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Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States.

Abstract

RATIONALE

Previous studies have shown associations between dust exposure or lung burden and emphysema in coal miners, although the separate contributions of various predictors have not been clearly demonstrated.

OBJECTIVES

To quantitatively evaluate the relationship between cumulative exposure to respirable coal mine dust, cigarette smoking, and other factors on emphysema severity.

METHODS

The study group included 722 autopsied coal miners and nonminers in the United States. Data on work history, smoking, race, and age at death were obtained from medical records and questionnaire completed by next-of-kin. Emphysema was classified and graded using a standardized schema. Job-specific mean concentrations of respirable coal mine dust were matched with work histories to estimate cumulative exposure. Relationships between various metrics of dust exposure (including cumulative exposure and lung dust burden) and emphysema severity were investigated in weighted least squares regression models.

MEASUREMENTS AND MAIN RESULTS

Emphysema severity was significantly elevated in coal miners compared with nonminers among ever- and never-smokers (P < 0.0001). Cumulative exposure to respirable coal mine dust or coal dust retained in the lungs were significant predictors of emphysema severity (P < 0.0001) after accounting for cigarette smoking, age at death, and race. The contributions of coal mine dust exposure and cigarette smoking were similar in predicting emphysema severity averaged over this cohort.

CONCLUSIONS

Coal dust exposure, cigarette smoking, age, and race are significant and additive predictors of emphysema severity in this study.

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  • Authors+Show Affiliations

    ,

    National Institute for Occupational Safety and Health, Education and Information Division, Risk Evaluation Branch, Cincinnati, Ohio 45226-1998, USA. ekuempel@cdc.gov

    , , ,

    Source

    MeSH

    Aged
    Autopsy
    Coal Mining
    Dust
    Female
    Humans
    Male
    Middle Aged
    Occupational Diseases
    Pulmonary Emphysema
    Severity of Illness Index
    Smoking
    Survival Rate
    Tobacco Smoke Pollution
    United States

    Pub Type(s)

    Comparative Study
    Journal Article
    Multicenter Study
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    19423717

    Citation

    Kuempel, Eileen D., et al. "Contributions of Dust Exposure and Cigarette Smoking to Emphysema Severity in Coal Miners in the United States." American Journal of Respiratory and Critical Care Medicine, vol. 180, no. 3, 2009, pp. 257-64.
    Kuempel ED, Wheeler MW, Smith RJ, et al. Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States. Am J Respir Crit Care Med. 2009;180(3):257-64.
    Kuempel, E. D., Wheeler, M. W., Smith, R. J., Vallyathan, V., & Green, F. H. (2009). Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States. American Journal of Respiratory and Critical Care Medicine, 180(3), pp. 257-64. doi:10.1164/rccm.200806-840OC.
    Kuempel ED, et al. Contributions of Dust Exposure and Cigarette Smoking to Emphysema Severity in Coal Miners in the United States. Am J Respir Crit Care Med. 2009 Aug 1;180(3):257-64. PubMed PMID: 19423717.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States. AU - Kuempel,Eileen D, AU - Wheeler,Matthew W, AU - Smith,Randall J, AU - Vallyathan,Val, AU - Green,Francis H Y, Y1 - 2009/05/07/ PY - 2009/5/9/entrez PY - 2009/5/9/pubmed PY - 2009/8/7/medline SP - 257 EP - 64 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 180 IS - 3 N2 - RATIONALE: Previous studies have shown associations between dust exposure or lung burden and emphysema in coal miners, although the separate contributions of various predictors have not been clearly demonstrated. OBJECTIVES: To quantitatively evaluate the relationship between cumulative exposure to respirable coal mine dust, cigarette smoking, and other factors on emphysema severity. METHODS: The study group included 722 autopsied coal miners and nonminers in the United States. Data on work history, smoking, race, and age at death were obtained from medical records and questionnaire completed by next-of-kin. Emphysema was classified and graded using a standardized schema. Job-specific mean concentrations of respirable coal mine dust were matched with work histories to estimate cumulative exposure. Relationships between various metrics of dust exposure (including cumulative exposure and lung dust burden) and emphysema severity were investigated in weighted least squares regression models. MEASUREMENTS AND MAIN RESULTS: Emphysema severity was significantly elevated in coal miners compared with nonminers among ever- and never-smokers (P < 0.0001). Cumulative exposure to respirable coal mine dust or coal dust retained in the lungs were significant predictors of emphysema severity (P < 0.0001) after accounting for cigarette smoking, age at death, and race. The contributions of coal mine dust exposure and cigarette smoking were similar in predicting emphysema severity averaged over this cohort. CONCLUSIONS: Coal dust exposure, cigarette smoking, age, and race are significant and additive predictors of emphysema severity in this study. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/19423717/full_citation L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.200806-840OC?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -