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Hall NB, Blackley DJ, Markle T, Crum JB, Halldin CN, Laney AS. Postexposure progression of pneumoconiosis among former Appalachian coal miners. Am J Ind Med 2022; 65:953-958. [PMID: 36161659 PMCID: PMC10428085 DOI: 10.1002/ajim.23431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/10/2022] [Accepted: 09/14/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The prevalence of pneumoconiosis among working United States underground coal miners has been increasing for the past two decades, with the highest rates of disease observed among miners in the central Appalachian states of Kentucky, Virginia, and West Virginia. Surveillance for this disease in the United States focuses on working coal miners, who continue to be occupationally exposed to dust. This study examines the radiographic evidence for postexposure progression of pneumoconiosis in a population of former coal miners no longer occupationally exposed to coal mine dust who were seen at a community radiology clinic in eastern Kentucky. METHODS Data were obtained and analyzed from clinical records of former coal miners who had a clinic encounter during January 1, 2017-August 1, 2019, a recorded final year of employment, and ≥2 postemployment digital chest radiographs. Radiographs were classified according to the International Labour Office guidelines by at least two B Readers. A final summary pneumoconiosis severity score (range, 0-13), accounting for both small and large opacities, was assigned to each chest radiograph. Progression was defined as an increase in severity score between a miner's radiographs over time. RESULTS Data for 130 former coal miners were analyzed. All miners were male and most (n = 114, 88%) had worked primarily in Kentucky. Information on race/ethnicity was not available. The most common job types were roof bolters (n = 51, 39%) and continuous miner operators (n = 46, 35%). Forty-one (31.5%) miners had evidence of radiographic disease progression after leaving the workforce, with a median of 3.6 years between first and latest postretirement radiograph. A total of 80 (62%) miners had evidence of pneumoconiosis on their latest radiograph, and two-thirds (n = 53) of these were classified as progressive massive fibrosis (PMF), the most severe form of the disease. CONCLUSIONS Postexposure progression can occur in former coal miners, emphasizing the potential benefits of continued radiographic follow-up postemployment. In addition to participating in disease screening throughout their careers to detect pneumoconiosis early and facilitate intervention, radiographic follow-up of former coal miners can identify new or progressive radiographic findings even after workplace exposure to respirable coal mine dust ends. Identification of progressive pneumoconiosis in former miners has potential implications for clinical management and eligibility for disability compensation.
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Affiliation(s)
- Noemi B. Hall
- Surveillance Branch, Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - David J. Blackley
- Surveillance Branch, Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Travis Markle
- Surveillance Branch, Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | | | - Cara N. Halldin
- Surveillance Branch, Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - A. Scott Laney
- Surveillance Branch, Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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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.
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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
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Go LHT, Green FHY, Abraham JL, Churg A, Petsonk EL, Cohen RA. Coal mine dust lung disease in miners killed in the Upper Big Branch disaster: a review of lung pathology and contemporary respirable dust levels in underground US coal mines. Occup Environ Med 2021; 79:319-325. [PMID: 34880046 DOI: 10.1136/oemed-2021-107694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/28/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In 2010, 29 coal miners died due to an explosion at the Upper Big Branch (UBB) mine in West Virginia, USA. Autopsy examinations of 24 individuals with evaluable lung tissue identified 17 considered to have coal workers' pneumoconiosis (CWP). The objectives of this study were to characterise histopathological findings of lung tissue from a sample of UBB fatalities and better understand the respirable dust concentrations experienced by these miners at UBB relative to other US coal mines. METHODS Occupational pulmonary pathologists evaluated lung tissue specimens from UBB fatalities for the presence of features of pneumoconiosis. Respirable dust and quartz samples submitted for regulatory compliance from all US underground coal mines prior to the disaster were analysed. RESULTS Families of seven UBB fatalities provided consent for the study. Histopathologic evidence of CWP was found in all seven cases. For the USA, central Appalachia and UBB, compliance dust samples showed the geometric mean for respirable dust was 0.468, 0.420 and 0.518 mg/m3, respectively, and respirable quartz concentrations were 0.030, 0.038 and 0.061 mg/m3. After adjusting for quartz concentrations, UBB exceeded the US permissible exposure limit (PEL) for respirable dust in 28% of samples. CONCLUSIONS Although higher than average respirable dust and quartz levels were observed at UBB, over 200 US underground coal mines had higher dust concentrations than UBB and over 100 exceeded the PEL more frequently. Together with lung histopathological findings among UBB fatalities, these data suggest exposures leading to CWP in the USA are more prevalent than previously understood.
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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, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Francis H Y Green
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jerrold L Abraham
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Andrew Churg
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward L Petsonk
- Department of Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - 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, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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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.
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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
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Perret JL, Miles S, Brims F, Newbigin K, Davidson M, Jersmann H, Edwards A, Zosky G, Frankel A, Johnson AR, Hoy R, Reid DW, Musk AW, Abramson MJ, Edwards B, Cohen R, Yates DH. 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. Respirology 2020; 25:1193-1202. [PMID: 33051927 PMCID: PMC7702073 DOI: 10.1111/resp.13952] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/19/2020] [Accepted: 08/11/2020] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Jennifer L. Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and BiostatisticsThe University of MelbourneMelbourneVICAustralia
| | - Susan Miles
- Department of MedicineCalvary Mater NewcastleNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
| | - Fraser Brims
- Curtin Medical SchoolCurtin UniversityPerthWAAustralia
- Department of Respiratory MedicineSir Charles Gairdner HospitalPerthWAAustralia
| | | | - Maggie Davidson
- Health and Management School of ScienceWestern Sydney UniversitySydneyNSWAustralia
| | - Hubertus Jersmann
- Department of Thoracic MedicineRoyal Adelaide HospitalAdelaideSAAustralia
| | - Adrienne Edwards
- Christchurch Public HospitalCanterbury District Health BoardChristchurchNew Zealand
| | - Graeme Zosky
- Menzies Institute for Medical Research, College of Health and MedicineUniversity of TasmaniaHobartTASAustralia
- School of Medicine, College of Health and MedicineUniversity of TasmaniaHobartTASAustralia
| | - Anthony Frankel
- Bankstown HospitalSouth Western Sydney Local Heath DistrictSydneyNSWAustralia
- Department of MedicineUniversity of New South WalesSydneyNSWAustralia
| | | | - Ryan Hoy
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia
| | - David W. Reid
- QIMR‐Berghofer Institute of Medical ResearchBrisbaneQLDAustralia
| | - A. William Musk
- Department of Respiratory MedicineSir Charles Gairdner HospitalPerthWAAustralia
- School of Population HealthUniversity of Western AustraliaPerthWAAustralia
| | - Michael J. Abramson
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia
| | - Bob Edwards
- Wesley Dust Disease Research CentreBrisbaneQLDAustralia
| | - Robert Cohen
- School of Public Health, University of IllinoisChicagoILUSA
| | - Deborah H. Yates
- Department of Thoracic MedicineSt Vincent's HospitalSydneyNSWAustralia
- University of NSWSydneyNSWAustralia
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Almberg KS, Friedman LS, Rose CS, Go LHT, Cohen RA. Progression of coal workers' pneumoconiosis absent further exposure. Occup Environ Med 2020; 77:748-751. [PMID: 32788293 DOI: 10.1136/oemed-2020-106466] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/04/2020] [Accepted: 06/25/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The natural history of coal workers' pneumoconiosis (CWP) after cessation of exposure remains poorly understood. METHODS We characterised the development of and progression to radiographic progressive massive fibrosis (PMF) among former US coal miners who applied for US federal benefits at least two times between 1 January 2000 and 31 December 2013. International Labour Office classifications of chest radiographs (CXRs) were used to determine initial and subsequent disease severity. Multivariable logistic regression models were used to identify major predictors of disease progression. RESULTS A total of 3351 former miners applying for benefits without evidence of PMF at the time of their initial evaluation had subsequent CXRs. On average, these miners were 59.7 years of age and had 22 years of coal mine employment. At the time of their first CXR, 46.7% of miners had evidence of simple CWP. At the time of their last CXR, 111 miners (3.3%) had radiographic evidence of PMF. Nearly half of all miners who progressed to PMF did so in 5 years or less. Main predictors of progression included younger age and severity of simple CWP at the time of initial CXR. CONCLUSIONS This study provides further evidence that radiographic CWP may develop and/or progress absent further exposure, even among miners with no evidence of radiographic pneumoconiosis after leaving the industry. Former miners should undergo regular medical surveillance because of the risk for disease progression.
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Affiliation(s)
- Kirsten S Almberg
- School of Public Health, Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Lee S Friedman
- School of Public Health, Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Cecile S Rose
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Leonard H T Go
- School of Public Health, Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Robert A Cohen
- School of Public Health, Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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7
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Hall NB, Blackley DJ, Halldin CN, Laney AS. Pneumoconiosis progression patterns in US coal miner participants of a job transfer programme designed to prevent progression of disease. Occup Environ Med 2020; 77:402-406. [PMID: 32169972 DOI: 10.1136/oemed-2019-106307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/22/2020] [Accepted: 02/26/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Pneumoconiosis prevalence and severity among US coal miners has been increasing for the past 20 years. An examination of the current approaches to primary and secondary prevention efforts is warranted. One method of secondary prevention is the Mine Safety and Health Administration-administered part 90 option programme where US coal miners with radiographic evidence of pneumoconiosis can exercise their right to be placed in a less dusty area of the mine. This study focuses on characterising the progression of disease among US coal miners who participated in the National Institute for Occupational Safety and Health-administered Coal Workers' Health Surveillance Programme (CWHSP) and exercised their part 90 job transfer option. METHODS Chest radiograph classifications of working underground coal miners who exercised their part 90 job transfer option during 1 January 1986 to 21 November 2016 and participated in the CWHSP during 1 January 1981 to 19 March 2019 were analysed. RESULTS 513 miners exercised their part 90 option and participated in the CWHSP at least once during this time period. Of the 149 miners with ≥2 radiographs available, 48 (32%) showed progression after exercising part 90 and had more severe disease prior to exercising, compared with miners who did not progress (severity score of 2.8 vs 1.7, p=0.0002). CONCLUSION The part 90 job transfer option programme is not routinely used as intended to prevent progression of pneumoconiosis among US coal miners. The one-third of miners who participated in part 90 and continued to progress, exercised their part 90 option at a later stage of disease compared with non-progressors.
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Affiliation(s)
- Noemi B Hall
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - David J Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Cara N Halldin
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - A Scott Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Progressive Massive Fibrosis Resurgence Identified in U.S. Coal Miners Filing for Black Lung Benefits, 1970-2016. Ann Am Thorac Soc 2019; 15:1420-1426. [PMID: 30114941 DOI: 10.1513/annalsats.201804-261oc] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE There has been a resurgence of progressive massive fibrosis (PMF) in the United States, particularly among central Appalachian miners. OBJECTIVES We characterized the proportion of PMF among former U.S. coal miners applying for Federal Black Lung Program benefits, 1970-2016. METHODS Data from the U.S. Department of Labor were used to characterize trends in proportion of PMF cases, defined as an approved black lung claim with a determination of PMF, among all miners who filed for federal benefits between January 1, 1970, and December 31, 2016. Joinpoint, logistic, and linear regression models were used to identify changes in the proportion of claimants with PMF over time. RESULTS There were 4,679 unique PMF cases among claimants for federal black lung benefits between 1970 and 2016, with 2,474 miners determined to have PMF since 1996. The number of PMF cases among Federal Black Lung Program claimants fell from 404 (0.5% of claimants) in 1978 to a low of 18 cases (0.6%) in 1988, and then increased to 353 cases (8.3%) in 2014. The proportion of federal black lung benefits claimants with PMF has been increasing since 1978 (0.06% annual percent change [APC]; 95% confidence interval [CI], 0.05-0.07%; P < 0.0001), and began increasing at a significantly increased rate after 1996 (0.26% APC; 95% CI, 0.25-0.28%; P < 0.0001). Most miners with PMF (84%) last mined in West Virginia, Kentucky, Pennsylvania, or Virginia. Since 1970, the proportion of claimants with PMF has increased significantly among miners who last worked in Kentucky (16.6% APC; 95% CI, 16.5-16.7%), Pennsylvania (4.7% APC; 95% CI, 4.6-4.8%), Tennessee (16.1% APC; 95% CI, 15.7-16.4%), West Virginia (16.8% APC; 95% CI, 16.6-16.9%), and most sharply among miners last working in Virginia (31.5% APC; 95% CI, 31.2-31.7%), where in 2009, more than 17% of claimants received a PMF determination. The proportion of PMF determinations for the rest of the United States has not exceeded 4%. CONCLUSIONS There has been a resurgence of PMF, particularly in central Appalachian miners. The resurgence of this preventable disease points to the need for improved primary and secondary prevention of dust-related lung disease in U.S. coal miners.
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Mazurek JM, Wood J, Blackley DJ, Weissman DN. Coal Workers' Pneumoconiosis-Attributable Years of Potential Life Lost to Life Expectancy and Potential Life Lost Before Age 65 Years - United States, 1999-2016. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2018; 67:819-824. [PMID: 30070982 PMCID: PMC6072058 DOI: 10.15585/mmwr.mm6730a3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jacek M Mazurek
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC
| | - John Wood
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC
| | - David J Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC
| | - David N Weissman
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC
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Zhang L, Wang C, Yan Q, Zhang T, Han Z, Jiang G. Diagnostic and clinical application value of magnetic resonance imaging (MRI) for progressive massive fibrosis of coal worker pneumoconiosis: Case reports. Medicine (Baltimore) 2017; 96:e6890. [PMID: 28514304 PMCID: PMC5440141 DOI: 10.1097/md.0000000000006890] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 04/15/2017] [Accepted: 04/19/2017] [Indexed: 11/28/2022] Open
Abstract
RATIONALE Using magnetic resonance imaging (MRI), we diagnosed pneumoconiosis by identifying the content and distribution of hydrogen protons in the water molecules in different tissues and lesions. PATIENT CONCERNS 25 cases of CWP patients with progressive massive fibrosis (PMF) lesions. DIAGNOSES Patients were correctly diagnosed, with one case each of Phase I and II pneumoconiosis and 23 cases of Phase III pneumoconiosis. INTERVENTIONS None. OUTCOMES Through MRI, 39 PMF pneumoconiosis lesions exhibited equal, low or equally low, and uneven signals on T2WI and fat suppression (SPIR) (38/39, 37/39). LESSONS MRI has good specificity to identify the characteristics of PMF lesions of CWP, as well as has high application value for the differential diagnosis of lung cancer and other lung tumor-like lesions.
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Affiliation(s)
- Lansheng Zhang
- Department of Oncology, The Second Attached Hospital of Xuzhou Medical College, Xuzhou, Jiangsu
| | - Chun Wang
- Department of Ultrasound, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an
| | | | - Tao Zhang
- Department of Oncology, The Second Attached Hospital of Xuzhou Medical College, Xuzhou, Jiangsu
| | - Zhengxiang Han
- Department of Oncology, The Second Attached Hospital of Xuzhou Medical College, Xuzhou, Jiangsu
| | - Guan Jiang
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Blackley DJ, Halldin CN, Cummings KJ, Laney AS. Lung transplantation is increasingly common among patients with coal workers' pneumoconiosis. Am J Ind Med 2016; 59:175-7. [PMID: 26725917 DOI: 10.1002/ajim.22551] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND The prevalence of coal workers' pneumoconiosis (CWP) in U.S. coal miners has increased, and severe presentations are increasingly common. METHODS We describe trends in lung transplantation during 1996-2014 for recipients with a primary diagnosis of CWP or pneumoconiosis unspecified, and we summarize recipient characteristics and estimate survival. RESULTS A total of 47 transplants were included; nearly three-quarters were performed during 2008-2014. All recipients were male, 96% were white, and the mean age was 56 years. Mean FEV1 % was 35%; mean FVC% was 53%. Mean time on a waitlist was 155 days, and 60% of transplants were bilateral. Median survival was 3.7 years. CONCLUSIONS These transplants reflect the use of a scarce resource for an entirely preventable disease, and highlight the need for enhanced efforts to reduce coal mine dust exposures.
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Affiliation(s)
- David J. Blackley
- National Institute for Occupational Safety Health; Respiratory Health Division; Surveillance Branch; Morgantown West Virginia
| | - Cara N. Halldin
- National Institute for Occupational Safety Health; Respiratory Health Division; Surveillance Branch; Morgantown West Virginia
| | - Kristin J. Cummings
- National Institute for Occupational Safety and Health; Respiratory Health Division; Field Studies Branch; Morgantown West Virginia
| | - A. Scott Laney
- National Institute for Occupational Safety Health; Respiratory Health Division; Surveillance Branch; Morgantown West Virginia
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Respiratory Health Division; Morgantown West Virginia
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13
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Halldin CN, Wolfe AL, Laney AS. Comparative Respiratory Morbidity of Former and Current US Coal Miners. Am J Public Health 2015; 105:2576-7. [PMID: 26469667 DOI: 10.2105/ajph.2015.302897] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We compared the prevalence of respiratory disease in former and current US coal miners using chest radiographs and lung functions collected from 2009 to 2013 among miners of the Appalachian and Interior US coalfields. We calculated prevalence ratios (PRs) of pneumoconiosis and impaired lung function. Significantly higher prevalences of pneumoconiosis (PR = 1.5; 95% confidence interval = 1.2, 2.0) and impaired lung function were observed among former miners compared with active miners. Former miners continue to suffer negative health effects from occupational coal mine dust exposure. The respiratory health of active and former miners is a global concern because international coal production is projected to increase for decades to come.
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Affiliation(s)
- Cara N Halldin
- The authors are with the Surveillance Branch, Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV
| | - Anita L Wolfe
- The authors are with the Surveillance Branch, Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV
| | - A Scott Laney
- The authors are with the Surveillance Branch, Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV
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A longitudinal study on lung disease in dental technicians: what has changed after seven years? Int J Occup Med Environ Health 2014; 26:693-701. [PMID: 24254651 DOI: 10.2478/s13382-013-0140-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 09/05/2013] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of this 7-year follow-up study was to determine respiratory changes in dental technicians. MATERIAL AND METHODS In our region, in the year 2005, 36 dental technicians were evaluated with a cross-sectional study on respiratory occupational diseases, and in 2012 we evaluated them again. Inclusion of information on respiratory symptoms and demographic features questionnaires was applied. Pulmonary function tests (PFT) were performed. Chest X-rays (CXR) were evaluated according to the ILO-2000 classification. For the comparisons of the technicians' findings in 2005 and 2012, data analyses were performed with the Wilcoxon test in addition to descriptive statistical procedures. RESULTS In 2012, 19 out of the 36 technicians continued to work in the same place, so we were able to evaluate their findings. The prevalence of respiratory symptoms in dental technician was as follows: dyspnea 7 (37%), cough 6 (32%), and phlegm 5 (26%). According to ILO classifications in 2005, among the 36 technicians, 5 (13.8%) had pneumoconiosis. At the end of 7 years, there were 9 pneumoconiosis cases among the 19 remaining technicians (47%). Thus, there was a statistically significant progression on the profusion of the radiologic findings (p < 0.005). Also there was a significant worsening on spirometric findings (p < 0.05). CONCLUSION In dental technicians, a determination of both radiologic and functional progressions at the end of 7 years demonstrate that the primary and secondary preventive measures are necessary for these workplaces. Workplaces must be regularly controlled for worker health and hygiene.
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Petsonk EL, Rose C, Cohen R. Coal mine dust lung disease. New lessons from old exposure. Am J Respir Crit Care Med 2013; 187:1178-85. [PMID: 23590267 DOI: 10.1164/rccm.201301-0042ci] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Coal mining remains a sizable industry, with millions of working and retired coal miners worldwide. This article provides an update on recent advances in the understanding of respiratory health issues in coal miners and focuses on the spectrum of disease caused by inhalation of coal mine dust, termed coal mine dust lung disease. In addition to the historical interstitial lung diseases (coal worker's pneumoconiosis, silicosis, and mixed dust pneumoconiosis), coal miners are at risk for dust-related diffuse fibrosis and chronic airway diseases, including emphysema and chronic bronchitis. Recent recognition of rapidly progressive pneumoconiosis in younger miners, mainly in the eastern United States, has increased the sense of urgency and the need for vigilance in medical research, clinical diagnosis, and exposure prevention. Given the risk for disease progression even after exposure removal, along with few medical treatment options, there is an important role for chest physicians in the recognition and management of lung disease associated with work in coal mining.
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Affiliation(s)
- Edward L Petsonk
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, West Virginia University School of Medicine, Morgantown, WV 26506, USA.
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Dumavibhat N, Matsui T, Hoshino E, Rattanasiri S, Muntham D, Hirota R, Eitoku M, Imanaka M, Muzembo BA, Ngatu NR, Kondo S, Hamada N, Suganuma N. Radiographic progression of silicosis among Japanese tunnel workers in Kochi. J Occup Health 2013; 55:142-8. [PMID: 23485572 DOI: 10.1539/joh.12-0258-oa] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aim of our study was to investigate the natural course of silicosis in terms of radiographic progression among Japanese tunnel workers. METHODS Tunnel workers with silicosis were included in our study between January 2008 and June 2011. We retrospectively assessed workers' radiographs from their first through last visits to see whether there was progression. All films were interpreted by two physicians, who had been specially trained in using the ILO (2000) International Classification of Radiographs of Pneumoconioses (ILO/ICRP). We classified the radiographic findings according to the ILO/ICRP. Survival analysis was performed and then presented as time to progression. Subgroup analysis among the progressed group was performed to demonstrate duration of progression. RESULTS A total of 65 patients, who were no longer exposed to silica for the duration of the study, were included. The mean age at the first visit was 58.60 ± 7.10 years. The incidence rate of progression was 42 per 1,000 person-years with a median time to progression of 17 years. Progression was demonstrated among 33 cases (51%). The mean durations of progression from category 1 to category 4 and category 2 to category 4 were 14.55 and 10.65 years, respectively. Most patients (86%) had radiographic change from category 1 or 2 directly to category 4. CONCLUSION Silicosis progressed at a relatively high rate among tunnel workers without further silica exposure. The high probability of progression directly from category 1 to category 4 may lead to further investigation for the improvement of disease prevention.
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Affiliation(s)
- Won-Yeon Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Abstract
This study identifies the number of pneumoconiosis patients after eliminating deceased patients between 2003 and 2008 as of January 1st and estimates it for the next five years. From 2003 to 2008, the pneumoconiosis patients were 16,929, 17,224, 17,366, 17,566, 17,542, and 17,546, respectively. The number of pneumoconiosis patients will have increased by 1,014 from 2008 to 18,560 in 2013 after applying the average change rates taken from 2003 to 2007. It takes 15-20 yr to develop coal workers' pneumoconiosis (the main cause in Korea) and patients will continue to be diagnosed with pneumoconiosis for some years to come since it has only been 20 yr since the decline of the coal mining industry in Korea. In addition, pneumoconiosis patients are increasing in industries in which the risk of pneumoconiosis was relatively low shows the necessity to improve dust-exposed workplace environments.
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