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Excess lung function decline in gold miners following pulmonary tuberculosis.

Authors
Ross-J; Ehrlich-RI; Hnizdo-E; White-N; Churchyard-GJ
Source
Thorax 2010 Nov; 65(11):1010-1015
NIOSHTIC No.
20037988
Abstract
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.
Keywords
Age-groups; Gold-mines; Lung; 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; Thorax; Work-environment; Worker-health; Surveillance
Contact
Rodney Ehrlich, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa
CODEN
THORA7
CAS No.
7440-57-5; 7631-86-9
Publication Date
20101101
Document Type
Journal Article
Email Address
rodney.ehrlich@uct.ac.za
Fiscal Year
2011
NTIS Accession No.
NTIS Price
Issue of Publication
11
ISSN
0040-6376
NIOSH Division
DRDS
Priority Area
Mining; Construction
Source Name
Thorax
State
WV
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