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Radiographic outcomes among South African coal miners.
Int Arch Occup Environ Health. 2004 Oct; 77(7):471-81.IA

Abstract

OBJECTIVES

This study, the first to document the prevalence of pneumoconiosis among a living South African coal mining cohort, describes dose-response relationships between coal workers' pneumoconiosis and respirable dust exposure, and relationships between pneumoconiosis and both lung function deterioration and respiratory symptoms.

METHODS

A total of 684 current miners and 188 ex-miners from three bituminous-coal mines in Mpumalanga, South Africa, was studied. Chest radiographs were read according to the International Labour Organization (ILO) classification by two experienced readers, one an accredited National Institute for Occupational Safety and Health (NIOSH) "B" reader. Interviews were conducted to assess symptoms, work histories (also obtained from company records), smoking, and other risk factors. Spirometry was performed by trained technicians. Cumulative respirable dust exposure (CDE) estimates were constructed from historical company-collected sampling and researcher-collected personal dust measurements. kappa-Statistics compared the radiographic outcomes predicted by the two readers. An average profusion score was used in the analysis for the outcomes of interest. Because of possible confounding by employment status, most analyses were stratified on current and ex-miner status.

RESULTS

The overall prevalence of pneumoconiosis was low (2%-4%). The degree of agreement between the two readers for profusion was moderate to high (kappa=0.58). A significant association (P<0.001) and trend (P<0.001) was seen for pneumoconiosis with increasing categories of CDE among current miners only. A significant (P<0.0001) additional 58 mg-years/m3 CDE was seen among those with pneumoconiosis compared to those without. CDE contributed to a statistically significant 0.19% and 0.11% greater decline in the percent predicted 1-second forced expiration volume (FEV1) and forced vital capacity (FVC), respectively, among current miners with pneumoconiosis than among those without. Logistic regression models showed no significant relationships between pneumoconiosis and symptoms.

CONCLUSIONS

The overall prevalence of pneumoconiosis, although significantly associated with CDE, was low. The presence of pneumoconiosis is associated with meaningful health effects, including deterioration in lung function. Intervention measures that control exposure are indicated, to reduce these functional effects.

Authors+Show Affiliations

Centre for Occupational and Environmental Health/ Department of Community Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag X7, 4013, Congella, South Africa. naidoon@ukzn.ac.zaNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15558299

Citation

Naidoo, Rajen N., et al. "Radiographic Outcomes Among South African Coal Miners." International Archives of Occupational and Environmental Health, vol. 77, no. 7, 2004, pp. 471-81.
Naidoo RN, Robins TG, Solomon A, et al. Radiographic outcomes among South African coal miners. Int Arch Occup Environ Health. 2004;77(7):471-81.
Naidoo, R. N., Robins, T. G., Solomon, A., White, N., & Franzblau, A. (2004). Radiographic outcomes among South African coal miners. International Archives of Occupational and Environmental Health, 77(7), 471-81.
Naidoo RN, et al. Radiographic Outcomes Among South African Coal Miners. Int Arch Occup Environ Health. 2004;77(7):471-81. PubMed PMID: 15558299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiographic outcomes among South African coal miners. AU - Naidoo,Rajen N, AU - Robins,Thomas G, AU - Solomon,A, AU - White,Neil, AU - Franzblau,Alfred, Y1 - 2004/09/09/ PY - 2003/10/05/received PY - 2004/04/07/accepted PY - 2004/11/24/pubmed PY - 2005/3/23/medline PY - 2004/11/24/entrez SP - 471 EP - 81 JF - International archives of occupational and environmental health JO - Int Arch Occup Environ Health VL - 77 IS - 7 N2 - OBJECTIVES: This study, the first to document the prevalence of pneumoconiosis among a living South African coal mining cohort, describes dose-response relationships between coal workers' pneumoconiosis and respirable dust exposure, and relationships between pneumoconiosis and both lung function deterioration and respiratory symptoms. METHODS: A total of 684 current miners and 188 ex-miners from three bituminous-coal mines in Mpumalanga, South Africa, was studied. Chest radiographs were read according to the International Labour Organization (ILO) classification by two experienced readers, one an accredited National Institute for Occupational Safety and Health (NIOSH) "B" reader. Interviews were conducted to assess symptoms, work histories (also obtained from company records), smoking, and other risk factors. Spirometry was performed by trained technicians. Cumulative respirable dust exposure (CDE) estimates were constructed from historical company-collected sampling and researcher-collected personal dust measurements. kappa-Statistics compared the radiographic outcomes predicted by the two readers. An average profusion score was used in the analysis for the outcomes of interest. Because of possible confounding by employment status, most analyses were stratified on current and ex-miner status. RESULTS: The overall prevalence of pneumoconiosis was low (2%-4%). The degree of agreement between the two readers for profusion was moderate to high (kappa=0.58). A significant association (P<0.001) and trend (P<0.001) was seen for pneumoconiosis with increasing categories of CDE among current miners only. A significant (P<0.0001) additional 58 mg-years/m3 CDE was seen among those with pneumoconiosis compared to those without. CDE contributed to a statistically significant 0.19% and 0.11% greater decline in the percent predicted 1-second forced expiration volume (FEV1) and forced vital capacity (FVC), respectively, among current miners with pneumoconiosis than among those without. Logistic regression models showed no significant relationships between pneumoconiosis and symptoms. CONCLUSIONS: The overall prevalence of pneumoconiosis, although significantly associated with CDE, was low. The presence of pneumoconiosis is associated with meaningful health effects, including deterioration in lung function. Intervention measures that control exposure are indicated, to reduce these functional effects. SN - 0340-0131 UR - https://www.unboundmedicine.com/medline/citation/15558299/Radiographic_outcomes_among_South_African_coal_miners_ L2 - https://dx.doi.org/10.1007/s00420-004-0532-3 DB - PRIME DP - Unbound Medicine ER -