1
|
Cohen RA, Go LHT, Friedman L, Zell-Baran LM, Rose CS, Almberg KS. Resting diffusing capacity and severity of radiographic disease predict gas exchange abnormalities with exercise in former US coal miners. Am J Ind Med 2024. [PMID: 38830640 DOI: 10.1002/ajim.23621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/13/2024] [Accepted: 05/24/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND The US Department of Labor (DOL) does not fund diffusing capacity (DLCO) or metabolic measurements from cardiopulmonary exercise testing (CPET) for coal miners' disability evaluations. Although exercise arterial blood gas testing is covered, many miners are unable to perform maximal tests, and sampling at peak exercise can be challenging. We explored the relationship between resting DLCO, radiographic disease severity, and CPET abnormalities in former US coal miners. METHODS We analyzed data from miners evaluated between 2005 and 2015. Multivariable linear and logistic regression analyses were used to examine relationships between percent predicted (pp) forced expiratory volume in 1 s (FEV1pp), DLCOpp, VO2maxpp, A-a oxygen gradient (A-a)pp, dead space fraction (Vd/Vt), disabling oxygen tension (PO2), and radiographic findings of pneumoconiosis. RESULTS Data from 2015 male coal miners was analyzed. Mean tenure was 28 years (SD 8.6). Thirty-twopercent had an abnormal A-a gradient (>150 pp), 20% had elevated Vd/Vt (>0.33), and 34% a VO2max < 60 pp. DLCOpp strongly predicted a disabling PO2, with an odds ratio (OR) of 2.33 [2.09-2.60], compared to 1.18 [1.08-1.29] for FEV1. Each increase in subcategory of small opacity (simple) pneumoconiosis increased the odds of a disabling PO2 by 42% [1.29-1.57], controlling for age, body mass index, pack-years of tobacco smoke exposure, and years of coal mine employment. CONCLUSIONS DLCO is the best resting pulmonary function test predictor of CPET abnormalities. Radiographic severity of pneumoconiosis was also associated with CPET abnormalities. These findings support funding DLCO testing for impairment and suggest the term "small opacity" should replace "simple" pneumoconiosis to reflect significant associations with impairment.
Collapse
Affiliation(s)
- Robert A Cohen
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Leonard H T Go
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Lee Friedman
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Lauren M Zell-Baran
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA
| | - Cecile S Rose
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA
| | - Kirsten S Almberg
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| |
Collapse
|
2
|
Sun P, Wang B, Zhang H, Xu M, Han L, Zhu B. Predicting coal workers' pneumoconiosis trends: Leveraging historical data with the GARCH model in a Chinese Miner Cohort. Medicine (Baltimore) 2024; 103:e37237. [PMID: 38363918 PMCID: PMC10869087 DOI: 10.1097/md.0000000000037237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/22/2024] [Indexed: 02/18/2024] Open
Abstract
Coal workers' pneumoconiosis (CWP) is one of the most common and severe occupational diseases worldwide. The main risk factor of CWP is exposure to respirable mine dust. Prediction theory was widely applied in the prediction of the epidemic. Here, it was used to identify the characteristics of CWP today and the incidence trends of CWP in the future. Eight thousand nine hundred twenty-eight coal workers from a state-owned coal mine were included during the observation period from 1963 to 2014. In observations, the dust concentration gradually decreased over time, and the incidence of tunnels and mine, transportation, and assistance workers showed an overall downward trend. We choose a better prediction model by comparing the prediction effect of the Auto Regression Integrate Moving Average model and Generalized Autoregressive Conditional Heteroskedasticity model. Compared with the Auto Regression Integrate Moving Average model, the Generalized Autoregressive Conditional Heteroskedasticity model has a better prediction effect. Furthermore, the status quo and future trend of coal miners' CWP are still at a high level.
Collapse
Affiliation(s)
- Peng Sun
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
- Disease Prevention and Control Center of Liyang City, Changzhou, Jiangsu, China
| | - Bosheng Wang
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Hengdong Zhang
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Ming Xu
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
| | - Lei Han
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Baoli Zhu
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
- Center for Global Health, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center of PublicHealth Emergency, Nanjing, Jiangsu, China
| |
Collapse
|
3
|
Tomasi SE, Fechter-Leggett ED, Materna BL, Meiman JG, Nett RJ, Cummings KJ. Impact of Epidemic Intelligence Service Training in Occupational Respiratory Epidemiology. ATS Sch 2023; 4:441-463. [PMID: 38196681 PMCID: PMC10773279 DOI: 10.34197/ats-scholar.2023-0062ps] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/03/2023] [Indexed: 01/11/2024] Open
Abstract
The Centers for Disease Control and Prevention's Epidemic Intelligence Service (EIS) is a fellowship in applied epidemiology for physicians, veterinarians, nurses, scientists, and other health professionals. Each EIS fellow is assigned to a position at a federal, state, or local site for 2 years of on-the-job training in outbreak investigation, epidemiologic research, surveillance system evaluation, and scientific communication. Although the original focus of the program on the control of infectious diseases remains salient, positions are available for training in other areas of public health, including occupational respiratory disease. In this Perspective, we describe the EIS program, highlight three positions (one federal and two state-based) that provide training in occupational respiratory epidemiology, and summarize trainees' experiences in these positions over a 30-year period. For early-career health professionals interested in understanding and preventing occupational respiratory hazards and diseases, EIS offers a unique career development opportunity.
Collapse
Affiliation(s)
- Suzanne E. Tomasi
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Ethan D. Fechter-Leggett
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Barbara L. Materna
- Center for Healthy Communities, California Department of Public Health, Richmond, California
| | | | - Randall J. Nett
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Kristin J. Cummings
- Center for Healthy Communities, California Department of Public Health, Richmond, California
| |
Collapse
|
4
|
Li ZG, Li BC, Li ZW, Hu HY, Ma X, Cao H, Yu ZH, Dai HP, Wang J, Wang C. The Potential Diagnostic Biomarkers for the IgG Subclass in Coal Workers' Pneumoconiosis. J Immunol Res 2023; 2023:9233386. [PMID: 36959921 PMCID: PMC10030223 DOI: 10.1155/2023/9233386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 03/17/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Zhao-Guo Li
- Department of Respiratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086 Heilongjiang, China
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100730, China
| | - Bai-Cun Li
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100730, China
| | - Zhi-Wei Li
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100730, China
| | - Hui-Yuan Hu
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100730, China
- First Clinical College, Xi'an Jiaotong University, Xi'an 710061, China
| | - Xia Ma
- Department of Pulmonary and Critical Care Medicine, General Hospital of Datong Coal Mine Group Co., Ltd, Datong 037000, China
- Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Hong Cao
- Occupational Disease Prevention and treatment Hospital of Datong Coal Mine Group Co., Ltd, Datong 037001, China
| | - Zhi-Hua Yu
- Occupational Disease Prevention and treatment Hospital of Datong Coal Mine Group Co., Ltd, Datong 037001, China
| | - Hua-Ping Dai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Disease, Beijing 100029, China
- National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Jing Wang
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100730, China
| | - Chen Wang
- Department of Respiratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086 Heilongjiang, China
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100730, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Disease, Beijing 100029, China
- National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| |
Collapse
|
5
|
Liu W, Liang R, Zhang R, Wang B, Cao S, Wang X, Ma J, Wang D, Chen W. Prevalence of coal worker's pneumoconiosis: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:88690-88698. [PMID: 35836046 DOI: 10.1007/s11356-022-21966-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
Global prevalence trend and regional differences of coal worker's pneumoconiosis (CWP) remain unclear. This study aimed to provide systematic and comprehensive evidence for the global prevalence of CWP. Literature research for studies that reported prevalence of CWP was conducted in PubMed, CNKI, and Web of Science. The identified studies were strictly screened according to predetermined inclusion and exclusion criteria. The pooled prevalence of CWP in different periods and regions was calculated. A total of 37 studies were included after screening, and data from the Coal Workers' Health Surveillance Program was additionally included in the meta-analysis. The global pooled prevalence of CWP decreased from 23.33% (95% confidence interval [CI]: 18.03%, 28.62%) before 1970 to 6.00% (95% CI: 4.11%, 7.90%) in 1981-1990, but indicated a rebound (10.35%, 95% CI: 8.08%, 12.62%) in 1991-2000 and finally dropped to 2.29% (95% CI: 2.06%, 2.51%) in 2011-2020. In the recent 30 years, the top three pooled prevalence of CWP was found in Europe, China, and the USA, respectively. Few articles have reported the prevalence in developing regions, but available evidence indicated that the prevalence in developing regions was much higher than that in developed regions. Higher pooled prevalence was observed in studies which reported larger number of miners in collieries, older average age of miners, underground collieries, and longer dust exposure time. The global prevalence of CWP indicates a rebound in 1990s, but the overall trend is downward in the recent 60 years. The prevention and treatment of CWP should be currently emphasized in developing countries.
Collapse
Affiliation(s)
- Wei Liu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ruyi Liang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Rixin Zhang
- Department of Pathology and Shanxi Key Laboratory of Carcinogenesis and Translational Research on Esophageal Cancer, Shanxi Medical University, Taiyuan, China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shuting Cao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xing Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jixuan Ma
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| |
Collapse
|
6
|
袁 杨, 周 雨, 陈 伟, 沈 毅, 周 云. [Safety Analysis of Perioperative Period in Non-Small Cell Lung Cancer Patients with Comorbid Pneumoconiosis]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2022; 53:488-492. [PMID: 35642159 PMCID: PMC10409441 DOI: 10.12182/20220560108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Indexed: 06/15/2023]
Abstract
Objective To explore the surgical safety of patients with comorbid non-small cell lung cancer (NSCLC) and pneumoconiosis. Methods In this study, the clinical data of 165 NSCLC patients treated at West China Fourth Hospital, Sichuan University from August 2019 to May 2021 were collected. Among them, 21 patients with comorbid pneumoconiosis were included in the pneumoconiosis group, and the remaining 144 patients were included in the general group. Radical resection for lung cancer was performed in both groups. The perioperative clinical data, including preoperative, intraoperative and postoperative indicators, of the two groups were compared and analyzed. Results There was no perioperative death in either group. The proportions of male patients and patients with smoking history in the pneumoconiosis group were significantly higher than those in the general group ( P<0.05). The body mass index (BMI), pulmonary ventilation function and diffusion function in the pneumoconiosis group were significantly lower than those in the general group ( P<0.05). There was no significant difference in the median operative time and the median volume of intraoperative blood loss between the pneumoconiosis group and the general group. In the pneumoconiosis group, the proportion of advanced tumors (stage Ⅱ/Ⅲ), incidence of postoperative complications, median duration of postoperative intubation, and postoperative length of hospital stay were higher/longer than those of the normal group ( P<0.05). Compared with the general group, the incidences of lymph node calcification, dense pleural adhesion and surgical method alteration (switching from thoracoscopic surgery to open surgery or video-assisted thoracoscopy) were also significantly higher in the pneumoconiosis group ( P<0.05). Univariate analysis showed that age, smoking history, pneumoconiosis, pulmonary ventilation dysfunction, lymph node calcification, dense pleural adhesion and the volume of intraoperative blood loss were the risk factors for postoperative complications. Further multivariate regression analysis demonstrated that smoking history ( OR=1.37, P<0.05), lymph node calcification ( OR=2.36, P<0.05) and pulmonary ventilation dysfunction ( OR=5.21, P<0.05) were independent risk factors for postoperative complications. Conclusion NSCLC patients with comorbid pneumoconiosis face relatively greater risks during the perioperative period when they undergo radical resection for lung cancer. Therefore, the close attention of surgeons and the nursing staff should be raised accordingly.
Collapse
Affiliation(s)
- 杨 袁
- 四川大学华西第四医院 胸外科 (成都 610041)Department of Thoracic Surgery, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 雨霏 周
- 四川大学华西第四医院 胸外科 (成都 610041)Department of Thoracic Surgery, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 伟 陈
- 四川大学华西第四医院 胸外科 (成都 610041)Department of Thoracic Surgery, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 毅 沈
- 四川大学华西第四医院 胸外科 (成都 610041)Department of Thoracic Surgery, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 云峰 周
- 四川大学华西第四医院 胸外科 (成都 610041)Department of Thoracic Surgery, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
7
|
Go LHT, Almberg KS, Rose CS, Zell-Baran LM, Harris DA, Tomann M, Friedman LS, Weems DJ, Vonhof W, Mastel KM, Cohen RA. Prevalence and severity of abnormal lung function among US former coal miners with and without radiographic coal workers' pneumoconiosis. Occup Environ Med 2022; 79:527-532. [PMID: 35149597 DOI: 10.1136/oemed-2021-107872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/20/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Examination of lung function abnormalities among coal miners has historically focused on actively working miners. This likely underestimates the true burden of chronic respiratory disease. The objective of this study was to characterise patterns and severity of lung function impairment among a population of former coal miners. METHODS Cross-sectional data from 2568 former coal miners evaluated at eight US Black Lung clinics in a 12-month period were retrospectively analysed for patterns of prebronchodilator spirometric abnormality and severity of lung function impairment. Spirometry data from a subset of former miners with chest radiographs were analysed based on the presence and severity of coal workers' pneumoconiosis (CWP). RESULTS Abnormal spirometry was identified in 56.6% of subjects. The age-standardised prevalence of airflow obstruction among miners aged ≥45 years was 18.9% overall and 12.2% among never smokers. Among 1624 subjects who underwent chest radiography, the prevalence and severity of abnormal spirometry increased with worsening radiographic category for pneumoconiosis. Of never-smoking former miners without radiographic CWP, 39.0% had abnormal spirometry; 25.1% had abnormally low forced expiratory volume in 1 s (FEV1), and 17.1% had moderate to severe FEV1 impairment. CONCLUSIONS Abnormal spirometry is common among former coal miners. While ever-smoking former miners had higher rates of airflow obstruction, never-smoking former miners also demonstrated clinically significant airflow obstruction, including those without radiographic pneumoconiosis. These findings demonstrate the importance of recognising physiological as well as imaging manifestations of coal mine dust lung diseases in former miners.
Collapse
Affiliation(s)
- Leonard H T Go
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA .,Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kirsten S Almberg
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Cecile S Rose
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA
| | - Lauren M Zell-Baran
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA
| | - Drew A Harris
- Stone Mountain Health Services, St. Charles, Virginia, USA.,Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | | | - Lee S Friedman
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Dolores J Weems
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Wendy Vonhof
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA
| | - Krista M Mastel
- US Department of Health and Human Services, Health Resources and Services Administration, Rockville, Maryland, USA
| | - Robert A Cohen
- Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA.,Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
8
|
Go LHT, Cohen RA. Coal Workers' Pneumoconiosis and Other Mining-Related Lung Disease: New Manifestations of Illness in an Age-Old Occupation. Clin Chest Med 2021; 41:687-696. [PMID: 33153687 DOI: 10.1016/j.ccm.2020.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Coal workers' pneumoconiosis (CWP) and other mining-related lung diseases are entirely preventable, yet continue to occur. While greater attention has been given to CWP and silicosis, mining exposures cause a broad spectrum of respiratory disease, including chronic bronchitis, emphysema, and pulmonary fibrosis. Physicians must obtain a detailed occupational and exposure history from miners in order to make an accurate diagnosis and determine the risk of disease progression. Mining-related lung diseases are incurable and difficult to treat. Therefore, primary prevention by limiting dust exposure and secondary prevention through chest imaging and physiologic screening should be the primary focus of disease control.
Collapse
Affiliation(s)
- Leonard H T Go
- Division of Environmental and Occupational Health Sciences, University of Illinois Chicago School of Public Health, 1603 West Taylor Street, Chicago, IL 60612, USA; Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Robert A Cohen
- Division of Environmental and Occupational Health Sciences, University of Illinois Chicago School of Public Health, 1603 West Taylor Street, Chicago, IL 60612, USA; Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
9
|
Liu T, Liu S. The impacts of coal dust on miners' health: A review. ENVIRONMENTAL RESEARCH 2020; 190:109849. [PMID: 32763275 DOI: 10.1016/j.envres.2020.109849] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/14/2020] [Accepted: 06/16/2020] [Indexed: 05/28/2023]
Abstract
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.
Collapse
Affiliation(s)
- Ting Liu
- School of Safety Engineering, China University of Mining & Technology, Xuzhou, 221116, China; Department of Energy and Mineral Engineering, G3 Center and EMS Energy Institute, The Pennsylvania State University, University Park, PA, USA
| | - Shimin Liu
- Department of Energy and Mineral Engineering, G3 Center and EMS Energy Institute, The Pennsylvania State University, University Park, PA, USA.
| |
Collapse
|
10
|
Wang T, Sun W, Wu H, Cheng Y, Li Y, Meng F, Ni C. Respiratory traits and coal workers' pneumoconiosis: Mendelian randomisation and association analysis. Occup Environ Med 2020; 78:137-141. [PMID: 33097673 DOI: 10.1136/oemed-2020-106610] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Susceptibility loci of idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease were also significantly associated with the predisposition of coal worker's pneumoconiosis (CWP) in recent studies. However, only a few genes and loci were targeted in previous studies. METHODS To systematically evaluate the genetic associations between CWP and other respiratory traits, we reviewed the reported genome-wide association study loci of five respiratory traits and then conducted a Mendelian randomisation study and a two-stage genetic association study. RESULTS Interestingly, we found that for each SD unit, higher lung function was associated with a 66% lower risk of CWP (OR=0.34, 95% CI: 0.15 to 0.77, p=0.010) using conventional Mendelian randomisation analysis (inverse variance weighted method). Moreover, we found susceptibility loci of interstitial lung disease (rs2609255, OR=1.29, p=1.61×10-4) and lung function (rs4651005, OR=1.39, p=1.62×10-3; rs985256, OR=0.73, p=8.24×10-4 and rs6539952, OR=1.28, p=4.32×10-4) were also significantly associated with the risk of CWP. Functional annotation showed these variants were significantly associated with the expression of FAM13A (rs2609255, p=7.4 ×10-4), ANGPTL1 (rs4651005, p=5.4 ×10-7), SPATS2L (rs985256, p=1.1 ×10-5) and RP11-463O9.9 (rs6539952, p=7.1 ×10-6) in normal lung tissues, which were related to autophagy pathway simultaneously according to enrichment analysis. CONCLUSIONS These results provided a deeper understanding of the genetic predisposition basis of CWP.
Collapse
Affiliation(s)
- Ting Wang
- Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Wenqing Sun
- Department of Occupational Medicine and Environmental Health and Key Laboratory of Modern Toxicology of Ministry of Education, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongyan Wu
- Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yuxin Cheng
- Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yan Li
- Department of Occupational Medicine and Environmental Health and Key Laboratory of Modern Toxicology of Ministry of Education, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Fanqing Meng
- Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Chunhui Ni
- Department of Occupational Medicine and Environmental Health and Key Laboratory of Modern Toxicology of Ministry of Education, Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
11
|
Kurth L, Laney AS, Blackley DJ, Halldin CN. Prevalence of spirometry-defined airflow obstruction in never-smoking working US coal miners by pneumoconiosis status. Occup Environ Med 2020; 77:265-267. [PMID: 32041810 PMCID: PMC7970430 DOI: 10.1136/oemed-2019-106213] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/02/2019] [Accepted: 01/24/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION This study estimated the prevalence of spirometry-defined airflow obstruction and coal workers' pneumoconiosis (CWP) among never-smoking coal miners participating in the National Institute for Occupational Safety and Health (NIOSH) Coal Workers' Health Surveillance Program (CWHSP). METHODS Data were from working miners screened by a CWHSP mobile unit who had valid spirometry and chest radiography results. Spirometry-defined airflow obstruction was determined when the ratio of forced expiratory volume in the first second to forced vital capacity is less than the lower limit of normal. Chest radiographs were classified according to the International Labour Office system to identify pneumoconiosis, including the most severe form of pneumoconiosis, progressive massive fibrosis (PMF). RESULTS Prevalence of airflow obstruction among never-smoking coal miners in this sample was 7.7% overall, 16.4% among miners with CWP and 32.3% among miners with PMF. Airflow obstruction was significantly associated with CWP and PMF. CONCLUSIONS There was a higher prevalence of airflow obstruction among never-smoking coal miners with pneumoconiosis compared with those without pneumoconiosis. These findings support prior research on airflow obstruction and smoking and show pneumoconiosis might present with an obstructive pattern regardless of smoking status.
Collapse
Affiliation(s)
- Laura Kurth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Anthony S Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - David J Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Cara N Halldin
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| |
Collapse
|
12
|
Hall NB, Blackley DJ, Halldin CN, Laney AS. Current Review of Pneumoconiosis Among US Coal Miners. Curr Environ Health Rep 2019:10.1007/s40572-019-00246-4. [DOI: 10.1007/s40572-019-00246-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
13
|
Wu Q, Han L, Xu M, Zhang H, Ding B, Zhu B. Effects of occupational exposure to dust on chest radiograph, pulmonary function, blood pressure and electrocardiogram among coal miners in an eastern province, China. BMC Public Health 2019; 19:1229. [PMID: 31488099 PMCID: PMC6728990 DOI: 10.1186/s12889-019-7568-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 08/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background Coal dust is one of the most serious risk factor that leads to respiratory diseases and cardiovascular diseases in miners. This study aimed to observe the effects of occupational dust exposure on chest radiograph, pulmonary function (PF), blood pressure (BP) and electrocardiogram (ECG) indexes in coal miners and explore the related risk factors. Methods In the Chinese Occupational Disease Monitoring and Occupational Health Risk Assessment Program, a total of 11,061 subjects in 2015 and 12,597 subjects in 2016 were recruited in this study. The chest radiograph, PF, BP and ECG of coal miners were surveyed using radiograph machine, spirometer, sphygmomanometer and electrocardiograph, respectively. Results The prevalence of aberrant BP was the highest in coal miners, followed by abnormal ECG, PF and radiograph. Significant differences in abnormal BP, ECG, PF and radiograph of coal miners were closely associated with age, years of dust exposure, smoking, drinking, working types and size of mines. A total of 80 persons diagnosed with coal workers’ pneumoconiosis (CWP) in 2015–2016, which occupied 0.34% of the coal miners. Conclusion Abnormal BP, ECG, PF and radiograph of coal miners are highlighted health problems in China and require serious attention. Feasible health promotion and protective facilities should be adopted to guarantee coal miners’ health. Electronic supplementary material The online version of this article (10.1186/s12889-019-7568-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Qiuyun Wu
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, China
| | - Lei Han
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Ming Xu
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Hengdong Zhang
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Bangmei Ding
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Baoli Zhu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
| |
Collapse
|
14
|
Abstract
PURPOSE OF REVIEW This review summarizes recent research on pneumoconiosis in coal workers following the identification of the resurgence of this disease among US coal miners in the early 2000s. We describe the impact of this research and how this has led to increased public attention, benefitting affected miners. RECENT FINDINGS The latest research shows that the prevalence of pneumoconiosis, including progressive massive fibrosis, continues to increase, especially in central Appalachia. Contributing factors may include mining of thin coal seams or cutting rock to access coal, which may expose miners to coal mine dust with a higher content of silica and silicates than in the past. The impact of recently implemented changes, such as the reduced occupational exposure limit for respirable coal mine dust and the introduction of continuous personal dust monitors, will likely take years to appropriately evaluate.
Collapse
|
15
|
Zhang L, Hao C, Zhai R, Wang D, Zhang J, Bao L, Li Y, Yao W. Downregulation of exosomal let-7a-5p in dust exposed- workers contributes to lung cancer development. Respir Res 2018; 19:235. [PMID: 30497474 PMCID: PMC6267915 DOI: 10.1186/s12931-018-0949-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 11/22/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Either chronic or acute exposure to dust particles may lead to pneumoconiosis and lung cancer, and lung cancer mortality among patients diagnosed with pneumoconiosis is increasing. Utilizing genome-wide sequencing technology, this study aimed to identify methods to decrease the number of patients with pneumoconiosis who die from lung cancer. METHODS One hundred fifty-four subjects were recruited, including 54 pneumoconiosis patients and 100 healthy controls. Exosomes were isolated from the venous blood of every subject. Distinctive miRNAs were identified using high throughput sequencing technology, and bioinformatics analysis predicted target genes involved in lung cancer as well as their corresponding biological functions. Moreover, cross-cancer alterations of genes related to lung cancer were investigated, and survival analysis was performed using 2437 samples with an average follow-up period of 49 months. RESULTS Let-7a-5p was revealed to be downregulated by 21.67% in pneumoconiosis. Out of the 683 let-7a-5p target genes identified from bioinformatics analysis, four genes related to five signaling pathways were confirmed to be involved in lung cancer development. Alterations in these four target genes were then explored in 4105 lung cancer patients, and BCL2L1 and IGF1R were demonstrated to be aberrantly expressed. Survival analysis further revealed that high expression of BCL2L1 corresponded to reduced survival of lung cancer patients (HR (95%CI) = 1.75(1.33~2.30)), while patient survival time was unaffected by expression of IGF1R (HR (95%CI) = 1.15 (0.98~1.36)). CONCLUSIONS In patients with lung adenocarcinoma, simultaneous downregulation of exosomal let-7a-5p and elevated expression of BCL2L1 are useful as predictive biomarkers for poor survival.
Collapse
Affiliation(s)
- Lin Zhang
- Department of Occupational Hygiene, School of Public Health and Management, Healthy Shandong Collaborative Innovation Center for Major Social Risk Prediction and Governance, Weifang Medical University, 7166 Baotong West Street, Weifang, 261024 China
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| | - Changfu Hao
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| | - Ruonan Zhai
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| | - Di Wang
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| | - Jianhui Zhang
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| | - Lei Bao
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| | - Yiping Li
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| | - Wu Yao
- Department of Occupational and Environmental Health, School of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001 China
| |
Collapse
|
16
|
Linking Compensation and Health Surveillance Data Sets to Improve Knowledge of US Coal Miners' Health. J Occup Environ Med 2018; 59:930-934. [PMID: 28742764 DOI: 10.1097/jom.0000000000001084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Increase knowledge of US coal miners' respiratory health by linking data from the black lung benefits program (BLBP) and the coal workers' health surveillance program (CWHSP). METHODS BLBP claims data from 2000 through 2013 was linked to CWHSP data from 1970 through 2016. RESULTS Overall, 273,644 miners participated in CWHSP, 37,548 in BLBP, and 22,903 in both programs. Median age of miners at their time of first/only participation in CWHSP was 28 and 32 years, respectively. BLBP claimants were older (median age 59). Thirty-nine percent of BLBP claimants had not participated in CWHSP. The relative contributions of states to participation differed between CWHSP and BLBP. For example, Kentucky miners accounted for 18% of CWHSP participants, but 36% of BLPB participants. CONCLUSIONS Many BLBP claimants never appeared in CWHSP, indicating missed opportunities for secondary prevention.
Collapse
|
17
|
MiRNA-Regulated Changes in Extracellular Matrix Protein Levels Associated With a Severe Decline in Lung Function Induced by Silica Dust. J Occup Environ Med 2018; 60:316-321. [DOI: 10.1097/jom.0000000000001268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
18
|
Peng Y, Li X, Cai S, Chen Y, Dai W, Liu W, Zhou Z, Duan J, Chen P. Prevalence and characteristics of COPD among pneumoconiosis patients at an occupational disease prevention institute: a cross-sectional study. BMC Pulm Med 2018; 18:22. [PMID: 29378587 PMCID: PMC5789671 DOI: 10.1186/s12890-018-0581-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/09/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pneumoconiosis may play an important role in the development of chronic obstructive pulmonary disease (COPD), and the complication of COPD may impose a heavy burden of illness. METHODS The study was conducted in Hunan Province in China from December 1, 2015, to December 1, 2016. Consecutive underground male pneumoconiosis patients employed for at least 1 year were recruited from the Hunan Occupational Disease Prevention Institute. Patient information, respiratory symptoms and clinical data were collected using a structured questionnaire. The diagnosis of COPD were assessed using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Logistic regression analyses were conducted to examine the clinical and demographic risk factors of COPD among pneumoconiosis patients. RESULTS The prevalence of COPD in our sample of pneumoconiosis patients was 18.65% (119/638). In pneumoconiosis patients with and without smoking history, the prevalence of COPD was 19.32 and 16.77%. Compared with non-COPD patients, those with COPD are older in age, have longer exposure time, have lower body mass index (BMI), have a higher smoking index and have worse pulmonary function (all p < 0.05). For the five respiratory symptoms (cough, sputum, wheeze, dyspnea, and chest tightness), only the presence of wheeze and the severity scores for wheeze or dyspnea showed significant differences between the COPD and non-COPD groups (p < 0.01). Multivariate logistic regression analysis revealed that advanced pneumoconiosis category, older age and the presence of wheeze symptoms were significant risk factors for the development of COPD among pneumoconiosis patients. CONCLUSION Pneumoconiosis patients are at a high risk of COPD, and pneumoconiosis patients with COPD may suffer more severe respiratory symptoms, such as wheeze and dyspnea, than patients without COPD. Advanced pneumoconiosis category, older age and the presence of wheeze symptoms are associated with an increased risk of COPD in pneumoconiosis. We proposed that a routine assessment of lung function is necessary for timely and adequate clinical management.
Collapse
Affiliation(s)
- Yating Peng
- Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
- Research Unit of Respiratory Diseases, Central South University, Changsha, Hunan 410011 China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan 410011 China
| | - Xin Li
- Hunan Institute of Occupational Disease Prevention, Hunan Provincial Center for Disease Control and Prevention, 410011 Changsha, People’s Republic of China
| | - Shan Cai
- Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
- Research Unit of Respiratory Diseases, Central South University, Changsha, Hunan 410011 China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan 410011 China
| | - Yan Chen
- Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
- Research Unit of Respiratory Diseases, Central South University, Changsha, Hunan 410011 China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan 410011 China
| | - Weirong Dai
- Hunan Institute of Occupational Disease Prevention, Hunan Provincial Center for Disease Control and Prevention, 410011 Changsha, People’s Republic of China
| | - Wenfeng Liu
- Hunan Institute of Occupational Disease Prevention, Hunan Provincial Center for Disease Control and Prevention, 410011 Changsha, People’s Republic of China
| | - Zijing Zhou
- Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
- Research Unit of Respiratory Diseases, Central South University, Changsha, Hunan 410011 China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan 410011 China
| | - Jiaxi Duan
- Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
- Research Unit of Respiratory Diseases, Central South University, Changsha, Hunan 410011 China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan 410011 China
| | - Ping Chen
- Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
- Research Unit of Respiratory Diseases, Central South University, Changsha, Hunan 410011 China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan 410011 China
| |
Collapse
|
19
|
[Spirometry in a population of coal miners in Paipa, Colombia]. BIOMEDICA 2017; 37:498-506. [PMID: 29373770 DOI: 10.7705/biomedica.v37i4.3364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 10/17/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Respiratory diseases resulting from exposure to particulate matter such as in coal mining remains a research challenge in this country and a public health issue. Spirometry is a basic test of fundamental respiratory function for the diagnosis and monitoring of these types of chronic lung diseases. OBJECTIVE To determine spirometric values in the coal mining municipality of Paipa and their association with age and occupational exposure times. MATERIALS AND METHODS We conducted a descriptive cross-sectional study. The occupational respiratory disease questionnaire of the American Thoracic Society (ATS) was completed while spirometric measurements were performed and interpreted in accordance with international recommendations for conducting the test. RESULTS The sample consisted of 226 coal mining workers of the municipality of Paipa. Twenty-eight subjects (12.3%) of the sample showed patterns of obstructive and restrictive respiratory disease with mild degrees of severity. Eighty subjects (35%) showed a decrease in the forced vital capacity ratio/expiratory volume in one second (FVC/FEV1). A statistically significant association between age range (p=0.002) and years of mining work (p=0.34) with the development of restrictive and obstructive disorders was found. Also, there was a statistically significant association between age range (p<0.01) and years of mining work (p<0.01) with various degrees of severity of the spirometric pattern. CONCLUSIONS Spirometry is a useful test for detecting the presence of respiratory disorders in the population of coal miners. The time of exposure was significantly associated with the respiratory disease exhibited by these miners.
Collapse
|
20
|
Reynolds LE, Blackley DJ, Laney AS, Halldin CN. Respiratory morbidity among U.S. coal miners in states outside of central Appalachia. Am J Ind Med 2017; 60:513-517. [PMID: 28497853 DOI: 10.1002/ajim.22727] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent NIOSH publications have focused on the respiratory health of coal miners in central Appalachia, yet 57% of U.S. coal miners work in other regions. We characterized respiratory morbidity in coal miners from these regions. METHODS Active coal miners working outside of central Appalachia who received chest radiographs and/or spirometry during 2005-2015 were included. Chest radiographs were classified according to International Labour Office standards and spirometry was interpreted using the American Thoracic Society guidelines. Prevalence of coal workers' pneumoconiosis (CWP) and abnormal spirometry were compared by region. RESULTS A total of 103 (2.1%) miners had CWP. The eastern region had the highest prevalence (3.4%), followed by the western (1.7%), and interior (0.8%) regions. A total of 524 (9.3%) miners had abnormal spirometry. CONCLUSIONS CWP occurs in all U.S. coal mining regions. Prevalence of CWP was higher in the eastern region, but lower than levels reported in central Appalachia.
Collapse
Affiliation(s)
- Laura E. Reynolds
- Surveillance Branch; Respiratory Health Division; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
- Epidemic Intelligence Service Program; Centers for Disease Control and Prevention; Atlanta Georgia
| | - David J. Blackley
- Surveillance Branch; Respiratory Health Division; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| | - Anthony S. Laney
- Surveillance Branch; Respiratory Health Division; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| | - Cara N. Halldin
- Surveillance Branch; Respiratory Health Division; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| |
Collapse
|
21
|
Perret JL, Plush B, Lachapelle P, Hinks TSC, Walter C, Clarke P, Irving L, Brady P, Dharmage SC, Stewart A. Coal mine dust lung disease in the modern era. Respirology 2017; 22:662-670. [PMID: 28370783 DOI: 10.1111/resp.13034] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/05/2017] [Accepted: 02/07/2017] [Indexed: 12/15/2022]
Abstract
Coal workers' pneumoconiosis (CWP), as part of the spectrum of coal mine dust lung disease (CMDLD), is a preventable but incurable lung disease that can be complicated by respiratory failure and death. Recent increases in coal production from the financial incentive of economic growth lead to higher respirable coal and quartz dust levels, often associated with mechanization of longwall coal mining. In Australia, the observed increase in the number of new CWP diagnoses since the year 2000 has necessitated a review of recommended respirable dust exposure limits, where exposure limits and monitoring protocols should ideally be standardized. Evidence that considers the regulation of engineering dust controls in the mines is lacking even in high-income countries, despite this being the primary preventative measure. Also, it is a global public health priority for at-risk miners to be systemically screened to detect early changes of CWP and to include confirmed patients within a central registry; a task limited by financial constraints in less developed countries. Characteristic X-ray changes are usually categorized using the International Labour Office classification, although future evaluation by low-dose HRCT) chest scanning may allow for CWP detection and thus avoidance of further exposure, at an earlier stage. Preclinical animal and human organoid-based models are required to explore potential re-purposing of anti-fibrotic and related agents with potential efficacy. Epidemiological patterns and the assessment of molecular and genetic biomarkers may further enhance our capacity to identify susceptible individuals to the inhalation of coal dust in the modern era.
Collapse
Affiliation(s)
- Jennifer L Perret
- Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Institute for Breathing and Sleep (IBAS), Melbourne, Victoria, Australia
| | - Brian Plush
- PM10 Laboratories Pty Limited, Somersby, New South Wales, Australia.,Faculty of Engineering and Informational Sciences, The University of Wollongong, Wollongong, New South Wales, Australia
| | - Philippe Lachapelle
- Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.,Department of Respiratory Medicine and Sleep Disorders, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Timothy S C Hinks
- Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.,Department for Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia.,Clinical and Experimental Sciences, University of Southampton, Southampton, UK.,Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton University Hospital, Southampton, UK
| | - Clare Walter
- Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.,Department of Respiratory Medicine and Sleep Disorders, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Philip Clarke
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Louis Irving
- Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.,Department of Respiratory Medicine and Sleep Disorders, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Pat Brady
- Pump Investments Pty Limited, Melbourne, Victoria, Australia
| | - Shyamali C Dharmage
- Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alastair Stewart
- Lung Health Research Centre (LHRC), The University of Melbourne, Melbourne, Victoria, Australia.,Department of Pharmacology and Therapeutics, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
22
|
Altınsoy B, Öz İİ, Erboy F, Tor M, Atalay F. Emphysema and Airflow Obstruction in Non-Smoking Coal Miners with Pneumoconiosis. Med Sci Monit 2016; 22:4887-4893. [PMID: 27956734 PMCID: PMC5175685 DOI: 10.12659/msm.901820] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Accumulating evidence shows that functional impairment in subjects with coal workers’ pneumoconiosis (CWP) is principally due to emphysema and airflow obstruction, rather than underlying restrictive mechanisms. However, cigarette smoking has remained a major confounder. The aim of this study was to assess whether coal dust exposure was associated with emphysema and/or airflow obstruction in the absence of smoking history. Material/Method The subjects evaluated for possible pneumoconiosis between 2013 and 2015 were retrospectively enrolled into this study. After excluding those with history of smoking, tuberculosis, or lung cancer, the study population was a total of 57 subjects. The emphysema severity and airflow obstruction were quantified by computed tomographic densitometry analysis and spirometry, respectively. For comparability regarding emphysema, 9 age- and sex-matched nonsmoker (n=9) control subjects without known lung disease were randomly selected from a radiology database. Results Emphysema severity was significantly higher in the CWP group compared with the control group (15% vs. 4%, p<0.001). The median percent emphysema and percentage of those with FEV1/FVC <0.7 was 13% and 37% in subjects with simple CWP and 18% and 67% in subjects with complicated CWP, respectively. Percent emphysema and Perc15 (15th percentile of the attenuation curve) was correlated with FEV1/FVC (r=−0.45, r=−0.47) and FEF25–75 (r=−0.36, r=−0.56), respectively, but not with perfusion score. A linear regression analysis showed that factors associated with emphysema were FEV1/FVC (β=−0.24, p=0.009) and large opacity (β=−3.97, p=0.079), and factors associated with FEV1/FVC were percent emphysema (β=−0.51, p=0.018) and tenure (β=−0.63, p=0.044). Conclusions Our results support the observation that coal dust exposure is associated with emphysema and airflow obstruction, independent of smoking status.
Collapse
Affiliation(s)
- Bülent Altınsoy
- Department of Pulmonary Medicine, Bulent Ecevit University, School of Medicine, Zonguldak, Turkey
| | - İbrahim İlker Öz
- Department of Radiology, Bulent Ecevit University, School of Medicine, Zonguldak, Turkey
| | - Fatma Erboy
- Department of Pulmonary Medicine, Bulent Ecevit University, School of Medicine, Zonguldak, Turkey
| | - Meltem Tor
- Department of Pulmonary Medicine, Bulent Ecevit University, School of Medicine, Zonguldak, Turkey
| | - Figen Atalay
- Department of Pulmonary Medicine, Bulent Ecevit University, School of Medicine, Zonguldak, Turkey
| |
Collapse
|
23
|
|
24
|
|
25
|
Arnold C. A Scourge Returns: Black Lung in Appalachia. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:A13-A18. [PMID: 26720594 PMCID: PMC4710586 DOI: 10.1289/ehp.124-a13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|