The Changing Epidemiology of Coal Workers’ Pneumoconiosis in Appalachia – Investigating the Role of Silica Exposure

Details

• Personal Author:
  Attfield MD ; Laney AS ; Petsonk, Edward L.
• Description:
  Background: Epidemiologic reports since 2000 have documented increased severity and rapid progression of pneumoconiosis among underground coal miners in KY, VA, and WV. To investigate if silica exposure might explain the increased disease, we examined chest x-rays (CXRs) for specific abnormalities (r-type small opacities) known to be associated with silicosis lung pathology. Methods: Underground coal miners are offered CXRs every 5 years, and abnormalities consistent with pneumoconiosis are recorded by NIOSH B Readers using the International Labour Office (ILO) Classification of Radiographs of Pneumoconioses. CXRs from 1980-2008 of 46,117 participating miners in KY, VA, and WV were studied, focusing on reporting of r-type opacities (small rounded opacities 3-10 mm in diameter). Log binomial regression was used to calculate prevalence ratios adjusted for miner age and profusion category. Results: The percentage of CXRs showing any r-type opacities in the region increased from 0.18 in 1980-89 to 0.59 in the 1990-99 period (PR=2.5, 95% CI=1.7-3.7) and increased further from 1990-99 to 1.4 for 2000-08 (PR=1.6, 95% CI=1.2-2.2). The increase from 1980-89 to 2000-08 was 5.2 fold (95% CI=3.7-7.3). The proportion of CXRs showing profusion categories 2 or 3 (reflecting disease severity) in these states increased from 1980-99 to 2000-08 (crude PR=2.3, 95% CI=1.8-2.8). Conclusions: r-type opacities increased in the 1990s and 2000s among underground coal miners from KY, VA, and WV, suggesting increasingly excessive exposure to respirable silica. These results and reports from the region of severe and rapidly progressive pneumoconiosis challenge the effectiveness of current approaches to controlling respirable silica in US coal mines. [Description provided by NIOSH]
• Subjects:
  Coal Coal Mining Epidemiology Lung Lung Diseases Mining Occupational Health Respiratory System Respiratory Tract Diseases Safety Silicon Dioxide

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• Keywords:
  Coal-mining Coal-workers-pneumoconiosis Lung-disease Lung-disorders Mining-industry Pneumoconiosis Pulmonary-system-disorders Respiratory-system-disorders Silica-dusts Silicosis Statistical-analysis Surveillance Underground-mining

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• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 3 ; 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
• Volume:
  179
• NIOSHTIC Number:
  nn:20036358
• Citation:
  Am J Respir Crit Care Med 2009 Apr; 179(Meeting Abstracts):A5900
• CAS Registry Number:
  Quartz (SiO2) (CAS RN 14808-60-7)
• Federal Fiscal Year:
  2009
• NORA Priority Area:
  Mining
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0bf2ca9f124701abc7ea5edcdc341787abe4c81ef67d4685ccc023b5ce521b2956edf34472bc98804b1b919415655bd93b1fae63b74963cc7e6e763cf9228a45
• Download URL:
  https://stacks.cdc.gov/view/cdc/187824/cdc_187824_DS1.pdf
• File Type:
  [PDF - 116.39 KB ]