Coal mine dust lung disease in the modern era

Environmental impacts of Indian coal thermal power plants and associated human health risk to the nearby residential communities: A potential review

Worldwide, harmful emissions from coal power plants cause many illnesses contribute to premature deaths burden. Despite its high impact on human health and being a major source of toxic pollutants, coal has been considered a component of global energy for decades. Hence, this work was envisaged to understand the rising environmental and multiple health issues from coal power plants. Studies on the adverse impacts of coal power plants on the environment, including soil, surface water, groundwater and air, were critically evaluated. The health risk from exposure to different pollutants and toxic metals released from the power plant was also demonstrated. The study also highlighted the government initiatives and policies regarding coal power operation and generation. Lastly, the study focused on guiding coal power plant owners and policymakers in identifying the essential cues for the risk assessment and management. The current study found an association between environmental and human health risks due to power generation, which needs intervention from the scientific and medical fields to jointly address public concerns. It is also suggested that future research should concentrate on exposure assessment techniques by integrating source-identification and geographic information systems to assess the health effects of different contaminants from power plants and to mitigate their adverse impact.

The impact of coal mine dust characteristics on pathways to respiratory harm: investigating the pneumoconiotic potency of coals

Exposure to dust from the mining environment has historically resulted in epidemic levels of mortality and morbidity from pneumoconiotic diseases such as silicosis, coal workers' pneumoconiosis (CWP), and asbestosis. Studies have shown that CWP remains a critical issue at collieries across the globe, with some countries facing resurgent patterns of the disease and additional pathologies from long-term exposure. Compliance measures to reduce dust exposure rely primarily on the assumption that all "fine" particles are equally toxic irrespective of source or chemical composition. For several ore types, but more specifically coal, such an assumption is not practical due to the complex and highly variable nature of the material. Additionally, several studies have identified possible mechanisms of pathogenesis from the minerals and deleterious metals in coal. The purpose of this review was to provide a reassessment of the perspectives and strategies used to evaluate the pneumoconiotic potency of coal mine dust. Emphasis is on the physicochemical characteristics of coal mine dust such as mineralogy/mineral chemistry, particle shape, size, specific surface area, and free surface area-all of which have been highlighted as contributing factors to the expression of pro-inflammatory responses in the lung. The review also highlights the potential opportunity for more holistic risk characterisation strategies for coal mine dust, which consider the mineralogical and physicochemical aspects of the dust as variables relevant to the current proposed mechanisms for CWP pathogenesis.

Application of mNGS in the study of pulmonary microbiome in pneumoconiosis complicated with pulmonary infection patients and exploration of potential biomarkers

Background

Pneumoconiosis patients have a high prevalence of pulmonary infections, which can complicate diagnosis and treatment. And there is no comprehensive study of the microbiome of patients with pneumoconiosis. The application of metagenomic next-generation sequencing (mNGS) fills the gap to some extent by analyzing the lung microbiota of pneumoconiosis population while achieving accurate diagnosis.

Methods

We retrospectively analyzed 44 patients with suspected pneumoconiosis complicated with pulmonary infection between Jan 2020 and Nov 2022. Bronchoalveolar lavage fluid (BALF) specimens from 44 patients were collected and tested using the mNGS technology.

Results

Among the lung microbiome of pneumoconiosis patients with complicated pulmonary infection (P group), the most frequently detected bacteria and fungi at the genus level were Streptococcus and Aspergillus, at the species level were Streptococcus pneumoniae and Aspergillus flavus, respectively, and the most frequently detected DNA virus was Human gammaherpesvirus 4. There was no significant difference in α diversity between the P group and the non-pneumoconiosis patients complicated with pulmonary infection group (Non-P group) in pulmonary flora, while P< 0.01 for β diversity analysis, and the differential species between the two groups were Mycobacterium colombiense and Fusobacterium nucleatum. In addition, we monitored a high distribution of Malassezia and Pneumocystis in the P group, while herpes virus was detected in the majority of samples.

Conclusions

Overall, we not only revealed a comprehensive lung microbiome profile of pneumoconiosis patients, but also compared the differences between their microbiome and that of non-pneumoconiosis complicated with pulmonary infection patients. This provides a good basis for a better understanding of the relationship between pneumoconiosis and microorganisms, and for the search of potential biomarkers.

Efficient clinical data analysis for prediction of coal workers' pneumoconiosis using machine learning algorithms

PURPOSE

The purpose of this study is to propose an efficient coal workers' pneumoconiosis (CWP) clinical prediction system and put it into clinical use for clinical diagnosis of pneumoconiosis.

METHODS

Patients with CWP and dust-exposed workers who were enrolled from August 2021 to December 2021 were included in this study. Firstly, we chose the embedded method through using three feature selection approaches to perform the prediction analysis. Then, we performed the machine learning algorithms as the model backbone and combined them with three feature selection methods, respectively, to determine the optimal predictive model for CWP.

RESULTS

Through applying three feature selection approaches based on machine learning algorithms, it was found that AaDO₂ and some pulmonary function indicators played an important role in prediction for identifying CWP of early stage. The support vector machine (SVM) algorithm was proved as the optimal machine learning model for predicting CWP, with the ROC curves obtained from three feature selection methods using SVM algorithm whose AUC values of 97.78%, 93.7%, and 95.56%, respectively.

CONCLUSION

We developed the optimal model (SVM algorithm) through comparisons and analyses among the performances of different models for the prediction of CWP as a clinical application.

Serum Osteopontin, KL-6, and Syndecan-4 as Potential Biomarkers in the Diagnosis of Coal Workers' Pneumoconiosis: A Case-Control Study

Background

Coal worker's pneumoconiosis (CWP) is a chronic occupational disease mainly caused by coal dust inhalation in miners. This study aimed to investigate the clinical value of Osteopontin (OPN), KL-6, Syndecan-4 and Gremlin-1 as serum biomarkers in CWP.

Patients and Methods

We integrated reported lung tissues transcriptome data in pneumoconiosis patients with silica-exposed alveolar macrophage microarray data to identify four CWP-associated serum biomarkers. The serum concentrations of Osteopontin, Krebs von den Lungen-6 (KL-6), Syndecan-4 and Gremlin-1 were measured in 100 healthy controls (HCs), 100 dust-exposed workers (DEWs) and 200 patients of CWP. Receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity, specificity, cut-off value and area under the curve (AUC) value of biomarkers.

Results

The pulmonary function parameters decreased sequentially, and the serum OPN, KL-6, Syndecan-4 and Gremlin-1 concentrations were increased sequentially among the HC, DEW and CWP groups. Among all participants, multivariable analysis revealed that these four biomarkers were negatively correlated with the pulmonary function parameters (all p<0.05). Compared with HCs, patients with higher OPN, KL-6, Syndecan-4 and Gremlin-1 had higher risk for CWP. The combination of OPN, KL-6, and Syndecan-4 can improve the diagnostic sensitivity and specificity of CWP patients differentiated from HCs or DEWs.

Conclusion

OPN, KL-6 and Syndecan-4 are novel biomarkers that can be used for CWP auxiliary diagnosis. The combination of three biomarkers can improve the diagnostic values of CWP.

Anomalous Enrichment of As and Hg in Underground Coal Dust: A Case from Xishan Coalfield, Shanxi Province, North China

Coal dust is an important source of coal workers' pneumoconiosis, which is harmful to the health of underground workers. The coal dust samples were directly collected using a coal dust sampler from four major production positions in the underground coal mine. The particle size distribution, mineralogy, and occurrence of As and Hg in the coal dust samples were investigated. The results indicated that the contents of As and Hg were depleted or normal in the parent coal samples compared with the average values of C-P coal in North China and Chinese coal, but they were anomalously enriched in coal dusts. The concentrations of As and Hg in the coal dust samples studied are greater than the values of the elements in the parent coal. The As content in the coal dust samples studied is about one to three orders of magnitude above the parent coal value and the Hg content in the studied coal is 1.28 to 20.28 times higher than the parent coal value. The modes of occurrences of As and Hg were studied by sequential chemical extraction in combination with field emission scanning electron microscopy-energy dispersive spectroscopy (FESEM-EDS) and high-resolution transmission electron microscopy-EDS (HRTEM-EDS). The occurrence of As is dominated mainly by pyrite and secondarily by carbonate and silicate in the coal dust samples. Pyritic Hg and organic Hg may be the dominant forms in mining face and heading face samples, and carbonate and pyritic Hg are the main forms in rocks roadway and return airway samples. It is considered that the mechanochemical effect resulted in the formation of surface active sites and modification of the morphology. Harmful trace elements, such as As, Cd, Hg, Se, Pb, Co, Sb, and Tl, and minor grains associated with nanominerals that bear much hazardous elements, could easily be originally fractionated or adsorbed by airborne particulates. This research aims to provide a theoretical basis for the prevention of occupational disease and underground environmental evaluation.

Global evolutional trend of safety in coal mining industry: a bibliometric analysis

Mining safety is recognized as one of the factors influencing the mining industry's long-term viability. Therefore, we did a bibliometric analysis to take stock of safety management in the coal mining industry. This study suggests a three-step strategy, comprising literature extraction and screening, bibliometric analysis, and discussion, to provide an in-depth understanding of the present state and development trend of mine safety research. The findings raise additional concerns which include the following: (i) Coal dust pollution has a direct and indirect impact on the environment. (ii) Most research projects have prioritized technology innovation and development over safety norms. (iii) Most works have come from advanced countries such as China, the USA, the UK, and Australia to the neglect of developing nations, leaving a significant vacuum in the literature. (iv) There are more major safety principles in the food business than in the mining industry, indicating a weak safety culture in the mining industry. Additionally, future research goals are provided, such as creating safer policy guidelines to support technological advancements, constructing effective safety mines, and creating solutions to dust pollution and human errors.

The dependence of particle size on cell toxicity for modern mining dust

Progressive massive pulmonary fibrosis among coal miners has unexpectedly increased. It would likely due to the greater generation of smaller rock and coal particles produced by powerful equipment used in modern mines. There is limited understanding of the relationship between micro- or nanoparticles with pulmonary toxicity. This study aims to determine whether the size and chemical characteristics of typical coal-mining dust contribute to cellular toxicity. Size range, surface features, morphology, and elemental composition of coal and rock dust from modern mines were characterized. Human macrophages and bronchial tracheal epithelial cells were exposed to mining dust of three sub- micrometer and micrometer size ranges at varying concentrations, then assessed for cell viability and inflammatory cytokine expression. Coal had smaller hydrodynamic size (180–3000 nm) compared to rock (495–2160 nm) in their separated size fractions, more hydrophobicity, less surface charge, and consisted of more known toxic trace elements (Si, Pt, Fe, Al, Co). Larger particle size had a negative association with in-vitro toxicity in macrophages (p < 0.05). Fine particle fraction, approximately 200 nm for coal and 500 nm for rock particles, explicitly induced stronger inflammatory reactions than their coarser counterparts. Future work will study additional toxicity endpoints to further elucidate the molecular mechanism causing pulmonary toxicity and determine a dose–response curve.

Emissions monitoring and carcinogenic risk assessment of PM10-bounded PAHs in the air from Candiota's coal activity area, Brazil

The city of Candiota contains a great amount of coal resources. Coal activities, including coal combustion, are major releasers of polycyclic aromatic hydrocarbons (PAHs). The PAHs are considered priority air pollutants regarding their large carcinogenic potential. So, the carcinogenic risk assessment of populations living near areas with PAH sources is mandatory. This study aimed to evaluate the carcinogenic health risk of the PAH inhalation exposure of individuals living in Candiota City. A total of 158 individuals were enrolled in the study. Monitoring of PAH and meteorological parameters were carried out, and the health risk assessment was determined through the benzo(a)pyrene equivalent toxic equivalent quotient (BaP-TEQ) and the incremental lifetime cancer risk (ILCR) estimation. The coal activity area of Candiota demonstrated an annual PAH concentration of 27.7 ng/m³, PM10 concentration of 26.3 µg/m³, SO₂ concentration of 9.5 µg/m³, a BaP-TEQ value of 0.3 ng/m³, and a daily inhalation of 62.4 ng/day. The comparison among seasons showed no difference in PAH concentration and BaP-TEQ. It was observed ILCR values of 2.8 × 10^-6 and 2.6 × 10^-6 for estimation based on reference and real values, respectively, and these levels were above the reference limit of 10^-6, indicating cancer risk. Therefore, an epidemiological survey of cancer cases in the region and its relationship with environmental exposure and air pollutants levels must be required.

On the COP26 and coal's phase-out agenda: Striking a balance among the environmental, economic, and health impacts of coal consumption

Economic and environmental policy actions are often substitutionary in their impacts, as one man's food could be another's poison. One of the critical emphases at the recent Conference of Parties 26 (COP26) is the need for coal to be phased out in the energy consumption basket of nations to achieve environmental sustainability, but this could be at the expense of the positive performance of other socio-economic fundamentals. The best bet could then be to maintain an optimal consumption level to strike a balance. Relying on this, we examine the environmental, economic, and health impacts of coal consumption in the world's highest coal-consuming countries, putting the latter's threshold level into consideration. In summary, we find that there is a trade-off between pushing for a sustainable environment through a reduction in coal consumption and achieving better growth and health status. This implies that phasing out of coal totally will have severe economic and health costs. However, based on our threshold regression model results, it is most reasonable to maintain a lower level of coal use in the overall energy mix of these countries. This will definitely yield a relatively low level of carbon, but will still assure a certain level of economic growth and health performance. As such, reducing the intensity of coal gradually and simultaneously providing a substitute that can also serve economic and health needs are encouraged.

Exosomal miRNAs contribute to coal dust particle-induced pulmonary fibrosis in rats

Coal workers' pneumoconiosis (CWP) is a fatal occupational disease caused by inhalation of coal dust particles, which leads to progressive pulmonary fibrosis. Recently, as new signal carriers for intercellular communication, exosomal miRNAs have been validated in the pathogenesis of multiple diseases. However, the research on exosomal miRNAs in CWP is still in the preliminary stage. Here, using miRNA sequencing, exosomal miRNA profiles in bronchoalveolar lavage fluid (BALF) from rats with pulmonary fibrosis induced by coal dust particles were analyzed, and the underlying biological function of putative target genes was explored by GO term analysis and KEGG pathway enrichment analysis. According to the results, intratracheal instillation of coal dust particles can alter the exosomal miRNAs expression in the BALF of rats. Further bioinformatics analysis provided some clues to reveal their function in pathological process of pneumoconiosis. More importantly, we identified 4 differentially expressed exosomal miRNAs (miRNA-21-5p, miRNA-29a-3p, miRNA-26a-5p, and miRNA-34a-5p) by qRT‑PCR and further verified the temporal changes in the expression of these exosomal miRNAs in animal models from 2 weeks to 16 weeks postexposure. In addition, we conducted a preliminary study on Smad7 as a potential target of miRNA-21-5p and found that exosomal miRNA 21-5p/Smad7 may contribute to the pulmonary fibrosis induced by coal dust particles. Our study confirmed the contribution of exosomal miRNAs to coal dust particle-induced pulmonary fibrosis and provided new insights into the pathogenesis of CWP.

The Potential Diagnostic Biomarkers for the IgG Subclass in Coal Workers' Pneumoconiosis

Evidence suggests that exposure to coal dust increases immunoglobulin concentration. However, there is a paucity of data reporting immunoglobulin G (IgG) subclass in coal workers' pneumoconiosis (CWP). Therefore, this study intended to evaluate potential diagnostic biomarkers for the disease. CWP patients, dust-exposed workers without pneumoconiosis (DEW), and matched healthy controls (HCs) presented to the General Hospital of Datong Coal Mining Group and Occupational Disease Prevention and Treatment Hospital of Datong Coal Mining Group between May 2019 and September 2019 were recruited. The serum immunoglobulin concentration was determined by the multiplex immunoassay technique. Totally, 104 CWP patients, 109 DEWs, and 74 HCs were enrolled. Serum levels of IgG1, IgG2, IgM, and IgA were elevated in CWPs compared with those in DEWs and HCs (P < 0.05). The order of diagnostic accuracy between CWPs and DEWs depicted by the receiver operating characteristic (ROC) curve was IgG2, IgM, IgG1, IgG3, and IgA. Significantly higher IgG1/IgG3 and IgG2/IgG3 ratios were observed in the CWP group than in DEW and HC groups. Based on the IgG2/IgG3 ratio, the area under the ROC curve between CWP and DEW was 0.785 (95% CI 0.723-0.838), with a sensitivity of 73.1% and a specificity of 73.4%. Our findings suggest that IgG1, IgG2, IgM, and IgA are higher in the CWPs than DEWs and HCs. The IgG2/IgG3 ratio provides a viable alternative for the diagnosis of CWP.

Understanding the pathogenesis of occupational coal and silica dust-associated lung disease

Workers in the mining and construction industries are at increased risk of respiratory and other diseases as a result of being exposed to harmful levels of airborne particulate matter (PM) for extended periods of time. While clear links have been established between PM exposure and the development of occupational lung disease, the mechanisms are still poorly understood. A greater understanding of how exposures to different levels and types of PM encountered in mining and construction workplaces affect pathophysiological processes in the airways and lungs and result in different forms of occupational lung disease is urgently required. Such information is needed to inform safe exposure limits and monitoring guidelines for different types of PM and development of biomarkers for earlier disease diagnosis. Suspended particles with a 50% cut-off aerodynamic diameter of 10 µm and 2.5 µm are considered biologically active owing to their ability to bypass the upper respiratory tract's defences and penetrate deep into the lung parenchyma, where they induce potentially irreversible damage, impair lung function and reduce the quality of life. Here we review the current understanding of occupational respiratory diseases, including coal worker pneumoconiosis and silicosis, and how PM exposure may affect pathophysiological responses in the airways and lungs. We also highlight the use of experimental models for better understanding these mechanisms of pathogenesis. We outline the urgency for revised dust control strategies, and the need for evidence-based identification of safe level exposures using clinical and experimental studies to better protect workers' health.

Glycogen metabolism reprogramming promotes inflammation in coal dust-exposed lung

Long-term coal dust exposure triggers complex inflammatory processes in the coal workers' pneumoconiosis (CWP) lungs. The progress of the inflammation is reported to be affected by disordered cell metabolism. However, the changes in the metabolic reprogramming associated with the pulmonary inflammation induced by the coal dust particles are unknown. Herein, we show that coal dust exposure causes glycogen accumulation and the reprogramming of glucose metabolism in the CWP lung. The glycogen accumulation caused by coal dust is mainly due to macrophages, which reprogram glycogen metabolism and trigger an inflammatory response. In addition, 2-deoxy-D-glucose (2-DG) reduced glycogen content in macrophages, which was accompanied by mitigated inflammation and restrained NF-κB activation. Accordingly, we have pinpointed a novel and crucial metabolic pathway that is an essential regulator of the inflammatory phenotype of coal dust-exposed macrophages. These results shed light on new ways to regulate CWP inflammation.

A New Strategy for Identification of Coal Miners With Abnormal Physical Signs Based on EN-mRMR

Coal miners’ occupational health is a key part of production safety in the coal mine. Accurate identification of abnormal physical signs is the key to preventing occupational diseases and improving miners’ working environment. There are many problems when evaluating the physical health status of miners manually, such as too many sign parameters, low diagnostic efficiency, missed diagnosis, and misdiagnosis. To solve these problems, the machine learning algorithm is used to identify miners with abnormal signs. We proposed a feature screening strategy of integrating elastic net (EN) and Max-Relevance and Min-Redundancy (mRMR) to establish the model to identify abnormal signs and obtain the key physical signs. First, the raw 21 physical signs were expanded to 25 by feature construction technology. Then, the EN was used to delete redundant physical signs. Finally, the mRMR combined with the support vector classification of intelligent optimization algorithm by Gravitational Search Algorithm (GSA-SVC) is applied to further simplify the rest of 12 relatively important physical signs and obtain the optimal model with data of six physical signs. At this time, the accuracy, precision, recall, specificity, G-mean, and MCC of the test set were 97.50%, 97.78%, 97.78%, 97.14%, 0.98, and 0.95. The experimental results show that the proposed strategy improves the model performance with the smallest features and realizes the accurate identification of abnormal coal miners. The conclusion could provide reference evidence for intelligent classification and assessment of occupational health in the early stage.

Use data augmentation for a deep learning classification model with chest X-ray clinical imaging featuring coal workers' pneumoconiosis

PURPOSE

This paper aims to develop a successful deep learning model with data augmentation technique to discover the clinical uniqueness of chest X-ray imaging features of coal workers' pneumoconiosis (CWP).

PATIENTS AND METHODS

We enrolled 149 CWP patients and 68 dust-exposure workers for a prospective cohort observational study between August 2021 and December 2021 at First Hospital of Shanxi Medical University. Two hundred seventeen chest X-ray images were collected for this study, obtaining reliable diagnostic results through the radiologists' team, and confirming clinical imaging features. We segmented regions of interest with diagnosis reports, then classified them into three categories. To identify these clinical features, we developed a deep learning model (ShuffleNet V2-ECA Net) with data augmentation through performances of different deep learning models by assessment with Receiver Operation Characteristics (ROC) curve and area under the curve (AUC), accuracy (ACC), and Loss curves.

RESULTS

We selected the ShuffleNet V2-ECA Net as the optimal model. The average AUC of this model was 0.98, and all classifications of clinical imaging features had an AUC above 0.95.

CONCLUSION

We performed a study on a small dataset to classify the chest X-ray clinical imaging features of pneumoconiosis using a deep learning technique. A deep learning model of ShuffleNet V2 and ECA-Net was successfully constructed using data augmentation, which achieved an average accuracy of 98%. This method uncovered the uniqueness of the chest X-ray imaging features of CWP, thus supplying additional reference material for clinical application.

Inflammation and fibrosis in the coal dust-exposed lung described by confocal Raman spectroscopy

Background

Coal workers' pneumoconiosis (CWP) is an occupational disease that severely damages the life and health of miners. However, little is known about the molecular and cellular mechanisms changes associated with lung inflammation and fibrosis induced by coal dust. As a non-destructive technique for measuring biological tissue, confocal Raman spectroscopy provides accurate molecular fingerprints of label-free tissues and cells. Here, the progression of lung inflammation and fibrosis in a murine model of CWP was evaluated using confocal Raman spectroscopy.

Methods

A mouse model of CWP was constructed and biochemical analysis in lungs exposed to coal dust after 1 month (CWP-1M) and 3 months (CWP-3M) vs control tissues (NS) were used by confocal Raman spectroscopy. H&E, immunohistochemical and collagen staining were used to evaluate the histopathology alterations in the lung tissues.

Results

The CWP murine model was successfully constructed, and the mouse lung tissues showed progression of inflammation and fibrosis, accompanied by changes in NF-κB, p53, Bax, and Ki67. Meanwhile, significant differences in Raman bands were observed among the different groups, particularly changes at 1,248, 1,448, 1,572, and 746 cm^-1. These changes were consistent with collagen, Ki67, and Bax levels in the CWP and NS groups.

Conclusion

Confocal Raman spectroscopy represented a novel approach to the identification of the biochemical changes in CWP lungs and provides potential biomarkers of inflammation and fibrosis.

Computer-Aided Diagnosis of Coal Workers' Pneumoconiosis in Chest X-ray Radiographs Using Machine Learning: A Systematic Literature Review

Computer-aided diagnostic (CAD) systems can assist radiologists in detecting coal workers' pneumoconiosis (CWP) in their chest X-rays. Early diagnosis of the CWP can significantly improve workers' survival rate. The development of the CAD systems will reduce risk in the workplace and improve the quality of chest screening for CWP diseases. This systematic literature review (SLR) amis to categorise and summarise the feature extraction and detection approaches of computer-based analysis in CWP using chest X-ray radiographs (CXR). We conducted the SLR method through 11 databases that focus on science, engineering, medicine, health, and clinical studies. The proposed SLR identified and compared 40 articles from the last 5 decades, covering three main categories of computer-based CWP detection: classical handcrafted features-based image analysis, traditional machine learning, and deep learning-based methods. Limitations of this review and future improvement of the review are also discussed.

Estimating mortality from coal workers' pneumoconiosis among Medicare beneficiaries with pneumoconiosis using binary regressions for spatially sparse data

Background

Coal workers' pneumoconiosis (CWP) is an occupational lung disease due to inhalation of coal dust. We estimated mortality from CWP and other pneumoconioses among Medicare beneficiaries.

Methods

We used the 5% Medicare Limited Claims Data Set, 2011–2014, to identify patients diagnosed with ICD‐9‐CM 500 (CWP) through 505 (Asbestosis, Pneumoconiosis due to other silica or silicates, Pneumoconiosis due to other inorganic dust, Pneumonopathy due to inhalation of other dust, and Pneumoconiosis, unspecified) codes. We applied binary regression models with spatial random effects to determine the association between CWP and mortality. Our inferences are based on Bayesian spatial hierarchical models, and model fitting was performed using Integrated Nested Laplace Approximation (INLA) algorithm in R/RStudio software.

Results

The median age of the sample was 76 years. In a sample of 8531 Medicare beneficiaries, 2568 died. Medicare beneficiaries with CWP had 25% higher odds of death (adjusted OR: 1.25, 95% CI: 1.07, 1.46) than those with other types of pneumoconiosis. The number of comorbid conditions elevated the odds of death by 10% (adjusted OR: 1.10, 95% CI: 1.09, 1.10).

Conclusion

CWP increases the likelihood of death among Medicare beneficiaries. Healthcare professionals should make concerted efforts to monitor patients with CWP to prevent premature mortality.

Study on dust migration law and spray dedusting technology in parallel double belt transportation

To effectively solve the problem of dust pollution caused by the parallel double-belt transportation of coal in a coal preparation plant, taking the Huangyuchuan coal preparation plant as an example, a numerical model of the air flow-dust distribution was established by means of simulation. The flow lines between the strips of tape and the tail of the tape machine will gather, and there will be backflow on the right side of the 3001 tape and left side of the 3002 tape. Under the action of wind current, most of the dust particles larger than 10 μm are distributed in the range of 0–5 m on both sides of the tape; dust particles smaller than 10 μm spread to the entire preparation workshop. Combined with field test verification, dust pollution is mainly concentrated at the guide trough, the feed inlet, the rear of the machine, and the joint of the belt corridor. Based on this, a targeted spray dust reduction treatment plan is proposed. By measuring the dust concentration before and after the treatment of dust-polluted areas, it is proven that the dust reduction efficiency of this plan can reach more than 90%.

Cost-effectiveness of comprehensive preventive measures for coal workers' pneumoconiosis in China

Background

Coal workers’ pneumoconiosis (CWP) remains one of the most severe occupational diseases in China. Despite the implementation of CWP comprehensive preventive measures, the unreasonable allocation of investment by coal enterprises limits the effect of preventing CWP, especially when the health resources are inadequate. This study aims to evaluate the cost-effectiveness of comprehensive measures for CWP from the perspective of coal enterprises.

Methods

Comprehensive measures and two primary interventions (engineering controls and individual protective equipment) were selected. A time-dependent Markov model was developed to evaluate cost and quality-adjusted life-years (QALYs). The input data were collected from the survey and literature. A hypothetical null situation, in which the currently implemented interventions were eliminated, was used as a comparator based on the generalised cost-effectiveness analysis (GCEA) recommended by the World Health Organization (WHO). The primary outcomes of the model were reported in terms of incremental cost-effectiveness ratios (ICERs). Uncertainty was verified using one-way and probabilistic sensitivity analyses.

Results

The QALYs of the comprehensive measures, engineering controls, and individual protective equipment were 17.60, 17.50, and 16.85 years, respectively. Compared with null, the ICERs of the interventions were 65,044.73, 30,865.15, and 86,952.41 RMB/QALY, respectively. Individual protective equipment was dominated by an ICER of -11,416.02 RMB/QALY compared to engineering controls. Sensitivity analysis suggested the robustness of the results.

Conclusions

The comprehensive preventive measures for CWP that are currently implemented in Chinese state-owned mines are cost-effective. In comprehensive measures, engineering controls are more cost-effective than individual protective equipment. Investment in engineering controls should be increased to improve the cost-effectiveness of preventing CWP.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07654-7.

Coal dust exposure triggers heterogeneity of transcriptional profiles in mouse pneumoconiosis and Vitamin D remedies

Background

Coal dust particles (CDP), an inevitable by-product of coal mining for the environment, mainly causes coal workers’ pneumoconiosis (CWP). Long-term exposure to coal dust leads to a complex alternation of biological processes during regeneration and repair in the healing lung. However, the cellular and complete molecular changes associated with pulmonary homeostasis caused by respiratory coal dust particles remain unclear.

Methods

This study mainly investigated the pulmonary toxicity of respirable-sized CDP in mice using unbiased single-cell RNA sequencing. CDP (< 5 μm) collected from the coal mine was analyzed by Scanning Electron Microscope (SEM) and Mass Spectrometer. In addition, western blotting, Elisa, QPCR was used to detect gene expression at mRNA or protein levels. Pathological analysis including HE staining, Masson staining, immunohistochemistry, and immunofluorescence staining were performed to characterize the structure and functional alternation in the pneumoconiosis mouse and verify the reliability of single-cell sequencing results.

Results

SEM image and Mass Spectrometer analysis showed that coal dust particles generated during coal mine production have been crushed and screened with a diameter of less than 5 µm and contained less than 10% silica. Alveolar structure and pulmonary microenvironment were destroyed, inflammatory and death (apoptosis, autophagy, and necrosis) pathways were activated, leading to pneumoconiosis in post 9 months coal dust stimulation. A distinct abnormally increased alveolar type 2 epithelial cell (AT2) were classified with a highly active state but reduced the antimicrobial-related protein expression of LYZ and Chia1 after CDP exposure. Beclin1, LC3B, LAMP2, TGF-ß, and MLPH were up-regulated induced by CDP, promoting autophagy and pulmonary fibrosis. A new subset of macrophages with M2-type polarization double expressed MLPH + /CD206 + was found in mice having pneumoconiosis but markedly decreased after the Vitamin D treatment. Activated MLPH + /CD206 + M2 macrophages secreted TGF-β1 and are sensitive to Vitamin D treatment.

Conclusions

This is the first study to reconstruct the pathologic progression and transcriptome pattern of coal pneumoconiosis in mice. Coal dust had obvious toxic effects on lung epithelial cells and macrophages and eventually induced pulmonary fibrosis. CDP-induced M2-type macrophages could be inhibited by VD, which may be related to the alleviation of the pulmonary fibrosis process.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12989-022-00449-y.

Wetting Mechanism and Experimental Study of Synergistic Wetting of Bituminous Coal with SDS and APG1214

To solve the problem of poor dust wettability during coal mine dust treatment, sodium dodecyl sulfate (SDS) and alkyl glycoside (APG1214) were selected for compounding. An efficient, environmentally friendly, economical wetting agent was prepared. First, through molecular dynamics simulation studies, it was determined that the tail group C of SDS and APG1214 was adsorbed on the surface of bituminous coal, and the head groups S and O were adsorbed on the surface of water. The simulation result is found to be consistent with the surfactant solution dust removal theory, which proves the confidence of simulation. Then, by comparing the interaction of water-SDS and APG1214-bituminous coal and water-bituminous coal systems and the number of hydrogen bonds, the wetting mechanism of the SDS and APG1214 solution on bituminous coal was revealed. Finally, the surface tension, contact angle, and wetting time of different SDS and APG1214 solutions were determined by experiments and they decreased with decreasing mass fraction of SDS at the same concentration. The surface tension of the SDS and APG1214 solution and the number of micelles affected the wettability of bituminous coal. The optimal concentration of the SDS and APG1214 solution was 0.7%, and the optimal ratio was SDS/APG1214 = 1:3.

Environmental Exposures and Lung Aging: Molecular Mechanisms and Implications for Improving Respiratory Health

PURPOSE OF REVIEW

Inhaled environmental exposures cause over 12 million deaths per year worldwide. Despite localized efforts to reduce environmental exposures, tobacco smoking and air pollution remain the urgent public health challenges that are contributing to the growing prevalence of respiratory diseases. The purpose of this review is to describe the mechanisms through which inhaled environmental exposures accelerate lung aging and cause overt lung disease.

RECENT FINDINGS

Environmental exposures related to fossil fuel and tobacco combustion and occupational exposures related to silica and coal mining generate oxidative stress and inflammation in the lungs. Sustained oxidative stress causes DNA damage, epigenetic instability, mitochondrial dysfunction, and cell cycle arrest in key progenitor cells in the lung. As a result, critical repair mechanisms are impaired, leading to premature destruction of the lung parenchyma. Inhaled environmental exposures accelerate lung aging by injuring the lungs and damaging the cells responsible for wound healing. Interventions that minimize exposure to noxious antigens are critical to improve lung health, and novel research is required to expand our knowledge of therapies that may slow or prevent premature lung aging.

A systematic review and meta-analysis on international studies of prevalence, mortality and survival due to coal mine dust lung disease

BACKGROUND

Coal mine dust lung disease comprises a group of occupational lung diseases including coal workers pneumoconiosis. In many countries, there is a lack of robust prevalence estimates for these diseases. Our objective was to perform a systematic review and meta-analysis of published contemporary estimates on prevalence, mortality, and survival for coal mine dust lung disease worldwide.

METHODS

Systematic searches of PubMed, EMBASE and Web of Science databases for English language peer-reviewed articles published from 1/1/2000 to 30/03/2021 that presented quantitative estimates of prevalence, mortality, or survival for coal mine dust lung disease. Review was conducted per PRISMA guidelines. Articles were screened independently by two authors. Studies were critically assessed using Joanna Briggs Institute tools. Pooled prevalence estimates were obtained using random effects meta-analysis models. Heterogeneity was measured using the I2 statistics and publication bias using Egger's tests.

RESULTS

Overall 40 studies were included, (31 prevalence, 8 mortality, 1 survival). Of the prevalence estimates, fifteen (12 from the United States) were retained for the meta-analysis. The overall pooled prevalence estimate for coal workers pneumoconiosis among underground miners was 3.7% (95% CI 3.0-4.5%) with high heterogeneity between studies. The pooled estimate of coal workers pneumoconiosis prevalence in the United States was higher in the 2000s than in the 1990s, consistent with published reports of increasing prevalence following decades of declining trends. Sub-group analyses also indicated higher prevalence among underground miners, and in Central Appalachia. The mortality studies were suggestive of reduced pneumoconiosis mortality rates over time, relative to the general population.

CONCLUSION

The ongoing prevalence of occupational lung diseases among contemporary coal miners highlights the importance of respiratory surveillance and preventive efforts through effective dust control measures. Limited prevalence studies from countries other than the United States limits our understanding of the current disease burden in other coal-producing countries.

Respirable Coal Mine Dust: A Review of Respiratory Deposition, Regulations, and Characterization

In the late 1990s, despite years of efforts to understand and reduce coal worker’s pneumoconiosis (CWP) prevalence from more than 30% in 1970 to less than 4.2%, the level of occurrence among the US coal miners increased unexpectedly. The recent resurgence of lung diseases has raised concerns in the scientific and regulatory communities. In 2014, the United States Mine Safety and Health Administration (MSHA) issued a new dust rule changing the respirable coal mine dust (RCMD) exposure limits, measurement technology, and sampling protocol. The analysis for probable causes for the substantial increase in the CWP incidence rate is rather complicated. This paper aims to conduct a review of RCMD respiratory deposition, health effects, monitoring, regulations, and particle characteristics. The primary sources of RCMD along with the health risks from potential exposure are highlighted, and the current RCMD exposure regulations of the major coal producer countries are compared. A summary of RCMD characterization studies from 1972 to the present is provided. A review of the literature revealed that numerous factors, including geological and mining parameters, advancements in mining practices, particle characteristics, and monitoring approaches are considered to contribute to the recent resurgence of RCMD lung diseases. However, the root causes of the problem are still unknown. The effectiveness of the new dust rules in the United States will probably take years to be correctly assessed. Therefore, future research is needed to understand the relationship between RCMD particle characteristics and lung deposition, and the efficacy of current monitoring practices to measure the true dose of RCMD exposure.

Exploration of Three Incidence Trend Prediction Models Based on the Number of Diagnosed Pneumoconiosis Cases in China From 2000 to 2019

OBJECTIVE

To predict the future incidence trend of pneumoconiosis in China, and to evaluate three predictive models.

METHODS

We selected pneumoconiosis cases (2000-2019) to fit Generalized Additive Model (GAM), Curve Fitting Method, and GM (1,1) Model, chosen average fitting relative error, relative error of prediction, and coefficient of determination to evaluate models.

RESULTS

Chinese incidence trend of pneumoconiosis would decrease in the future. Predicted value of GAM (14,566) and Curve Fitting Method (15,781) in 2019 was close to the actual value (15,898). Relative error of prediction of GAM and Curve Fitting Method was -8.38% and -0.73%, respectively.

CONCLUSIONS

The government needs to strengthen prevention and control since pneumoconiosis cases might remain huge in the future. Besides, we advise that GAM and Curve Fitting Method can be used to predict Chinese incidence trend of pneumoconiosis.

No association between pyrite content and lung cell responses to coal particles

There has been an increase in the identification of cases of coal workers’ pneumoconiosis (CWP) in recent years around the world. While there are a range of possible explanations for this, studies have implicated the pyrite content of coal as a key determinant of CWP risk. However, experimental studies to support this link are limited. The aim of this study was to assess the association between the pyrite content, and subsequent release of bioavailable iron, in coal particles and the response of lung cells involved in the pathogenesis of CWP (epithelial cells, macrophages and fibroblasts). Using real-world Australian coal samples, we found no evidence of an association between the pyrite content of the coal and the magnitude of the detrimental cell response. We did find evidence of an increase in IL-8 production by epithelial cells with increasing bioavailable iron (p = 0.01), however, this was not linked to the pyrite content of the coal (p = 0.75) and we did not see any evidence of a positive association in the other cell types. Given the lack of association between the pyrite content of real-world coal particles and lung cell cytotoxicity (epithelial cells and macrophages), inflammatory cytokine production (epithelial cells, macrophages and fibroblasts), and cell proliferation (fibroblasts) our data do not support the use of coal pyrite content as a predictor of CWP risk.

Pneumoconiosis: current status and future prospects

ABSTRACT

Pneumoconiosis refers to a spectrum of pulmonary diseases caused by inhalation of mineral dust, usually as the result of certain occupations. The main pathological features include chronic pulmonary inflammation and progressive pulmonary fibrosis, which can eventually lead to death caused by respiratory and/or heart failure. Pneumoconiosis is widespread globally, seriously threatening global public health. Its high incidence and mortality lie in improper occupational protection, and in the lack of early diagnostic methods and effective treatments. This article reviews the epidemiology, safeguard procedures, diagnosis, and treatment of pneumoconiosis, and summarizes recent research advances and future research prospects.

A Nurse-Led Education Program for Pneumoconiosis Caregivers at the Community Level

Pneumoconiosis is an irreversible chronic disease. With functional limitations and an inability to work, pneumoconiosis patients require support from family caregivers. However, the needs of pneumoconiosis caregivers have been neglected. This study aimed to evaluate the effectiveness of a nurse-led education program, which involved four weekly 90-min workshops led by an experienced nurse and guided by Orem’s self-care deficit theory. A single-group, repeated-measure study design was adopted. Caregivers’ mental health (Hospital Anxiety and Depression Scale, HADS, four single items for stress, worriedness, tiredness, and insufficient support), caregiving burdens (caregiving burden scale, CBS), and unmet direct support and enabling needs (Carer Support Needs Assessment Tool, CSNAT) were measured at the baseline (T0), immediately after (T1), and one month after intervention (T2); 49, 41, and 28 female participants completed the T0, T1, and T2 measurements. Mean age was 65.9 years old (SD 10.08) with a range between 37 and 85 years old. The program improved the caregivers’ mental wellbeing, and reduced their caregiving burdens and their unmet support and enabling needs, both immediately (T1) and one-month after the intervention (T2). In particular, the intervention improved the caregivers’ mental wellbeing significantly, specifically depression symptoms, stress, and tiredness immediately after the intervention; and reduced most of their unmet support needs and unmet enabling needs one-month after the intervention. This was the first nurse-led program for pneumoconiosis caregivers and should serve as a foundation for further studies to test the program with robust designs.

Meteorological normalisation of PM10 using machine learning reveals distinct increases of nearby source emissions in the Australian mining town of Moranbah

The impacts of poor air quality on human health are becoming more apparent. Businesses and governments are implementing technologies and policies in order to improve air quality. Despite this the PM₁₀ air quality in the mining town of Moranbah, Australia, has worsened since measurements commenced in 2011. The annual average PM₁₀ concentrations during 2012, 2017, 2018 and 2019 have all exceeded the Australian National Environmental Protection Measure's standard, and there has been an increase in the frequency of exceedances of the daily standard. The average annual increase in PM₁₀ was 1.2 ± 0.5 μg m - 3 per year between 2011 and 2019 and has been 2.5 ± 1.2 μg m - 3 per year since 2014. The cause of this has not previously been established. Here, two machine learning algorithms (gradient boosted regression and random forest) have been implemented to model and then meteorologically normalise PM₁₀ mass concentrations measured in Moranbah. The best performing model, using the random forest algorithm, was able to explain 59% of the variance in PM₁₀ using a range of meteorological, environmental and temporal variables as predictors. An increasing trend after normalising for these factors was found of 0.6 ± 0.5 μg m - 3 per year since 2011 and 1.7 ± 0.3 μg m - 3 per year since 2014. These results indicate that more than half of the increase in PM₁₀ is due to a rise in local emissions in the region. The remainder of the rise in PM₁₀ was found to be due to a decrease of soil water content in the surrounding region, which can facilitate higher dust emissions. Whether the presence of open-cut coal mines exacerbated the role of soil water content is unclear. Although fires can have drastic effects on the local air quality, changes in fire patterns are not responsible for the rising trend. PM₁₀ composition measurements or more detailed data relating to local sources is still needed to better isolate these emissions. Nonetheless, this study highlights the need and potential for action by industry and government to improve the air quality and reduce health risks for the nearby population.

Coal Dust-Induced Systematic Hypoxia and Redox Imbalance among Coal Mine Workers

Continuous inhalation of coal dust among coal workers leads to a variety of disorders. The present study aims to evaluate the potential oxidative stress associated with coal dust generated from coal mining activities among exposed workers through the antioxidant enzyme system, including superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). In this study cohort, intensive coal mine workers were assessed for antioxidant variations. Blood samples were collected from dust-exposed workers (engaged in different activities at coal mines; n = 311) and residents of the same city (nonexposed, control group; n = 50). The workers' exposure to coal dust was categorized based on working area (administrative group, surface workers, underground workers), working hours (up to 8 h and more than 8 h), and time of service. The results showed significantly altered activities of SOD, CAT, and GSH among the whole exposed group and its categories compared to the control group. A significant difference was also observed between high- and low-exposure groups. Statistical analysis revealed a negative correlation between antioxidant activity (catalase and SOD) and coal dust levels. Besides, coal exposure was associated with the time of service, smoking status, and dietary habits. The findings of this study reveal higher oxidative stress among highly exposed coal mine workers (underground workers > surface workers > administrative group > nonexposed group), and longer working hours have more pronounced adverse effects on workers' health.

The impacts of coal dust on miners' health: A review

As one of the most important energy resources in the world, coal contributes a great deal to the world economy. Coal mining and processing involve multiple dust generation processes including coal cutting, transport, crushing and milling etc. Coal dust is one of the main sources of health hazard for the coal workers. Exposure of coal dusts can be prevented through administrative controls and engineering controls. Ineffective control of coal dust exposure can harm coal workers' health. Although many efforts have been made to eliminate these threats, recent years have seen an unexpected increase in coal workers' pneumoconiosis (CWP) in Appalachian basin in US. To explore the reasons for this phenomenon, in this review, we first reviewed the historical studies on coal mine dust including the regulation and engineering controls. Then, the effects of coal dust on human health was comprehensively reviewed. Next, the effects of nanoparticles on human health were reviewed, with an emphasis on toxicity of nanoparticles such as carbon nanotubes in other industries. From all this information, we hypothesize that nano-sized coal dust has contributed to the increase of CWP prevalence in recent years. As no research has been reported in this area, four directions which may need further investigation and future studies are recommended in this review. They include: 1) Systematic characterization of physicochemical properties of nano-size coal dust; 2) Toxicity and pathogenesis of nano-sized coal dust; 3) Development of real-time monitoring technology and equipment for nano-sized coal dust; 4) Development of exposure control technology and equipment. The intent of this review paper is to demonstrate the variation of coal dust properties and their impact on the mine worker's health. We suggest that the impact of nano-sized coal mine dust on miner's health has not yet been understood well and further improvements are necessary.

Respiratory surveillance for coal mine dust and artificial stone exposed workers in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand

Coal mine lung dust disease (CMDLD) and artificial stone (AS) silicosis are preventable diseases which have occurred in serious outbreaks in Australia recently. This has prompted a TSANZ review of Australia's approach to respiratory periodic health surveillance. While regulating respirable dust exposure remains the foundation of primary and secondary prevention, identification of workers with early disease assists with control of further exposure, and with the aims of preserving lung function and decreasing respiratory morbidity in those affected. Prompt detection of an abnormality also allows for ongoing respiratory specialist clinical management. This review outlines a medical framework for improvements in respiratory surveillance to detect CMDLD and AS silicosis in Australia. This includes appropriate referral, improved data collection and interpretation, enhanced surveillance, the establishment of a nationwide Occupational Lung Disease Registry and an independent advisory group. These measures are designed to improve health outcomes for workers in the coal mining, AS and other dust-exposed and mining industries.

Extracellular Histones Promote Pulmonary Fibrosis in Patients With Coal Workers' Pneumoconiosis

OBJECTIVE

This investigation assessed the profibrotic role that extracellular histones play in the pathogenesis of coal workers' pneumoconiosis (CWP).

METHODS

The correlation of extracellular histones with small opacity profusion (SOP) and transforming growth factor-β (TGF-β) was analyzed. The stimulating effect of extracellular histones on pulmonary fibroblast was assessed in vitro.

RESULTS

The levels of extracellular histones in plasma were positively correlated with SOP and TGF-β in the coal miners investigated. Plasma collected from patients with CWP caused apparent lung fibroblast proliferation, while anti-H4 antibody antagonized the stimulating effect of the patient plasma by blocking histone H4. In vitro experiments showed that extracellular histones directly stimulated fibroblast proliferation.

CONCLUSION

Consistent with our hypothesis, the concentrations of extracellular histones were indices of the severity of pulmonary fibrosis in simple CWP, and extracellular histones-targeted intervention could inhibit the proliferation of lung fibroblast.

NAF1 rs4691896 Is Significantly Associated with Coal Workers' Pneumoconiosis in a Chinese Han Population: A Case-Control Study

Background

Previous studies have demonstrated the important role of genetic predisposition in coal workers’ pneumoconiosis (CWP) in addition to environmental factors. The pathogenesis of pulmonary fibrosis disease is related to telomere activity. We performed this study to assess the association between genetic variants of telomere-related genes and the risk of CWP.

Material/Methods

We enrolled 652 CWP Chinese Han patients and 648 dust-exposed controls in this case-control design study, genotyping 8 single-nucleotide polymorphisms (SNPs) including TERT (rs2736100), TERC (rs10936599 and rs12696304), and NAF1 (rs7675998, rs3822304, rs12331717, rs936562 and rs4691896) using the Sequenom MassARRAY system.

Results

We identified a significant allele association between NAF1 rs4691896 and CWP by comparing patients with controls (22.0% vs. 13.0%, odds ratio [OR]: 1.89, 95% confidence interval [CI]: 1.54–2.33, Pc=1.14×10⁻⁸). The genotype frequency of rs4691896 differed significantly between the patients and controls (Pc=1.49×10⁻⁸). In addition, rs4691896 was correlated with CWP in an additive genetic model (OR: 1.96, 95% CI: 1.58–2.44, Pc=8.96×10⁻⁹) and a dominant model (OR: 2.15, 95% CI: 1.70–2.73, Pc=2.39×10⁻⁹).

Conclusions

Our study for the first time demonstrates an association between a telomere-related gene (NAF1) and CWP in a Chinese Han population, and provides valuable insight to further understand the possible pathogenetic mechanism of fibrosis in CWP.

Mining is bad for health: a voyage of discovery

Mining continues to be a dangerous activity, whether large-scale industrial mining or small-scale artisanal mining. Not only are there accidents, but exposure to dust and toxins, along with stress from the working environment or managerial pressures, give rise to a range of diseases that affect miners. I look at mining and health from various personal perspectives: that of the ordinary man (much of life depends on mined elements in the house, car and phone); as a member of the Society for Environmental Geochemistry and Health (environmental contamination and degradation leads to ill health in nearby communities); as a public health doctor (mining health is affected by many factors, usually acting in a mix, ranging from individual inheritance-genetic makeup, sex, age; personal choices-diet, lifestyle; living conditions-employment, war; social support-family, local community; environmental conditions-education, work; to national and international constraints-trade, economy, natural world); as a volunteer (mining health costs are not restricted to miners or industry but borne by everyone who partakes of mining benefits-all of us); and as a lay preacher (the current global economy concentrates on profit at the expense of the health of miners). Partnership working by academics with communities, government and industry should develop evidence-based solutions. Employment, health, economic stability and environmental protection need not be mutually exclusive. We all need to act.

Trends in global, regional and national incidence of pneumoconiosis caused by different aetiologies: an analysis from the Global Burden of Disease Study 2017

OBJECTIVES

Pneumoconiosis remains a major global occupational health hazard and illness. Accurate data on the incidence of pneumoconiosis are critical for health resource planning and development of health policy.

METHODS

We collected data for the period between 1990 and 2017 on the annual incident cases and the age-standardised incidence rates (ASIR) of pneumoconiosis aetiology from the Global Burden of Disease Study 2017. We calculated the average annual percentage changes of ASIR by sex, region and aetiology in order to determine the trends of pneumoconiosis.

RESULTS

Globally, the number of pneumoconiosis cases increased by a measure of 66.0%, from 36 186 in 1990 to 60 055 in 2017. The overall ASIR decreased by an average of 0.6% per year in the same period. The number of pneumoconiosis cases increased across the five sociodemographic index regions, and there was a decrease in the ASIR from 1990 to 2017. The ASIR of silicosis, coal workers' pneumoconiosis and other pneumoconiosis decreased. In contrast, measures of the ASIR of asbestosis displayed an increasing trend. Patterns of the incidence of pneumoconiosis caused by different aetiologies were found to have been heterogeneous for analyses across regions and among countries.

CONCLUSION

Incidence patterns of pneumoconiosis which were caused by different aetiologies varied considerably across regions and countries of the world. The patterns of incidence and temporal trends should facilitate the establishment of more effective and increasingly targeted methods for prevention of pneumoconiosis and reduce associated disease burden.

Air Pollution Emissions 2008-2018 from Australian Coal Mining: Implications for Public and Occupational Health

Occupational exposure limits for respirable coal dust are based on exposure during working hours, but coal miners may experience additional community-based exposures during nonworking hours. We analyzed Australia National Pollutant Inventory (NPI) data for the years 2008–2018 to estimate air pollutants (metals, nitrogen oxides, particulate matter ≤ 10 micrometers (PM10) and ≤2.5 micrometers (PM2.5)) originating from coal mines. PM10 levels from community-based air monitors in Queensland and New South Wales were also compared between mining and nonmining communities. Results indicated that tons of coal mined increased over the study period, and that levels of particulate matter, metals, and nitrogen oxides increased significantly over time as well. Coal mines accounted for 42.1% of national PM10 air emissions from NPI sites. PM2.5 from coal mines accounted for 19.5% of the national total, metals for 12.1%, and nitrogen oxides for 10.1%. Coal mining occurred in 57 different post codes; the 20 coal-mining post codes with the highest PM10 emissions were home to 160,037 people. Emissions of all studied pollutants were significantly higher from coal mining sites than from other types of NPI sites. Results from community-based air monitoring stations indicated significantly higher population PM10 exposure in coal mining communities than in nonmining communities. The health of the public at large is impacted by coal mining, but to the extent that miners also live near coal mining operations, their total exposure is underestimated by consideration of exposure only during working hours.

Imaging methods used in the assessment of environmental disease networks: a brief review for clinicians

Background

Across the globe, diseases secondary to environmental exposures have been described, and it was also found that existing diseases have been modified by exposure to environmental chemicals or an environmental factor that has been found in their pathogenesis. The Institute of Medicine has shared a permanent concern related to the nations environmental health capacity since 1988.

Main body

Contemporary imaging methods in the last 15 years started reporting alterations in different human systems such as the central nervous system, cardiovascular system and pulmonary system among others; evidence suggests the existence of a human environmental disease network. The primary anatomic regions, affected by environmental diseases, recently assessed with imaging methods include Brain (lead exposure, cerebral stroke, pesticide neurotoxicity), uses MRI, DTI, carotid ultrasonography and MRS; Lungs (smoke inhalation, organophosphates poisoning) are mainly assessed with radiography; Gastrointestinal system (chronic inflammatory bowel disease), recent studies have reported the use of aortic ultrasound; Heart (myocardial infarction), its link to environmental diseased has been proved with carotid ultrasound; and Arteries (artery hypertension), the impairment of aortic mechanical properties has been revealed with the use of aortic and brachial ultrasound.

Conclusions

Environmental epidemiology has revealed that several organs and systems in the human body are targets of air pollutants. Current imaging methods that can assess the deleterious effects of pollutants includes a whole spectrum: radiography, US, CT and MRI. Future studies will help to reveal additional links among environmental disease networks.

Environmental Sustainability of Open-Pit Coal Mining Practices at Baganuur, Mongolia

In this paper, we studied one of the largest coal mines in Mongolia, the Baganuur Coal Mine, in terms of environmental sustainability related to mining practices, with a focus on discharged water and waste sediments. The present quality and potential for future pollution were assessed. Based on World Health Organization and Mongolian guidelines, groundwater pumped from the mining operations could be used for drinking and domestic purposes. In addition, based on the Na absorption ratio, groundwater samples from GW-2 and GW-3 could be used as agriculture water supplies with salinity reduction, or used to grow halophytes as a measure for desertification control and pasture production. All waste soil samples appeared to have a desertification potential. Dust particles smaller than 150 μm comprised more than 80% of soil samples, which had arsenic levels higher than the Mongolian soil pollution standards. In addition, soil collected between coal seams (S-5) showed high sulphur content based on X-ray fluorescence (XRF) and scanning electron microscopy–energy dispersive X-ray (SEM-EDX) spectroscopy analyses, strong potential for producing acid mine drainage in the analysis of pH of net acid generation and net acid production potential, and potential for leaching of metals, such as Co. Therefore, the Baganuur Coal Mine requires soil pollution control measures to mitigate the risks of dust and desertification. In this perspective, mine groundwater could be used to reduce environmental stresses by supporting pasture crops such as halophytes on waste disposal sites, thereby preventing dust issues and desertification. Continuous efforts, including monitoring and enacting environmental management measures, are needed from both the mining company and the government to ensure sustainable mine development.

Effect of Tetrahydrofuran Extraction on Surface Functional Groups of Coking Coal and Its Wettability

Coking coal was extracted with tetrahydrofuran solvent using ultrasonic and microwave-assisted method at 50°C and atmospheric pressure. Wettability of raw coal and its residue (residual coal) was tested with capillary penetration method. The raw and residual coals were studied by Fourier transform infrared spectroscopy (FTIR) with curve-fitting analysis. The variation of main surface functional groups of coking coal before and after extraction and its effect on wettability were analyzed. The results were obtained as the following: after extraction with tetrahydrofuran, hydroxyl, ether oxygen, and carbonyl in the coal structure were dissolved, the content of hydrophilic functional groups reduced, and then the hydrophobicity of coal enhanced. At the same time, part of aliphatic hydrocarbon dissolved, the length of aliphatic chains (I ₂) decreased from 3.961 of raw coal to 3.636 of residual coal, the length of aliphatic chains became shorter, aliphatic CH₂ side-chains decreased and aliphatic CH₃ side-chains increased, and hydrophobic functional groups content increased. In the aromatic structure, four hydrogens per ring increased and two, three, and five hydrogens per ring decreased. Reduction of substitution functional groups and aliphatic hydrocarbon decreased with the side-chains breakage produce more active sites, which increases the degree of condensation of the aromatic ring (I ₃). The combined action of the decrease of the hydrophilic functional groups and the increase of the hydrophobic functional groups made the wettability of the coking coal become weak.

The utility of health belief model to explain self-protective behaviour against pneumoconiosis in Chinese underground coal miners: a cross-sectional study

OBJECTIVES

Coal workers' pneumoconiosis is caused by exposure to respirable coal mine dust. The self-protection of underground coal miners (UCM) plays an irreplaceable role against this threat. The purpose of this study was to evaluate the predictors of self-protective behaviour (SPB) in Chinese UCM based on the health belief model (HBM).

METHODS

A cross-sectional study was conducted among 341 UCM in January 2016 in Pingdingshan City, Henan Province, People's Republic of China. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, HBM variables and SPB. An exploratory factor analysis of the principal components with varimax rotation was carried out on the HBM-related items. Pearson's correlation and multiple linear regression analysis were used to assess the relationship between sociodemographic characteristics, HBM variables and SPB.

RESULTS

Multiple regression analysis demonstrated the monthly income (B=0.403, p=0.001), the internal cues to action (B=0.380, p<0.001) and external cues to action (B=0.401, p<0.001) as the predictors of UCM's SPB, accounting for 24.8% of total variance (F=34.96, p<0.001), while the cognition variables of HBM were not significantly associated with SPB.

CONCLUSION

The results suggested that both internal and external cues to action were powerful predictors for SPB. These findings highlight that further efforts are required to provide the UCM with periodic health check-up reports and promote the active role of doctors and family members in miners' decision-making to simulate them for better SPB.

ETHICS APPROVAL

All data collection procedures received ethical approval from the Ethics Committee of Xuhui District Centre for Disease Control and Prevention (XHHEC-2016-7).

China's dusty lung crisis: Rural-urban health inequity as social and spatial injustice

This paper examines rural-urban inequities in dusty lung (pneumoconiosis) deaths in China from 2002 to 2016 and possible causes for such inequities in the framework of social and spatial justice. The research reveals alarming results that have not been reported before. Dusty lung death rates for rural men increased twice as fast as those among urban men. The rural rates were particularly higher among middle-aged men, but lower in older age groups, as compared to urban rates. There were dramatic increases in death rates from 2011 to 2016 particularly among rural men aged 40-49 years old, who were many times more likely to die from dusty lung than urban men of a similar age. Chinese rural male victims also die at a younger age, compared to men in any of the seven countries or regions included in the study. For example, rural Chinese men aged 35-59 years old were many times more likely to die from dusty lung than their American, German, Polish, and Spanish counterparts. A possible explanation for the high death rates among middle-aged rural Chinese men is the tendency for rural migrant workers to be employed in unhealthy and unsafe working conditions in decent decades. Other explanations for the severe spatial injustice include the Hukou (household registration) system and the development policies that prioritize economic growth and urban development over occupational health and safety. The paper demonstrates the usefulness and weakness of the social and spatial justice concepts in understanding health inequity. Therefore, it proposes new definitions and models of social justice and spatial justice that combine the competing distribution and capabilities approaches and highlight interactions among multiple attributes.

Effects of occupational exposure to respirable quartz dust on acute myocardial infarction

Objectives

The aim of this study is to investigate the effects of occupational exposure to respirable quartz (RQ) on first acute myocardial infarction (AMI). RQ causes pulmonary diseases like silicosis and has also been linked to cardiovascular diseases. Inflammation is hypothesised as the underlying pathway.

Methods

We performed a 1:3 matched case–control study nested in a cohort of male uranium miners. We included cases (identified from hospital records and validated according to WHO criteria) who had suffered their first AMI while still employed and <65 years of age. Controls were matched by date of birth and Wismut recruitment era. RQ exposure was derived from a job-exposure matrix. We performed a conditional logistic regression adjusted for smoking, metabolic syndrome and baseline erythrocyte sedimentation rate. Subgroups by date of birth and Wismut recruitment era were analysed to minimise the impact of pre-exposures.

Results

The study base comprised 292 matched sets. The cumulative exposure ranged from 0 to 38.9 mg/m³-years RQ. The adjusted OR of the highest RQ tertile (>14.62 mg/m³-years) was 1.27 (95% CI 0.82 to 1.98). However, for miners born after 1928 and hired in the earliest recruitment era (1946–1954), a significantly elevated risk was seen in the highest RQ tertile (OR=6.47 [95% CI 1.33 to 31.5]; 50 matched sets).

Conclusions

An impact of quartz dust on first AMI was observed only in a small subgroup that had virtually no pre-exposure to RQ. Further studies on the basis of complete occupational history are required to substantiate this finding.

Combined effect of coal dust exposure and smoking on the prevalence of respiratory impairment among coal miners of West Bengal, India

Accelerating prevalence of coal workers pneumoconiosis is considered as a serious occupational health problem. This cross-sectional study was designed to determine the prevalence of lung function impairment of underground coal miners in West Bengal, India. A total of 230 underground coal dust-exposed subjects and 130 nonexposed subjects were examined for lung function test and also information on sociodemographic characteristics, addiction, respiratory morbidity, personnel protective equipment and dust exposure were collected. Lung function impairment was significantly higher in exposed group than nonexposed group and personnel dust exposure level were exceeded above the NIOSH recommended level. In addition, respiratory ailments were found to be higher in exposed group than the nonexposed group. So, this study has established the need for an advanced understanding of the quantifiable and measurable remedies for protection of lung disorder of coal mine workers.

Pharmacological management of progressive-fibrosing interstitial lung diseases: a review of the current evidence

A proportion of patients with interstitial lung diseases (ILDs) are at risk of developing a progressive-fibrosing phenotype, which is associated with a deterioration in lung function and early mortality. In addition to idiopathic pulmonary fibrosis (IPF), fibrosing ILDs that may present a progressive phenotype include idiopathic nonspecific interstitial pneumonia, connective tissue disease-associated ILDs, hypersensitivity pneumonitis, unclassifiable idiopathic interstitial pneumonia, ILDs related to other occupational exposures and sarcoidosis. Corticosteroids and/or immunosuppressive therapies are sometimes prescribed to patients with these diseases. However, this treatment regimen may not be effective, adequate on its own or well tolerated, suggesting that there is a pressing need for efficacious and better tolerated therapies. Currently, the only approved treatments to slow disease progression in patients with IPF are nintedanib and pirfenidone. Similarities in pathobiological mechanisms leading to fibrosis between IPF and other ILDs that may present a progressive-fibrosing phenotype provide a rationale to suggest that nintedanib and pirfenidone may be therapeutic options for patients with the latter diseases.

This review provides an overview of the therapeutic options currently available for patients with fibrosing ILDs, including fibrosing ILDs that may present a progressive phenotype, and explores the status of the randomised controlled trials that are underway to determine the efficacy and safety of nintedanib and pirfenidone.

Aside from IPF, there are no proven therapies for other ILDs with a progressive-fibrosing phenotype that are effective and have tolerable adverse effects. Clinical studies evaluating the benefits of antifibrotic therapy in these populations are underway.http://ow.ly/40yL30mOs0q