Historical shift in pathological type of progressive massive fibrosis among coal miners in the USA.

Background: Pneumoconiosis among coal miners in the USA has been resurgent over the past two decades, despite modern dust controls and regulatory standards. Previously published studies have suggested that respirable crystalline silica (RCS) is a contributor to this disease resurgence. However, evidence has been primarily indirect, in the form of radiographic features.

Pathology and Mineralogy Demonstrate Respirable Crystalline Silica Is a Major Cause of Severe Pneumoconiosis in U.S. Coal Miners.

The reasons for resurgent coal workers' pneumoconiosis and its most severe forms, rapidly progressive pneumoconiosis and progressive massive fibrosis (PMF), in the United States are not yet fully understood. To compare the pathologic and mineralogic features of contemporary coal miners with severe pneumoconiosis with those of their historical counterparts. Lung pathology specimens from 85 coal miners with PMF were included for evaluation and analysis.

Coal mine dust lung disease in miners killed in the Upper Big Branch disaster: a review of lung pathology and contemporary respirable dust levels in underground US coal mines.

Objectives: In 2010, 29 coal miners died due to an explosion at the Upper Big Branch (UBB) mine in West Virginia, USA. Autopsy examinations of 24 individuals with evaluable lung tissue identified 17 considered to have coal workers' pneumoconiosis (CWP). The objectives of this study were to characterise histopathological findings of lung tissue from a sample of UBB fatalities and better understand the respirable dust concentrations experienced by these miners at UBB relative to other US coal mines.

Respiratory protection for health care workers: A 2020 COVID-19 perspective.

As the US health care system began to respond to the coronavirus disease-2019 pandemic, demand for respiratory personal protective equipment (PPE) increased precipitously, as did the number of users. This commentary discusses ensuing deviations from accepted respiratory PPE program practices, which potentially increased risk to health care workers. Such lapses included omitting user training and fit testing, provision of unapproved devices, and application of devices in settings and ways for which they were not intended.

The National Institute for Occupational Safety and Health B Reader Certification Program-An Update Report (1987 to 2018) and Future Directions.

Objective: The National Institute for Occupational Safety and Health (NIOSH) B Reader Program provides the opportunity for physicians to demonstrate proficiency in the International Labour Office (ILO) system for classifying radiographs of pneumoconioses. We summarize trends in participation and examinee attributes and performance during 1987 to 2018.

Methods: Since 1987, NIOSH has maintained details of examinees and examinations.

Increasing Severity of Pneumoconiosis Among Younger Former US Coal Miners Working Exclusively Under Modern Dust-Control Regulations.

Background: Coal workers' pneumoconiosis (CWP) steadily declined among US miners following dust control regulations in 1970. In 2000, severe forms of this disease reemerged among young miners, and are well described among working-but not former-miners.

Methods: Black lung benefits program (BLBP) data (2001 to 2013) were used to estimate respiratory disease burden among former miners including: (1) CWP (simple; advanced CWP, and progressive massive fibrosis [CWP/PMF]); and (2) respiratory impairment (FEV1 percent reference: mild, moderate, ≥moderately-severe).

Pneumoconioses Radiographs in a Large Population of U.S. Coal Workers: Variability in A Reader and B Reader Classifications by Using the International Labour Office Classification.

Purpose To assess the level of concordance between chest radiographic classifications of A and B Readers in a national surveillance program offered to U.S. coal miners over an approximate 36-year period.

Small Airway Dysfunction and Abnormal Exercise Responses. A Study in Coal Miners.

Rationale: Coal mine dust exposure can cause symptoms and loss of lung function from multiple mechanisms, but the roles of each disease process are not fully understood.

Objectives: We investigated the implications of small airway dysfunction for exercise physiology among a group of workers exposed to coal mine dust.

Methods: Twenty coal miners performed spirometry, first breathing air and then helium-oxygen, single-breath diffusing capacity, and computerized chest tomography, and then completed cardiopulmonary exercise testing.

Occupational Interstitial Lung Diseases.

Objective: Evidence-based diagnostic and treatment guidelines for occupationally related interstitial lung diseases (ILDs) have been developed and are summarized herein.

Methods: Comprehensive literature reviews were conducted with article abstraction, critiquing, objective grading, and evidence table compilation. A multidisciplinary expert panel drafted evidence- and consensus-based guidance.

Lung Pathology in U.S. Coal Workers with Rapidly Progressive Pneumoconiosis Implicates Silica and Silicates.

Rationale: Recent reports of progressive massive fibrosis and rapidly progressive pneumoconiosis in U.S. coal miners have raised concerns about excessive exposures to coal mine dust, despite reports of declining dust levels.

Small airways involvement in coal mine dust lung disease.

Inhalation of coal mine dust results in a spectrum of symptoms, dysfunction, and pathological changes in the respiratory tract that collectively have been labeled coal mine dust lung disease. Recent reports from periodic health surveillance among underground and surface coal miners in the United States have demonstrated an increasing prevalence and severity of dust diseases, and have also documented that some miners experience rapid disease progression. The coal macule is an inflammatory lesion associated with deposited dust, and occurs in the region of the most distal conducting airways and proximal respiratory bronchioles.

Debilitating lung disease among surface coal miners with no underground mining tenure.

Objective: To characterize exposure histories and respiratory disease among surface coal miners identified with progressive massive fibrosis from a 2010 to 2011 pneumoconiosis survey.

Methods: Job history, tenure, and radiograph interpretations were verified. Previous radiographs were reviewed when available.

Validation of the international labour office digitized standard images for recognition and classification of radiographs of pneumoconiosis.

Rationale And Objectives: Chest radiographs are recommended for prevention and detection of pneumoconiosis. In 2011, the International Labour Office (ILO) released a revision of the International Classification of Radiographs of Pneumoconioses that included a digitized standard images set. The present study compared results of classifications of digital chest images performed using the new ILO 2011 digitized standard images to classification approaches used in the past.

Lung-function impairment among US underground coal miners, 2005 to 2009: geographic patterns and association with coal workers' pneumoconiosis.

Objective: To investigate contemporary geographic distributions of lung-function impairment and radiographic evidence of coal workers' pneumoconiosis (CWP) and their associations.

Methods: From 2005 to 2009, 6373 underground coal miners completed a health survey, including spirometry testing and chest radiography. Coal workers' pneumoconiosis and progressive massive fibrosis were determined by NIOSH B readers, using the International Labour Office classification.

Rapid decline in lung function in coal miners: evidence of disease in small airways.

Background: Coal mine dust exposure can cause both pneumoconiosis and chronic airflow limitation. The contributions of various pathophysiologic mechanisms to dust-related lung function decrements remain unclear.

Methods: Clinical and physiological findings were assessed for 15 underground coal miners who had demonstrated accelerated FEV1 losses (decliners) over 6-18 years.

Coal mine dust lung disease. New lessons from old exposure.

Coal mining remains a sizable industry, with millions of working and retired coal miners worldwide. This article provides an update on recent advances in the understanding of respiratory health issues in coal miners and focuses on the spectrum of disease caused by inhalation of coal mine dust, termed coal mine dust lung disease. In addition to the historical interstitial lung diseases (coal worker's pneumoconiosis, silicosis, and mixed dust pneumoconiosis), coal miners are at risk for dust-related diffuse fibrosis and chronic airway diseases, including emphysema and chronic bronchitis.

Combined effect of lung function level and decline increases morbidity and mortality risks.

Lung function level and decline are each predictive of morbidity and mortality. Evaluation of the combined effect of these measurements may help further identify high-risk groups. Using Copenhagen City Heart Study longitudinal spirometry data (n = 10,457), 16-21 year risks of chronic obstructive pulmonary disease (COPD) morbidity, COPD or coronary heart disease mortality, and all-cause mortality were estimated from combined effects of level and decline in forced expiratory volume in one second (FEV(1)).

Self-reported hand symptoms: a role in monitoring health care workers for latex sensitization?

Background: The use of powdered natural rubber latex (NRL) gloves increased greatly in the 1980s because of concerns about transmission of blood-borne infections and the subsequent implementation of universal precautions. The most common clinical reactions to glove use are irritant and T-cell-mediated contact dermatitis. However, IgE-mediated immediate reactions to latex have become a serious concern for health care workers (HCWs).

Small pneumoconiotic opacities on U.S. coal worker surveillance chest radiographs are not predominantly in the upper lung zones.

Background: Radiographic shadows of coal workers' pneumoconiosis (CWP) are commonly described as predominantly in the upper lung zones.

Methods: We evaluated the lung distribution of small opacities on surveillance chest radiographs (CXRs) taken between 1981 and 2010 among 2,467 underground US coal miners. All had evidence of pneumoconiosis (category ≥1/0), based on the contemporary International Labour Office Classification of Radiographs of Pneumoconioses.

Post-hire asthma among insect-rearing workers.

Objective: To evaluate the incidence of post-hire asthma (PHA) among insect-rearing workers, defined as asthma, the symptoms of which appeared after hire at the current workplace.

Methods: We surveyed the health of workers at three insect-rearing facilities and an associated office facility. We calculated the incidence and estimated hazard ratios for PHA.

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

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.