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

Survival and disease burden analyses of occupational pneumoconiosis during 1958-2021 in Huangshi city, China: a retrospective cohort study

BACKGROUND

Pneumoconiosis, a chronic disease stemming from prolonged inhalation of dust particles, stands as a significant global burden of occupational diseases. This study aims to investigate the survival outcomes of pneumoconiosis patients in Huangshi city, China, while also evaluating the disease burden on afflicted patients.

METHODS

Data for this study were sourced from the Huangshi Center for Disease Control and Prevention. Survival analyses of pneumoconiosis patients were conducted employing life tables and the Kaplan-Meier method. The Cox proportional hazards models were deployed to identify factors influencing pneumoconiosis patients' survival duration. Competing risks models were employed to confirm the validity of the model outcomes. Additionally, in the disease burden assessment, disability-adjusted life years (DALYs) were computed for various demographic groups and time frames.

RESULTS

A total of 5,641 pneumoconiosis cases, diagnosed in Huangshi City, Hubei Province between 1958 and 2021, were incorporated into the cohort analysis. The probability of mortality and the risk ratio increased with advancing age. Notably, the median survival time of stage III pneumoconiosis patients was significantly shorter compared with those in stages I and II. The Cox proportional hazards model and competing risks analyses underscored several significant factors influencing survival time, including dust exposure duration (HR = 1.197, 95% CI: 1.104-1.298), age at first diagnosis (HR = 3.149, 95% CI: 2.961-3.349), presence of silicosis (HR = 1.378, 95% CI: 1.254-1.515), and stage II-III pneumoconiosis (HR = 1.456, 95% CI: 1.148-1.848). Cumulatively, DALYs amounted to 7,974.35 person-years, with an average of 1.41 person-years. The period between 2000 and 2019 witnessed the highest disease burden.

CONCLUSION

Our findings highlight the urgent need for improved prevention, earlier detection, and more effective management strategies for the occupational pneumoconiosis population. This study not only underscores the persistent issue of pneumoconiosis in industrial environments but also serves as a crucial call to action for policymakers and healthcare providers.

Prevalence of parental supply of alcohol to minors: a systematic review

Parental supply of alcohol to minors (i.e. those under the legal drinking age) is often perceived by parents as protective against harms from drinking, despite evidence linking it with adverse alcohol-related outcomes. This systematic review describes the prevalence of parental supply of alcohol, as reported in the international literature. The review was registered with PROSPERO (CRD42020218754). We searched seven online databases (Medline, Embase, PsycINFO, CINAHL, Scopus, Web of Science and Public Health Database) and grey literature from January 2011 to December 2022 and assessed the risk of bias with the JBI Critical Appraisal Checklist. Among 58 articles included in narrative synthesis from 29 unique datasets, there was substantial variation in the definition and measurement of parental supply of alcohol. Overall prevalence rates ranged from 7.0 to 60.0% for minor-report samples, and from 24.0 to 48.0% for parent-report samples. Data indicate that parental supply prevalence is generally proportionately higher for older minors or later-stage students, for girls, and has increased over time among minors who report drinking. Literature on the prevalence of parental supply of alcohol is robust in quantity but inconsistent in quality and reported prevalence. Greater consistency in defining and measuring parental supply is needed to better inform health promotion initiatives aimed at increasing parents' awareness.

The evaluation analysis on the airborne dust regional pollution of the anchor drilling operation in the tunnel

The anchor drilling operations generate massive airborne dust particles in the tunnel heading face that raises the pneumoconiosis morbidity and explosion risk. In this paper, a full-scale tunnel physical model is constructed to study the effect of the wind velocity and drilling site position on the airborne dust regional pollution scope based on the actual anchor drilling craft. The research indicates that the four extensive vortex areas keep the dust suspension at 14 m from the heading face and make the deposition dust particle refloat. The average respirable dust rate reaches the maximum value at section 5 m and presents a gradual decline as the dust particle migrates along the outlet direction. Raising the wind velocity contributes to alleviating the airborne dust pollution in the anchor drilling operation. As the wind velocity increases from 3 to 24 m/s, the high dust concentration area and number higher than 200 mg/m³ pose overall decrease trends, and the average dust concentration displays a linear decrease until 26.14-58.65 mg/m³ around the anchor worker head. Moving the drilling site positions closer to the exhaust air duct aggravates the airborne dust pollution in the front breathing zone. As the anchor drilling operation switches from the return air side to the supply air side, the dust concentration area ascends by 59.4-84.4% in the personnel respiratory space.

Workers with Suspected Diagnosis of Silicosis: A Case Study of Sarcoidosis Versus Siderosis

Silicosis is one of the most important occupational respiratory diseases worldwide, hence the importance of making a correct diagnosis. Diagnosis is commonly based on radiological findings according to the ILO International Classification of Radiographs of Pneumoconioses and occupational exposure. High-resolution computed tomography is indicated for differential diagnosis. This article presents two cases with an initial diagnosis of silicosis that ended up being diagnosed as sarcoidosis and siderosis, respectively. The first case was a 42-year-old male who worked as a crushing operator in an underground copper and molybdenum mine for 22 years. He had a history of exposure to silicon dioxide and was asymptomatic. X-rays did not distinguish silicosis or siderosis, but histological findings (open lung biopsy) allowed for a diagnosis of sarcoidosis. The second case was a 50-year-old male who had worked as a welder in a molybdenum filter plant, an open pit mine since 2013; he spent the previous 20 years as a welder in an underground copper mine, with exposure to silicon dioxide and was symptomatic. The first radiograph showed opacities that were compatible with pulmonary silicosis. A subsequent high-resolution computed tomography and lung biopsy showed a pattern of pulmonary siderosis. Due to the similarities in the radiographs of these three diseases, greater emphasis must be placed on the differential diagnosis, for which a complete occupational and clinical history is important in order to provide clues for the performance of complementary tests to avoid misdiagnosing.

Submission of mandatory respiratory health examinations among US coal miners participating in the Coal Workers' Health Surveillance Program

BACKGROUND

Mandatory examination requirements for US coal miners newly entering the workforce have been in place since the 1969 Coal Act mandated chest radiographs and were updated to include spirometry with promulgation of the 2014 Mine Safety and Health Administration Dust Rule. Compliance with the mandatory respiratory screening series is described using data from the National Institute for Occupational Safety and Health Coal Workers' Health Surveillance Program (CWHSP).

METHODS

Among all radiographic and spirometry submissions to the CWHSP during 30 June 1971-15 March 2022, new underground coal miners who began work in the industry after 30 June 1971, and new underground, surface miners and contractors who began work after new regulations were implemented 1 August 2014, were identified and included in analysis.

RESULTS

Of the 115 093 unique miners who participated in the CWHSP and whose estimated entry into mining occurred during 30 June 1971-15 March 2019, 50 487 (43.9%) received their initial mandatory radiograph, and 15 452 (13.4%) submitted their initial and 3-year mandatory radiographs. Since new regulations were implemented, compliance with initial radiographs appeared to improve (80%) but compliance with 3-year radiographs remained low (11.6%). Compliance with spirometry testing was also low for initial (17.1%) and follow-up screenings (2.7%).

CONCLUSIONS

The majority of new coal miners eligible for health surveillance did not receive a baseline radiograph or spirometry test through the CWHSP even though coal mine operators are required by law to provide these. Ensuring coal miners' regular participation in health surveillance from early in their careers is an important way to monitor and protect their respiratory health.

Incidence and influencing factors of occupational pneumoconiosis: a systematic review and meta-analysis

OBJECTIVES

To determine the incidence of pneumoconiosis worldwide and its influencing factors.

DESIGN

Systematic review and meta-analysis.

SETTING

Cohort studies on occupational pneumoconiosis.

PARTICIPANTS

PubMed, Embase, the Cochrane Library and Web of Science were searched until November 2021. Studies were selected for meta-analysis if they involved at least one variable investigated as an influencing factor for the incidence of pneumoconiosis and reported either the parameters and 95% CIs of the risk fit to the data, or sufficient information to allow for the calculation of those values.

PRIMARY OUTCOME MEASURES

The pooled incidence of pneumoconiosis and risk ratio (RR) and 95% CIs of influencing factors.

RESULTS

Our meta-analysis included 19 studies with a total of 335 424 participants, of whom 29 972 developed pneumoconiosis. The pooled incidence of pneumoconiosis was 0.093 (95% CI 0.085 to 0.135). We identified the following influencing factors: (1) male (RR 3.74; 95% CI 1.31 to 10.64; p=0.01), (2) smoking (RR 1.80; 95% CI 1.34 to 2.43; p=0.0001), (3) tunnelling category (RR 4.75; 95% CI 1.96 to 11.53; p<0.0001), (4) helping category (RR 0.07; 95% CI 0.13 to 0.16; p<0.0001), (5) age (the highest incidence occurs between the ages of 50 and 60), (6) duration of dust exposure (RR 4.59, 95% CI 2.41 to 8.74, p<0.01) and (7) cumulative total dust exposure (CTD) (RR 34.14, 95% CI 17.50 to 66.63, p<0.01). A dose-response analysis revealed a significant positive linear dose-response association between the risk of pneumoconiosis and duration of exposure and CTD (P-non-linearity=0.10, P-non-linearity=0.16; respectively). The Pearson correlation analysis revealed that silicosis incidence was highly correlated with cumulative silica exposure (r=0.794, p<0.001).

CONCLUSION

The incidence of pneumoconiosis in occupational workers was 0.093 and seven factors were found to be associated with the incidence, providing some insight into the prevention of pneumoconiosis.

PROSPERO REGISTRATION NUMBER

CRD42022323233.

Differences in the characteristics and pulmonary toxicity of nano- and micron-sized respirable coal dust

BACKGROUND

The characteristics of coal dust (CD) particles affect the inhalation of CD, which causes coal worker's pneumoconiosis (CWP). CD nanoparticles (CD-NPs, < 500 nm) and micron particles (CD-MPs, < 5 μm) are components of the respirable CD. However, the differences in physicochemical properties and pulmonary toxicity between CD-NPs and CD-MPs remain unclear.

METHODS

CD was analyzed by scanning electron microscopy, Malvern nanoparticle size potentiometer, energy dispersive spectroscopy, infrared spectroscopy, and electron paramagnetic resonance spectroscopy. CCK-8 assay, ELISA, transmission electron microscope, JC-1 staining, reactive oxygen species activity probe, calcium ion fluorescent probe, AO/EB staining, flow cytometry, and western blot were used to determine the differences between CD-NPs and CD-MPs on acute pulmonary toxicity. CCK-8, scratch healing and Transwell assay, hematoxylin-eosin and Masson staining, immunohistochemistry, immunofluorescence, and western blot were applied to examine the effects of CD-NPs and CD-MPs on pneumoconiosis.

RESULTS

Analysis of the size distribution of CD revealed that the samples had been size segregated. The carbon content of CD-NPs was greater than that of CD-MPs, and the oxygen, aluminum, and silicon contents were less. In in vitro experiments with A549 and BEAS-2B cells, CD-NPs, compared with CD-MPs, had more inflammatory vacuoles, release of pro-inflammatory cytokines (IL-6, IL-1β, TNFα) and profibrotic cytokines (CXCL2, TGFβ1), mitochondrial damage (reactive oxygen species and Ca2+ levels and decreased mitochondrial membrane potential), and cell death (apoptosis, pyroptosis, and necrosis). CD-NPs-induced fibrosis model cells had stronger proliferation, migration, and invasion than did CD-MPs. In in vivo experiments, lung coefficient, alveolar inflammation score, and lung tissue fibrosis score (mean: 1.1%, 1.33, 1.33) of CD-NPs were higher than those of CD-MPs (mean: 1.3%, 2.67, 2.67). CD-NPs accelerated the progression of pulmonary fibrosis by upregulating the expression of pro-fibrotic proteins and promoting epithelial-mesenchymal transition. The regulatory molecules involved were E-cadherin, N-cadherin, COL-1, COL-3, ZO-1, ZEB1, Slug, α-SMA, TGFβ1, and Vimentin.

CONCLUSIONS

Stimulation with CD-NPs resulted in more pronounced acute and chronic lung toxicity than did stimulation with CD-MPs. These effects included acute inflammatory response, mitochondrial damage, pyroptosis, and necrosis, and more pulmonary fibrosis induced by epithelial-mesenchymal transition.

Requirement of preoperative blood typing for cholecystectomy and appendectomy: a systematic review

Purpose

Blood typing, or group and save (G&S) testing, is commonly performed prior to cholecystectomy and appendectomy in many hospitals. In order to determine whether G&S testing is required prior to these procedures, we set out to evaluate the relevant literature and associated rates of perioperative blood transfusion.

Methods

Studies from January 1990 to June 2021 assessing the requirement of preoperative G&S testing for elective or emergency cholecystectomy and appendectomy were retrieved from MEDLINE, EMBASE and CINAHL databases. The search was performed on 6th July 2021 (PROSPERO registration number CRD42021267967). Number of patients, co-morbidities, operation performed, number of patients that underwent preoperative G&S testing, perioperative transfusion rates and financial costs were extracted.

Results

We initially screened 194 studies of which 15 retrospective studies, a total of 477,437 patients, specifically met the inclusion criteria. Ten studies reported on cholecystectomy, two studies on appendectomy and three studies included both procedures. Where reported, a total of 177,539/469,342 (37.8%) patients underwent preoperative G&S testing with a perioperative transfusion rate of 2.1% (range 0.0 to 2.1%). The main preoperative risk factors associated with perioperative blood transfusion identified include cardiovascular co-morbidity, coagulopathy, anaemia and haematological malignancy. All 15 studies concluded that routine G&S is not warranted.

Conclusion

The current evidence suggests that G&S is not necessarily required for all patients undergoing cholecystectomy or appendectomy. Having a targeted G&S approach would reduce delays in elective and emergency lists, reduce the burden on the blood transfusion service and have financial implications.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00423-022-02600-x.

Experimental and Molecular Dynamics Simulation Study for Preferring Coal Dust Wetting Agents

To improve the efficiency of coal dust removal by water spray technology, the addition of wetting agents in water becomes the main dust removal method. The influence of sodium dodecyl sulfate (SDS), sodium dodecyl sulfonate (SDDS), and sodium dodecylbenzene sulfonate (SDBS) on the wettability of coal dust is studied by experimental and molecular dynamics (MD) simulation. Measurement of the contact angle and surface tension was accomplished via relevant experiments for the three wetting agents, and their adhesion work, spreading work, and wetting work were also calculated. A preferred experimental method of conventional coal dust wetting agent is optimized. The wettability of the three wetting agents upon bituminous coal follows the trend: SDS > SDDS > SDBS. The simulation was performed based on MD to derive the intermolecular interaction energy, diffusion coefficient of water molecules, and water molecule count in the vicinity of the hydrophilic groups of the wetting agents. The wetting mechanism and performance of the wetting agent solution on bituminous coal were identified. The simulation results of the wetting performance of the wetting agents are consistent with the experimental results, which verifies the reliability of the simulation method. An easy, time-saving, and labor-saving MD simulation method is proposed, which provides a novel insight for choosing various wetting agents of coal dust.