Lung pathology in U.S. coal workers with rapidly progressive pneumoconiosis implicates silica and silicates

Details

• Personal Author:
  Abraham JL ; Churg A ; Cohen RA ; Green FHY ; Najmuddin A ; Petsonk, Edward L. ; Regier M ; Rose C ; Young B
• Description:
  Rationale: Recent reports of progressive massive fibrosis and rapidly progressive pneumoconiosis among US coal miners have raised concerns over excessive exposures to coal mine dust, despite reports of declining dust levels. Objectives: To evaluate the histologic abnormalities and retained dust particles in available coal miner lung pathology specimens and compare findings to those from corresponding chest radiographs. Methods: Miners with severe disease and available lung tissue were identified through investigator outreach. Demographics, smoking, and work history were obtained. Chest radiographs were interpreted according to the International Labour Organization classification to determine if criteria for rapidly progressive pneumoconiosis were confirmed. Pathology slides were scored by three expert pulmonary pathologists, using standardized nomenclature and scoring system. Measurements and Main Results: Of the 13 cases reviewed; 12 had progressive massive fibrosis, 11 had silicosis, many with features of accelerated silicosis and mixed dust lesions. Only four had classic lesions of simple coal workers' pneumoconiosis. Four had diffuse interstitial fibrosis with chronic inflammation, and two had focal alveolar proteinosis. Polarized light microscopy revealed large amounts of birefringent mineral dust particles consistent with silica and silicates; carbonaceous coal dust was less prominent. Specimens with features of silicosis were significantly associated (p=0.047) with rounded (p,q,r) opacities on chest imaging, while grade 3 interstitial fibrosis was associated (p=0.02) with the presence of irregular (s,t,u) opacities on chest imaging. Conclusions: Our findings suggest that rapidly progressive pneumoconiosis in these miners was associated with exposure to coal mine dusts containing high concentrations of respirable silica and silicates. [Description provided by NIOSH]
• Subjects:
  Aluminum Silicates Coal Coal Mining Dust Lung Lung Diseases Mining Occupational Health Pathology Pneumoconiosis Radiography Respiratory System Respiratory Tract Diseases Safety Silicon Dioxide Silicosis

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• Keywords:
  Author Keywords: Anthracosis Chest X-rays Coal Miners Coal Mining Coal Workers Pneumoconiosis Dust Exposure Lung Fibrosis Pneumoconiosis Radiographic Analysis Silica Dusts Silicates Silicosis

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; Illinois ; New York ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 8 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  193
• Issue:
  6
• NIOSHTIC Number:
  nn:20046989
• Citation:
  Am J Respir Crit Care Med 2016 Mar; 193(6):673-680
• Contact Point Address:
  Robert A. Cohen, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair, Chicago, Illinois, 60611
• Email:
  bobcohen@northwestern.edu
• CAS Registry Number:
  Quartz (SiO2) (CAS RN 14808-60-7) ; Silica (CAS RN 7631-86-9)
• Federal Fiscal Year:
  2016
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:01707c8efdffa708beca27f2342a62aa7d1263c95431f6cbb243f1ce8561fe60be1fbe9e85380d51d852918b6464e2129be94ecf22c43afcf9de51703d6fad5b
• Download URL:
  https://stacks.cdc.gov/view/cdc/202233/cdc_202233_DS1.pdf
• File Type:
  [PDF - 1.28 MB ]