Geographic variability in coal workers' pneumoconiosis mortality in the U.S.
Pinheiro GA; Antão VC; Wood J; Attfield MD
Proc Am Thorac Soc 2005 May; 2(Abstracts):A443
U.S. national mortality rates from coal workers' pneumoconiosis (CWP) have declined substantially over time, showing a major peak in 1972 and a secondary peak around 1982. However, state-specific temporal trends in mortality rates show very different patterns between Pennsylvania (PA) and the other states. Objectives: To explore the nature and causes of the geographic differences in CWP mortality rates around the country. Methods: Numbers of deaths and age-adjusted mortality rates from 1968 to 2000 were calculated for the main coal-mining states and regions for U.S. residents aged 15 and older and analyzed in relation to coal type (anthracite versus bituminous), employment, and production (surrogate for dust level). Results: In PA, mortality from CWP peaked in 1972 and declined continuously from then on. In contrast, in all other states but Wyoming, CWP mortality rose from the early 1970s and peaked 10-20 years later (mean=1982). Numbers of deaths and mortality rates were about 300% and 400% higher in the PA anthracite counties versus the PA bituminous counties and other states. Temporal trends were associated with patterns of employment and production in the different regions. Conclusions: The temporal trend in national CWP mortality reflects the combination of different trends in the anthracite and bituminous regions and is heavily influenced by mortality rates among anthracite miners in the period 1970-80. Geographic patterns of mortality reflect the influence of mining employment, toxicity (coal rank) and possibly mine dust concentrations. Although not investigated, diagnostic perceptions in different regions of the country may also have played a role.
Mining-industry; Coal-workers-pneumoconiosis; Coal-workers; Coal-miners; Coal-mining; Underground-mining; Underground-miners; Respiratory-system-disorders; Pulmonary-system-disorders; Statistical-analysis; Surveillance
Abstract; Conference/Symposia Proceedings
Issue of Publication
Proceedings of the American Thoracic Society. 2005 ATS International Conference, May 20-25, 2005, San Diego, California