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The influence of dust standards on the prevalence and severity of coal worker's pneumoconiosis at autopsy in the United States of America.

Abstract

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% had coal macules, 46.3% coal nodules, 28.2% silicotic nodules, and 10.3% progressive massive fibrosis. Lower prevalences were noted among miners exposed exclusively to post-1970 dust levels: 58.8% had coal macules, 15.0% coal nodules, 8.0% silicotic nodules, and 1.2% progressive massive fibrosis. The differences in prevalence were highly significant (P < .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.

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  • Authors+Show Affiliations

    ,

    Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.

    , , , , ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Anthracosis
    Autopsy
    Coal Mining
    History, 20th Century
    Humans
    Logistic Models
    Male
    Middle Aged
    Occupational Diseases
    Occupational Exposure
    Prevalence
    Severity of Illness Index
    United States
    Young Adult

    Pub Type(s)

    Historical Article
    Journal Article

    Language

    eng

    PubMed ID

    22129182

    Citation

    Vallyathan, Val, et al. "The Influence of Dust Standards On the Prevalence and Severity of Coal Worker's Pneumoconiosis at Autopsy in the United States of America." Archives of Pathology & Laboratory Medicine, vol. 135, no. 12, 2011, pp. 1550-6.
    Vallyathan V, Landsittel DP, Petsonk EL, et al. The influence of dust standards on the prevalence and severity of coal worker's pneumoconiosis at autopsy in the United States of America. Arch Pathol Lab Med. 2011;135(12):1550-6.
    Vallyathan, V., Landsittel, D. P., Petsonk, E. L., Kahn, J., Parker, J. E., Osiowy, K. T., & Green, F. H. (2011). The influence of dust standards on the prevalence and severity of coal worker's pneumoconiosis at autopsy in the United States of America. Archives of Pathology & Laboratory Medicine, 135(12), pp. 1550-6. doi:10.5858/arpa.2010-0393-OA.
    Vallyathan V, et al. The Influence of Dust Standards On the Prevalence and Severity of Coal Worker's Pneumoconiosis at Autopsy in the United States of America. Arch Pathol Lab Med. 2011;135(12):1550-6. PubMed PMID: 22129182.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The influence of dust standards on the prevalence and severity of coal worker's pneumoconiosis at autopsy in the United States of America. AU - Vallyathan,Val, AU - Landsittel,Douglas P, AU - Petsonk,Edward L, AU - Kahn,Jeffrey, AU - Parker,John E, AU - Osiowy,Karen Tofflemire, AU - Green,Francis H Y, PY - 2011/12/2/entrez PY - 2011/12/2/pubmed PY - 2012/1/21/medline SP - 1550 EP - 6 JF - Archives of pathology & laboratory medicine JO - Arch. Pathol. Lab. Med. VL - 135 IS - 12 N2 - 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% had coal macules, 46.3% coal nodules, 28.2% silicotic nodules, and 10.3% progressive massive fibrosis. Lower prevalences were noted among miners exposed exclusively to post-1970 dust levels: 58.8% had coal macules, 15.0% coal nodules, 8.0% silicotic nodules, and 1.2% progressive massive fibrosis. The differences in prevalence were highly significant (P < .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. SN - 1543-2165 UR - https://www.unboundmedicine.com/medline/citation/22129182/The_influence_of_dust_standards_on_the_prevalence_and_severity_of_coal_worker's_pneumoconiosis_at_autopsy_in_the_United_States_of_America_ L2 - http://www.archivesofpathology.org/doi/10.5858/arpa.2010-0393-OA?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -