Correlation Between Autopsy Findings for Chronic Obstructive Airways Disease and In-Life Disability in South African Gold Miners

Details

• Personal Author:
  Davison A ; Hnizdo, Eva ; Murray J
• Description:
  Objectives: In South Africa chronic obstructive airway disease (COAD), which could be due to working in a dusty atmosphere in scheduled mines or works, is a compensatable disease. Miners are compensated for in-life respiratory disability and for findings at autopsy of COAD, which includes emphysema, bronchitis assessed by mucus gland hyperplasia in the main bronchus, and bronchiolitis assessed by goblet cell metaplasia. The question arises as to whether the autopsy findings correlate with in-life impairment. The objectives of the study were: (1) to determine whether autopsy COAD outcomes relate to lung function and to respiratory symptoms and signs; and (2) to quantify the individual contributions of emphysema, bronchiolitis and bronchitis to lung function impairment. Methods: On 724 gold miners, pathological findings of COAD emphysema, bronchitis and bronchiolitis - were related to lung function measurements and respiratory symptoms and signs observed within 5 years prior to death. Results: Emphysema diagnosed at autopsy was the main determinant of airflow impairment. The emphysema score categories 0-5, 5-35, 35-65 and >65 were associated with decreased forced expiratory volume in 1 s, expressed as percentage predicted (FEV1%) as follows: 78.8%, 66.2%, 52.0% and 46.0%, respectively. The score was also associated with increasing frequency of dyspnoea. After adjustment for emphysema, the bronchitis and bronchiolitis were not related to significant lung function loss, and in subjects without emphysema, the presence of moderate or marked bronchitis was associated with a mild impairment only. Bronchitis at autopsy was associated with increased frequency of rhonchi, sputum and cough, whereas bronchiolitis was associated with increased sputum only. Silicosis found at autopsy was associated with some obstructive and restrictive lung function impairment. Tobacco smoking was associated with all the COAD outcomes. [Description provided by NIOSH]
• Subjects:
  Accidents, Occupational Age Factors Air Pollutants, Occupational Asthma Asthma, Occupational Dust Irritants Lung Lung Diseases Mining Occupational Health Particulate Matter Respiratory Hypersensitivity Respiratory System Respiratory Tract Diseases Safety Smoke Smokers

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• Keywords:
  Accident-analysis Age-factors Airborne-dusts Analytical-methods Analytical-processes Author Keywords: Clinico-pathological Correlations Bronchial-asthma Bronchiolitis Bronchitis Emphysema Inhalation-studies Lung-disorders Lung-function Lung-irritants Lung Function Mine-workers Mineral-dusts Particulate-dust Pulmonary-system-disorders Respiratory-hypersensitivity Respiratory-irritants Respiratory-system-disorders Silica Dust Smoke-inhalation Smoking Statistical-analysis

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• ISSN:
  0340-0131
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; Pennsylvania ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  235-244
• Volume:
  73
• Issue:
  4
• NIOSHTIC Number:
  nn:20032637
• Citation:
  Int Arch Occup Environ Health 2000 May; 73(4):235-244
• Contact Point Address:
  E. Hnizdo, National Institute for Occupational Safety and Health, 1095 Willowdale Road, MS 2800 Morgantown, WV 26505-2845
• Email:
  EXH6@cdc.gov
• Federal Fiscal Year:
  2000
• Peer Reviewed:
  True
• Source Full Name:
  International Archives of Occupational and Environmental Health
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:24b723d0d9cafdf8f8d3cfc518a78567be9125dad260d92d863ff4da66c7a40c73503a854812b4aaa144a62bb51f78d00a6739cb8ad3a19a35690743d3fe3cf7
• Download URL:
  https://stacks.cdc.gov/view/cdc/186536/cdc_186536_DS1.pdf
• File Type:
  [PDF - 128.13 KB ]