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Respiratory disease mortality among US coal miners; results after 37 years of follow-up.

Abstract

OBJECTIVES

To evaluate respiratory related mortality among underground coal miners after 37 years of follow-up.

METHODS

Underlying cause of death for 9033 underground coal miners from 31 US mines enrolled between 1969 and 1971 was evaluated with life table analysis. Cox proportional hazards models were fitted to evaluate the exposure-response relationships between cumulative exposure to coal mine dust and respirable silica and mortality from pneumoconiosis, chronic obstructive pulmonary disease (COPD) and lung cancer.

RESULTS

Excess mortality was observed for pneumoconiosis (SMR=79.70, 95% CI 72.1 to 87.67), COPD (SMR=1.11, 95% CI 0.99 to 1.24) and lung cancer (SMR=1.08; 95% CI 1.00 to 1.18). Coal mine dust exposure increased risk for mortality from pneumoconiosis and COPD. Mortality from COPD was significantly elevated among never [corrected] smokers and former smokers (HR=1.84, 95% CI 1.05 to 3.22; HRK=1.52, 95% CI 0.98 to 2.34, respectively) but not current smokers (HR=0.99, 95% CI 0.76 to 1.28). Respirable silica was positively associated with mortality from pneumoconiosis (HR=1.33, 95% CI 0.94 to 1.33) and COPD (HR=1.04, 95% CI 0.96 to 1.52) in models controlling for coal mine dust. We saw a significant relationship between coal mine dust exposure and lung cancer mortality (HR=1.70; 95% CI 1.02 to 2.83) but not with respirable silica (HR=1.05; 95% CI 0.90 to 1.23). In the most recent follow-up period (2000-2007) both exposures were positively associated with lung cancer mortality, coal mine dust significantly so.

CONCLUSIONS

Our findings support previous studies showing that exposure to coal mine dust and respirable silica leads to increased mortality from malignant and non-malignant respiratory diseases even in the absence of smoking.

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  • Authors+Show Affiliations

    ,

    Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA.

    , , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Coal
    Coal Mining
    Dust
    Follow-Up Studies
    Humans
    Inhalation Exposure
    Lung Diseases
    Lung Neoplasms
    Middle Aged
    Occupational Diseases
    Occupational Exposure
    Occupations
    Pneumoconiosis
    Proportional Hazards Models
    Pulmonary Disease, Chronic Obstructive
    Silicon Dioxide
    Smoking
    United States
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    24186945

    Citation

    Graber, Judith M., et al. "Respiratory Disease Mortality Among US Coal Miners; Results After 37 Years of Follow-up." Occupational and Environmental Medicine, vol. 71, no. 1, 2014, pp. 30-9.
    Graber JM, Stayner LT, Cohen RA, et al. Respiratory disease mortality among US coal miners; results after 37 years of follow-up. Occup Environ Med. 2014;71(1):30-9.
    Graber, J. M., Stayner, L. T., Cohen, R. A., Conroy, L. M., & Attfield, M. D. (2014). Respiratory disease mortality among US coal miners; results after 37 years of follow-up. Occupational and Environmental Medicine, 71(1), pp. 30-9. doi:10.1136/oemed-2013-101597.
    Graber JM, et al. Respiratory Disease Mortality Among US Coal Miners; Results After 37 Years of Follow-up. Occup Environ Med. 2014;71(1):30-9. PubMed PMID: 24186945.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Respiratory disease mortality among US coal miners; results after 37 years of follow-up. AU - Graber,Judith M, AU - Stayner,Leslie T, AU - Cohen,Robert A, AU - Conroy,Lorraine M, AU - Attfield,Michael D, Y1 - 2013/11/01/ PY - 2013/11/5/entrez PY - 2013/11/5/pubmed PY - 2014/2/4/medline SP - 30 EP - 9 JF - Occupational and environmental medicine JO - Occup Environ Med VL - 71 IS - 1 N2 - OBJECTIVES: To evaluate respiratory related mortality among underground coal miners after 37 years of follow-up. METHODS: Underlying cause of death for 9033 underground coal miners from 31 US mines enrolled between 1969 and 1971 was evaluated with life table analysis. Cox proportional hazards models were fitted to evaluate the exposure-response relationships between cumulative exposure to coal mine dust and respirable silica and mortality from pneumoconiosis, chronic obstructive pulmonary disease (COPD) and lung cancer. RESULTS: Excess mortality was observed for pneumoconiosis (SMR=79.70, 95% CI 72.1 to 87.67), COPD (SMR=1.11, 95% CI 0.99 to 1.24) and lung cancer (SMR=1.08; 95% CI 1.00 to 1.18). Coal mine dust exposure increased risk for mortality from pneumoconiosis and COPD. Mortality from COPD was significantly elevated among never [corrected] smokers and former smokers (HR=1.84, 95% CI 1.05 to 3.22; HRK=1.52, 95% CI 0.98 to 2.34, respectively) but not current smokers (HR=0.99, 95% CI 0.76 to 1.28). Respirable silica was positively associated with mortality from pneumoconiosis (HR=1.33, 95% CI 0.94 to 1.33) and COPD (HR=1.04, 95% CI 0.96 to 1.52) in models controlling for coal mine dust. We saw a significant relationship between coal mine dust exposure and lung cancer mortality (HR=1.70; 95% CI 1.02 to 2.83) but not with respirable silica (HR=1.05; 95% CI 0.90 to 1.23). In the most recent follow-up period (2000-2007) both exposures were positively associated with lung cancer mortality, coal mine dust significantly so. CONCLUSIONS: Our findings support previous studies showing that exposure to coal mine dust and respirable silica leads to increased mortality from malignant and non-malignant respiratory diseases even in the absence of smoking. SN - 1470-7926 UR - https://www.unboundmedicine.com/medline/citation/24186945/Respiratory_disease_mortality_among_US_coal_miners L2 - http://oem.bmj.com/cgi/pmidlookup?view=long&pmid=24186945 DB - PRIME DP - Unbound Medicine ER -