Small mine size is associated with lung function abnormality and pneumoconiosis among underground coal miners in Kentucky, Virginia and West Virginia

• Published in: Occupational and environmental medicine (London, England) Vol. 71; no. 10; pp. 690 - 694
• Main Authors: Blackley, David J, Halldin, Cara N, Wang, Mei Lin, Laney, A Scott
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group 01.10.2014; BMJ Publishing Group LTD
• Subjects: Abnormalities; Adolescent; Adult; Aged; Biological and medical sciences; Body mass index; Chemical and industrial products toxicology. Toxic occupational diseases; Coal; Coal industry; Coal mines; Coal Mining; Disease; Dust; Female; Health; Humans; Inorganic dusts (pneumoconiosises) and organic dusts (byssinosis etc.); Kentucky - epidemiology; Lung diseases; Lungs; Male; Medical sciences; Middle Aged; Miners; Mines; Mining; Mining accidents & safety; Occupational medicine; Occupational safety; Pneumoconiosis; Pneumoconiosis - epidemiology; Pneumoconiosis - physiopathology; Public health; Public health. Hygiene-occupational medicine; Radiography; Regression analysis; Respiratory diseases; Respiratory function; Smoking - epidemiology; Spirometry; Studies; Surface mining; Surveillance; Toxicology; Underground mines; Virginia - epidemiology; West Virginia - epidemiology; Working conditions; Workplace; Young Adult; West Virginia; United States; North America; Virginia; America; Kentucky; United States > US; USA, West Virginia; ANW, USA, Virginia; USA, Kentucky; Human; Lung disease; Lung function; Pneumoconiosis; Respiratory disease; Coal mine; Toxicity; Size; Underground mining; Occupational exposure; Epidemiology; Occupational medicine
• ISSN: 1351-0711; 1470-7926; 1470-7926
• DOI: 10.1136/oemed-2014-102224

Objectives To describe the prevalence of lung function abnormality and coal workers’ pneumoconiosis (CWP) by mine size among underground coal miners in Kentucky, Virginia and West Virginia. Methods During 2005–2012, 4491 miners completed spirometry and chest radiography as part of a health surveillance programme. Spirometry was interpreted according to American Thoracic Society and European Respiratory Society guidelines, and radiography per International Labour Office standards. Prevalence ratios (PR) were calculated for abnormal spirometry (obstructive, restrictive or mixed pattern using lower limits of normal derived from National Health and Nutrition Examination Survey (NHANES) III) and CWP among workers from small mines (≤50 miners) compared with those from large mines. Results Among 3771 eligible miners, those from small mines were more likely to have abnormal spirometry (18.5% vs 13.8%, p<0.01), CWP (10.8% vs 5.2%, p<0.01) and progressive massive fibrosis (2.4% vs 1.1%, p<0.01). In regression analysis, working in a small mine was associated with 37% higher prevalence of abnormal spirometry (PR 1.37, 95% CI 1.16 to 1.61) and 2.1 times higher prevalence of CWP (95% CI 1.68 to 2.70). Conclusions More than one in four of these miners had evidence of CWP, abnormal lung function or both. Although 96% of miners in the study have worked exclusively under dust regulations implemented following the 1969 Federal Coal Mine Safety and Health Act, we observed high rates of respiratory disease including severe cases. The current approach to dust control and provision of safe work conditions for central Appalachian underground coal miners is not adequate to protect them from adverse respiratory health effects.