Radiographic disease progression in contemporary US coal miners with progressive massive fibrosis.
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TLDR
Improved participation in CWHSP could allow more precise characterisation of the burden and characteristics of pneumoconiosis in US coal miners and provide an important early detection tool to prevent cases of severe disease.Abstract:
Introduction Among contemporary US coal miners, there has been an increase in the prevalence and severity of pneumoconiosis, including its advanced form progressive massive fibrosis (PMF). We examine radiographic progression in Coal Workers’ Health Surveillance Program (CWHSP) participants. Methods CWHSP participants with a final determination of PMF during 1 January 2000–1 October 2016 with at least one prior radiograph in the system were included. We characterised demographics, participation and progression patterns. Results A total of 192 miners with a PMF determination contributed at least one additional radiograph (total count: 2–10). Mean age at first radiograph was 28.8 years, 162 (84%) worked in Kentucky, Virginia or West Virginia and 169 (88%) worked exclusively underground. A total of 163 (85%) miners had a normal initial radiograph. Mean time from most recent normal radiograph to one with a PMF determination was 20.7 years (range: 1–43) and 27 (17%) progressed to PMF in less than 10 years. Discussion Dust exposure is the sole cause of this disease, and a substantial number of these miners progressed from normal to PMF in less than a decade. Participation in CWHSP is voluntary, and these findings are influenced by participation patterns, so for many miners it remains unclear how rapidly their disease progressed. The National Institute for Occupational Safety and Health recommends all working miners to participate in radiographic surveillance at 5-year intervals. Improved participation could allow more precise characterisation of the burden and characteristics of pneumoconiosis in US coal miners and provide an important early detection tool to prevent cases of severe disease.read more
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TL;DR: It is suggested that rapidly progressive pneumoconiosis in these miners was associated with exposure to coal mine dust containing high concentrations of respirable silica and silicates.
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A. Scott Laney,David N. Weissman +1 more
TL;DR: Coal mine dust remains a relevant occupational hazard and miners remain at risk for CMDLD, and prevention is critical.
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TL;DR: An urgent need for effective dust control in coal mines to prevent coal workers' pneumoconiosis is highlighted, and for improved surveillance to promptly identify the early stages of the disease and stop its progression to progressive massive fibrosis (PMF).
Journal ArticleDOI
Coal workers' pneumoconiosis in the United States: regional differences 40 years after implementation of the 1969 Federal Coal Mine Health and Safety Act
TL;DR: Whether the recent increases in the prevalence of coal workers' pneumoconiosis (CWP) in the USA reflect increased measured exposures over recent decades, and to identify other potential causative factors, is assessed.