The influence of dust standards on the prevalence and severity of coal worker's pneumoconiosis at autopsy in the United States of America.
Vallyathan-V; Landsittel-DP; Petsonk-EL; Kahn-J; Parker-JE; Osiowy-KT; Green-FHY
Arch Pathol Lab Med 2011 Dec; 135(12):1550-1556
Context.-Coal worker's pneumoconiosis is a major occupational lung disease in the United States. The disease is primarily controlled through reducing dust exposure in coal mines using technological improvements and through the establishment of dust standards by regulatory means. Objective.-To determine if dust standards established in the US Federal Coal Mine Health and Safety Act of 1969 have reduced the prevalence and severity of coal worker's pneumoconiosis. Design.-The study population included materials from 6103 deceased coal miners submitted to the National Coal Workers' Autopsy Study from 1971 through 1996. Type and severity of coal worker's pneumoconiosis were classified using standardized diagnostic criteria. Results.-Among miners who worked exclusively prior to the 1969 dust standard, 82.6 percent had coalmacules, 46.3 percent coal nodules, 28.2 percent silicotic nodules, and 10.3 percent progressive massive fibrosis. Lower prevalences were noted among miners exposed exclusively to post-1970 dust levels: 58.8 percent had coal macules, 15.0 percent coal nodules, 8.0 percent silicotic nodules, and 1.2 percent progressive massive fibrosis. The differences in prevalence were highly significant (P less than .001) for all types of pneumoconiosis, including progressive massive fibrosis, after adjustment for age, years of mining, and smoking status. Conclusions.-The study confirms a beneficial impact of the first 25 years of the dust standard established by the 1969 act on the prevalence and severity of coal worker's pneumoconiosis in US coal miners. However, pneumoconiosis continues to occur among miners who have worked entirely within the contemporary standard, suggesting a need for further reductions in exposure to respirable coal mine dust.
Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disease; Lung-disorders; Coal-workers-pneumoconiosis; Pneumoconiosis; Coal-miners; Coal-dust; Autopsies; Dust-control; Dust-exposure; Standards; Regulations; Control-technology; Mortality-data; Statistical-analysis; Miners; Lung-fibrosis; Surveillance
Francis H. Y. Green, University of Calgary, Department of Pathology & Laboratory Medicine, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
Archives of Pathology and Laboratory Medicine