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Contributions of dust exposure and cigarette smoking to emphysema severity in U.S. coal miners.

Authors
Kuempel-ED; Wheeler-MW; Smith-RJ; Vallyathan-V; Green-FHY
Source
Am J Respir Crit Care Med 2009 Aug; 180(3):257-264
NIOSHTIC No.
20035401
Abstract
Rationale: Previous studies have shown associations between dust exposure or lung burden and emphysema in coal miners, although the separate contributions of various predictors have not been clearly demonstrated. Objectives: To quantitatively evaluate the relationship between cumulative exposure to respirable coal mine dust, cigarette smoking, and other factors on emphysema severity. Methods: The study group included 722 autopsied U.S. coal miners and non-miners. Data on work history, smoking, race, and age at death were obtained from medical records and questionnaire completed by next-of-kin. Emphysema was classified and graded using a standardized schema. Job-specific mean concentrations of respirable coal mine dust were matched with work histories to estimate cumulative exposure. Relationships between various metrics of dust exposure (including cumulative exposure and lung dust burden) and emphysema severity were investigated in weighted least squares regression models. Measurements and Main Results: Emphysema severity was significantly elevated in coal miners compared to non-miners, among both ever and never smokers (p<0.0001). Cumulative exposure to respirable coal mine dust or coal dust retained in the lungs were each significant predictors of emphysema severity (p<0.0001), after accounting for cigarette smoking, age at death, and race. The contributions of coal mine dust exposure and cigarette smoking were similar in predicting emphysema severity averaged over this cohort. Conclusions: Coal dust exposure, cigarette smoking, age, and race are significant and additive predictors of emphysema severity in this study.
Keywords
Respiratory-system-disorders; Pulmonary-system-disorders; Respirable-dust; Coal-dust; Statistical-analysis; Mine-workers; Mining-industry; Miners; Smoking; Cigarette-smoking; Demographic-characteristics; Author Keywords: Occupational exposure; regression analysis; chronic obstructive lung disease; autopsy; severity of illness index;
CODEN
AJCMED
Publication Date
20090801
Document Type
Journal Article
Email Address
ekuempel@cdc.gov
Fiscal Year
2009
NTIS Accession No.
NTIS Price
Issue of Publication
3
ISSN
1073-449X
NIOSH Division
EID; HELD
Priority Area
Manufacturing; Mining; Services
Source Name
American Journal of Respiratory and Critical Care Medicine
State
OH; WV
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