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Similarity in geographic clustering of pulmonary function impairment and pneumoconiosis in US coal miners.
Beeckman-Wagner LF; Wang ML; Syamlal G; Petsonk EL
Am J Respir Crit Care Med 2009 Apr; 179(Meeting Abstracts):A5901
Rationale: Rapidly progressive coal workers' pneumoconiosis (CWP) has recently been shown to be more prevalent among miners in parts of Appalachia. We studied whether pulmonary function impairment and CWP among working coal miners have similar geographic distributions. Methods: From September 2005 to November 2007, 3687 underground coal miners participated in the NIOSH Enhanced Coal Workers' Health Surveillance Program. Spirometry was conducted and interpreted in accordance with ATS/ERS guidelines; tests with at least two acceptable curves showing maximum effort were analyzed. Chest x-rays (CXRs) were classified using the International Labour Office system. Both spirometry results and classifications were available for 3444 miners. County-based prevalences were calculated as the number with abnormal spirometry or CWP (category >1/0 based on agreement of at least two NIOSH-certified B Readers) divided by the total number of miners in the county with both spirometry and CXRs. Geographic distributions of impairment and CWP were analyzed using MapInfo Professional, v. 9.5. Results: Abnormal spirometry was detected in 13.3% (463/3477) of miners—6.3% with restrictive, 5.6% with obstructive, and 1.4% with mixed impairment. Among 3654 miners, the prevalence of CWP was 4.6%. In 2.0% (68/3444) of miners, both spirometry and CXRs were abnormal. The highest prevalences of impaired lung function were clustered in counties in eastern Kentucky, southern West Virginia, and western Virginia. The highest county-based prevalences of CWP generally clustered in the same geographic regions. Conclusions: Geographic clustering of lung function impairment and CWP is occurring among coal miners working in the same regions where high prevalences of rapidly progressive CWP have been reported. Prevention of both airflow limitation and interstitial dust disease in U.S. coal miners warrants increased attention.
Mining-industry; Underground-mining; Coal-mining; Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disease; Lung-disorders; Epidemiology; Statistical-analysis; Coal-workers-pneumoconiosis; Pneumoconiosis; Surveillance
American Journal of Respiratory and Critical Care Medicine