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Original Research: Occupational and Environmental Lung Disease |

Profusion of Opacities in Simple Coal Worker’s Pneumoconiosis Is Associated With Reduced Lung FunctionProfusion of Small Opacities and Lung Function

David J. Blackley, DrPH; A. Scott Laney, PhD; Cara N. Halldin, PhD; Robert A. Cohen, MD, FCCP
Author and Funding Information

From the Surveillance Branch (Drs Blackley, Laney, Halldin, and Cohen), Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV; Epidemic Intelligence Service Program (Dr Blackley), Centers for Disease Control and Prevention, Atlanta, GA; and Division of Environmental and Occupational Health Sciences (Dr Cohen), University of Illinois at Chicago School of Public Health, Chicago, IL.

CORRESPONDENCE TO: David J. Blackley, DrPH, Surveillance Branch, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Rd, Mail Stop HG900, Morgantown, WV 26505; e-mail: dblackley@cdc.gov


FUNDING/SUPPORT: Dr Cohen’s work was supported in part by funding from The Alpha Foundation for the Improvement of Mining Safety and Health, Inc.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(5):1293-1299. doi:10.1378/chest.15-0118
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BACKGROUND:  A large body of evidence demonstrates dose-response relationships of cumulative coal mine dust exposure with lung function impairment and with small-opacity profusion. However, medical literature generally holds that simple coal worker’s pneumoconiosis (CWP) is not associated with lung function impairment. This study examines the relationship between small-opacity profusion and lung function in US underground coal miners with simple CWP.

METHODS:  Miners were examined during 2005 to 2013 as part of the Enhanced Coal Workers’ Health Surveillance Program. Work histories were obtained, and chest radiographs and spirometry were administered. Lung parenchymal abnormalities consistent with CWP were classified according to International Labor Organization guidelines, and reference values for FEV1 and FVC were calculated using reference equations derived from the third National Health and Nutrition Examination Survey. Differences in lung function were evaluated by opacity profusion, and regression models were fit to characterize associations between profusion and lung function.

RESULTS:  A total of 8,230 miners were eligible for analysis; 269 had category 1 or 2 simple CWP. Decrements in FEV1 % predicted were nearly consistent across profusion subcategories. Clear decrements in FVC % predicted and FEV1/FVC were also observed, although these were less consistent. Controlling for smoking status, BMI, and mining tenure, each 1-unit subcategory increase in profusion was associated with decreases of 1.5% (95% CI, 1.0%-1.9%), 1.0% (95% CI, 0.6%-1.3%), and 0.6% (95% CI, 0.4%-0.8%) in FEV1 % predicted, FVC % predicted, and FEV1/FVC, respectively.

CONCLUSIONS:  We observed progressively lower lung function across the range of small-opacity profusion. These findings address a long-standing question in occupational medicine and point to the importance of medical surveillance and respiratory disease prevention in this workforce.

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