lung disease is based on evaluation of pulmonary function, radiology, serology and lung biopsy. High resolution CT scans are preferred to chest X-rays due to their sensitivity and specificity.

Associated doctors to diagnosis this properly would be a Rheumatologists or Pulmonologist.

Within a physical examination doctors could find possible indications, such as hearing crackles (rales) when listening to the lungs with a stethoscope. Or, there may be decreased breath sounds, wheezing, a rubbing sound, or normal breath sounds. When listening to the heart, there may be abnormal heart sounds. Bronchoscopic, video-assisted, or open lung biopsy allows the histological characterization of pulmonary lesions, which can distinguish rheumatoid lung disease from other interstitial lung diseases.

The following tests may also show signs of rheumatoid lung disease:

- Chest x-ray may show:

- pleural effusion

- lower zone predominant reticular or reticulonodular pattern

- volume loss in advanced disease

- skeletal changes, e.g. erosion of clavicles, glenohumeral erosive arthropathy, superior rib notching

- Chest CT or HRCT features include:

- pleural thickening or effusion

- interstitial fibrosis

- bronchiectasis

- bronchiolitis obliterans

- large rheumatoid nodules

- single or multiple

- tend to be based peripherally

- may cavitate (necrobiotic lung nodules)

- cavitation of a peripheral nodule can lead to pneumothorax or haemopneumothorax.

- follicular bronchiolitis

- small centrilobular nodules or tree-in-bud

- rare

- Caplan syndrome

- Echocardiogram (may show pulmonary hypertension)

- Lung biopsy (bronchoscopic, video-assisted, or open), which may show pulmonary lesions

- Lung function tests

- Needle inserted into the fluid around the lung (thoracentesis)

- Blood tests for rheumatoid arthritis