Excess lung function decline in gold miners following pulmonary tuberculosis

Details

• Personal Author:
  Churchyard GJ ; Ehrlich RI ; Hnizdo, Eva ; Ross J ; White N
• Description:
  Background: Few if any studies of the association between pulmonary tuberculosis (TB) and lung function loss have had access to premorbid lung function values. Methods: Using a retrospective cohort design, the study recruited employed South African gold miners who had undergone a pulmonary function test (PFT) between January 1995 and August 1996. The 'exposed' group comprised 185 miners treated for pulmonary TB after the initial PFT and the 'unexposed' group comprised 185 age-matched miners without TB. All participants had a follow-up PFT between April and June 2000. The outcome of interest was decline in lung function during the follow-up period as measured by forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Results: After controlling for age, height, baseline lung function, silicosis, years of employment, smoking and other respiratory diagnoses, pulmonary TB during the follow-up period was associated with a mean excess loss of 40.3 ml/year in FEV1 (95% CI 25.4 to 55.1) and 42.7 ml/year in FVC (95% CI 27.0 to 58.5). Lung function loss was greater among those with more severe or later clinical presentation of TB. Breathlessness was twice as common among TB cases (OR 2.20, 95% CI 1.18 to 4.11). Conclusion: There is a need for greater clinical recognition of the long-term respiratory consequences of treated pulmonary TB. Early detection of TB would help to reduce these sequelae and remains a priority, particularly in a workforce already subject to silica dust disease. However, strategies such as dust control, worker education about TB and dust and TB preventive therapy are also needed to avert the disease itself. [Description provided by NIOSH]
• Subjects:
  Aging Lung Lung Diseases Mining Occupational Health Public Health Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety Workplace

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• Keywords:
  Age-groups Gold-mines Lung-disease Lung-disorders Lung-function Miners Mining-industry Occupational-respiratory-disease Public-health Pulmonary-disorders Pulmonary-function Pulmonary-system Pulmonary-system-disorders Risk-analysis Risk-factors Statistical-analysis Surveillance Thorax Work-environment Worker-health

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• ISSN:
  0040-6376
• Document Type:
  Text
• Genre:
  Journal Article
• 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:
  65
• Issue:
  11
• NIOSHTIC Number:
  nn:20037988
• Citation:
  Thorax 2010 Nov; 65(11):1010-1015
• Contact Point Address:
  Rodney Ehrlich, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa
• Email:
  rodney.ehrlich@uct.ac.za
• CAS Registry Number:
  Gold (CAS RN 7440-57-5) ; Silica (CAS RN 7631-86-9)
• Federal Fiscal Year:
  2011
• Peer Reviewed:
  True
• Source Full Name:
  Thorax
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2b77bba99214b5c1c89b5408d2fe9244035a3fed722c99bea94e613fc53ca129d18f8010bf6f31ed5c7ad6251635d65f6300fd95b4d939da767905688e48e015
• Download URL:
  https://stacks.cdc.gov/view/cdc/191872/cdc_191872_DS1.pdf
• File Type:
  [PDF - 166.79 KB ]