Progressive Massive Fibrosis in Coal Miners from 3 Clinics in Virginia

Details

• Personal Author:
  Blackley DJ ; Carson R ; Halldin, Cara N. ; Laney AS ; Reynolds, Laura E. ; Short C ; Storey, Eileen
• Description:
  Since 1970, the Coal Workers' Health Surveillance Program (CWHSP), administered by the National Institute for Occupational Safety and Health, has offered periodic chest radiographs to working US coal miners. The primary purpose of the CWHSP is early detection of coalworkers' pneumoconiosis to prevent progression to disabling lung disease, including progressive massive fibrosis (PMF). By the late 1990s, PMF was rarely identified among miners participating in the CWHSP. However, a 2014 report documented an increase in the prevalence of PMF in Appalachia. On February 1, 2017, the director of a network of 3 federally funded black lung clinics (which primarily serve former miners, and are not affiliated with the CWHSP) in Southwest Virginia requested assistance to determine the burden of PMF in patients served by the clinics. ... Discussion: To our knowledge, this is the largest cluster of PMF reported in the scientific literature. A high proportion of these cases had r-type opacities, category B and C large opacities, and coal mining tenure of less than 20 years, which are indications of exceptionally severe and rapidly progressive disease. This report underestimates the total burden of PMF and other severe respiratory disease at these clinics because miners with PMF classifications outside the study period, those with non-B Reader classifications, and those with clinical notes indicating PMF but no accompanying B Reader classification form were excluded. An additional limitation is that only 3 clinics located in 1 state were included. In 2014, a federal rule improved protections for miners, including decreased allowable dust concentrations, changes in dust monitoring, and expansion of the CWHSP. During April 2016 through June 2016, 99% of more than 20,000 operator-provided samples from underground coal mines were in compliance with the new dust standard. Whether these added protections will decrease severe occupational lung disease in coal miners requires continued surveillance. [Description provided by NIOSH]
• Subjects:
  Coal Coal Mining Diagnosis Dust Environmental Exposure Health Care Facilities Workforce And Services Lung Lung Diseases Mining Occupational Health Radiation Radiography Respiratory System Respiratory Tract Diseases Safety

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• Keywords:
  Black Lung Disease Chest Radiography Chest X-rays Clinical Diagnosis Coal Dust Coal Miners Coal Workers' Health Surveillance Program Coal Workers Pneumoconiosis CWHSP Dust Exposure Dusts Exposure Levels Exposure Limits Lung Disease Lung Disorders Medical Monitoring Monitoring Systems Occupational Respiratory Disease Pneumoconiosis Protective Measures Regulations Respiratory Health Surveillance Surveillance Programs

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• ISSN:
  0098-7484
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; Virginia ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  319
• Issue:
  5
• NIOSHTIC Number:
  nn:20050968
• Citation:
  JAMA 2018 Feb; 319(5):500-501
• Contact Point Address:
  David J. Blackley, DrPH, Respiratory Health Division, National Institute for Occupational Safety and Health, 1095 Willowdale Rd, Mail Stop HG900.2, Morgantown, WV 26505
• Email:
  dblackley@cdc.gov
• Federal Fiscal Year:
  2018
• Peer Reviewed:
  False
• Source Full Name:
  Journal of the American Medical Association
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:784f7669cff45e40881b4f85b23783eef6cabd09e76185502a67346fb95257bf6acb4610c73187860e7856af64cbcaa3338c83fa1197c5697673189b7aed20b9
• Download URL:
  https://stacks.cdc.gov/view/cdc/211138/cdc_211138_DS1.pdf
• File Type:
  [PDF - 136.59 KB ]