Usual Interstitial Pneumonia Associated With Crystalline Silica Exposure in Pneumoconiosis: A Retrospective Cohort Study

OBJECTIVE

We aimed to identify a relation between the level of silica exposure and the associated increase in the risk of radiologic usual interstitial pneumonia (UIP) pattern.

METHODS

We selected data of 796 individuals with pneumoconiosis who had undergone a chest computed tomography (CT). We estimated the silica exposure by comparing their occupational history with the data silica dust exposure.

RESULTS

Individuals employed as stonemasons demonstrated a 2.30-fold increase in the risk of developing UIP than coal mine workers (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.04 to 5.07). The high silica exposure group was associated with a 2.23-fold increase in the risk of developing UIP than the low silica exposure group (OR, 2.23; 95% CI, 1.07 to 4.69).

CONCLUSIONS

This study suggests that silica exposure is associated with an increased risk of developing UIP pattern, highlighting a dose-response relationship.

Risk of pneumothorax in pneumoconiosis patients in Taiwan: a retrospective cohort study

OBJECTIVES

This study was conducted to explore the association between pneumoconiosis and pneumothorax.

DESIGN

Retrospective cohort study.

SETTING

Nationwide population-based study using the Taiwan National Health Insurance Database.

PARTICIPANTS

A total of 2333 pneumoconiosis patients were identified (1935 patients for propensity score (PS)-matched cohort) and matched to 23 330 control subjects by age and sex (7740 subjects for PS-matched cohort).

PRIMARY AND SECONDARY OUTCOME MEASURES

The incidence and the cumulative incidence of pneumothorax.

RESULTS

Both incidence and the cumulative incidence of pneumothorax were significantly higher in the pneumoconiosis patients as compared with the control subjects (p<0.0001). For multivariable Cox regression analysis adjusted for age, sex, residency, income level and other comorbidities, patients with pneumoconiosis exhibited a significantly higher risk of pneumothorax than those without pneumoconiosis (HR 3.05, 95% CI 2.18 to 4.28, p<0.0001). The male sex, heart disease, peripheral vascular disease, chronic pulmonary disease and connective tissue disease were risk factors for developing pneumothorax in pneumoconiosis patients.

CONCLUSIONS

Our study revealed a higher risk of pneumothorax in pneumoconiosis patients and suggested potential risk factors in these patients. Clinicians should be aware about the risk of pneumothorax in pneumoconiosis patients.

Balanced Convolutional Neural Networks for Pneumoconiosis Detection

Pneumoconiosis remains one of the most common and harmful occupational diseases in China, leading to huge economic losses to society with its high prevalence and costly treatment. Diagnosis of pneumoconiosis still strongly depends on the experience of radiologists, which affects rapid detection on large populations. Recent research focuses on computer-aided detection based on machine learning. These have achieved high accuracy, among which artificial neural network (ANN) shows excellent performance. However, due to imbalanced samples and lack of interpretability, wide utilization in clinical practice meets difficulty. To address these problems, we first establish a pneumoconiosis radiograph dataset, including both positive and negative samples. Second, deep convolutional diagnosis approaches are compared in pneumoconiosis detection, and a balanced training is adopted to promote recall. Comprehensive experiments conducted on this dataset demonstrate high accuracy (88.6%). Third, we explain diagnosis results by visualizing suspected opacities on pneumoconiosis radiographs, which could provide solid diagnostic reference for surgeons.

[Respiratory Tract Infection Pathogen Spectrum Study of 376 Pneumoconiosis Inpatients in Chengdu]

OBJECTIVE

To investigate the status of infections caused by respiratory pathogens and the patterns of infections caused by pathogens in different seasons, age groups and stages of pneumoconiosis so as to explore the pathogen spectrum of respiratory tract infections in pneumoconiosis patients.

METHODS

The sputum samples of 376 pneumoconiosis patients admitted to an occupational disease hospital in Chengdu between January, 2017 and October, 2019 were collected. Clinical information of the patients was collected and lab tests were conducted to check for 23 kinds of common respiratory viruses, bacteria and fungi in the sputum. The relationship between seasons, ages, and different stages of pneumoconiosis and the pathogen detection rate was analyzed.

RESULTS

In the 376 sputum samples, the detection rates of pathogens, viruses, bacteria and fungi were 42.29% (159/376), 32.98% (124/376), 9.57% (36/376) and 6.12% (23/376), respectively. The six pathogens with the highest detection rates were parainfluenza virus, rhinovirus, influenza virus, Candida albicans, Klebsiella pneumoniae and Candida krousei. The severity of respiratory tract infection did not show significant difference in different seasons, age groups, and pneumoconiosis stages.

CONCLUSION

The pathogen spectrum of respiratory tract infections in patients with pneumoconiosis is complicated and the proportion of viral infection is high. However, the severity of the infection is not associated with age, seasonal, or pneumoconiosis staging differences.

Pneumoconiosis: current status and future prospects

ABSTRACT

Pneumoconiosis refers to a spectrum of pulmonary diseases caused by inhalation of mineral dust, usually as the result of certain occupations. The main pathological features include chronic pulmonary inflammation and progressive pulmonary fibrosis, which can eventually lead to death caused by respiratory and/or heart failure. Pneumoconiosis is widespread globally, seriously threatening global public health. Its high incidence and mortality lie in improper occupational protection, and in the lack of early diagnostic methods and effective treatments. This article reviews the epidemiology, safeguard procedures, diagnosis, and treatment of pneumoconiosis, and summarizes recent research advances and future research prospects.

Less Common Respiratory Conditions: Occupational Lung Diseases

Occupational lung diseases are caused by workplace inhalation of chemicals, dusts, or fumes. They include asbestosis, silicosis, coal workers' pneumoconiosis (CWP), and occupational asthma. These diseases have nonspecific respiratory symptoms and are only identified if an occupational history is taken. Asbestosis typically is diagnosed 20 to 30 years after peak exposure, often when pleural plaques are noted on chest x-ray (CXR). Asbestosis is associated with an increased cancer risk, which is higher in smokers. Silicosis results from exposure to silica dust from sand, stone, and quartz. It is a fibrotic lung disease with acute, chronic, or accelerated presentations; CXR findings show interstitial fibrosis or nodular opacities. Silicosis increases risk of mycobacterial and fungal infections. In CWP, patients may present with mild symptoms and CXR findings showing small fibrous nodules; progressive massive fibrosis may develop, and there is a risk of mycobacterial and fungal infections. Occupational asthma (OA) can occur de novo from inhaling sensitizers that induce immunoglobulin E-mediated airway reactions, or from inhaling irritants such as smoke, dust, and fumes. OA also can be due to sensitizers/irritants aggravating preexisting asthma. There are no cures for these occupational lung diseases, so prevention, including elimination/control of workplace exposures, and early diagnosis are key.

The relationship between respiratory health and hard metal dust exposure: A cross-sectional study

The frequency and severity of respiratory disorders among workers exposed to hard metal dust is not well known.The objective of this cross-sectional study is to report the prevalence of respiratory symptoms, functional status, and radiological findings in hard metal-exposed workers in Türkiye.Among 139 workers, 96 were machining workers, and 43 were industrial tool sharpening workers. Radiographic abnormalities compatible with pneumoconiosis were found 39% of the workers and were more in machining workers statistically significant.Also, in machining workers group, percentage of expected values of FVC was lower than industrial tool sharpening workers group. The prevalence of respiratory symptoms was 14.3%, and there was not a statistically significant difference in working groups. The study reveals that pulmonary symptoms, functional abnormalities, and radiological findings are mild. Assuming that reversibility may develop with avoidance from exposure when detected at this stage, early diagnosis of lung damage is essential.

Association of occupational dust exposure with combined chronic obstructive pulmonary disease and pneumoconiosis: a cross-sectional study in China

OBJECTIVES

Occupational dust exposure may induce various lung diseases, including pneumoconiosis and chronic obstructive pulmonary disease (COPD). The features of combined COPD and pneumoconiosis have not been well described, and this may hamper the management. This study aimed to describe the prevalence and characteristics as well as the risk factors of the combined diseases.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

758 patients with pneumoconiosis were recruited at a single-medical centre. Of these, 675 patients with pneumoconiosis, including asbestosis, silicosis, coal workers' pneumoconiosis and other pneumoconiosis, was eligible for analysis.

PRIMARY OUTCOME MEASURES

COPD was diagnosed based on clinical features and/or history of exposure to risk factors and post bronchodilator forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) ratio <0.7. Clinical data were collected from predesigned medical reports. The patients underwent both chest radiograph and high-resolution CT scans. Risk factors for combined COPD and pneumoconiosis were analysed using regression analysis.

RESULTS

COPD prevalence overall was 32.7% (221/675) and was the highest in silicosis (84/221) and coal workers' pneumoconiosis (100/221). COPD prevalence increased with smoking pack-years, dust exposure duration and pneumoconiosis stage. Patients with combined diseases had lower body mass index, higher smoking index and worse pulmonary function. Risk factors for combined diseases included heavy smoking, silica or coal exposure and advanced pneumoconiosis. The interaction between dust exposure and smoking in COPD was also identified. The risk of combined COPD significantly increased with heavy smoking and silica or coal exposure (OR 5.49, 95% CI 3.04 to 9.93, p<0.001).

CONCLUSIONS

COPD is highly prevalent in patients with pneumoconiosis, especially patients with silicosis and coal workers' pneumoconiosis. Occupational dust exposure as well as heavy smoking is associated with an increased risk of combined COPD and pneumoconiosis, which demands an effective preventive intervention.

Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND

Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017.

METHODS

Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs.

FINDINGS

In 2017, 544·9 million people (95% uncertainty interval [UI] 506·9-584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8-7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578-4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), age-standardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region.

INTERPRETATION

Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis.

FUNDING

Bill & Melinda Gates Foundation.

[Dose-response relationship between different respirable coal dust exposures and pneumoconiosis risk]

Objective: To investigate the dose-response relationship between the cumulative dust exposures to anthracite, bituminous coal, and lignite and the cumulative prevalence rates of pneumoconiosis due to the exposures, respectively and provide a basis for scientific development of occupational health standards. Methods: Investigation on the exposure to coal dust and pneumoconiosis prevalence was conducted in 9 state-owned coal mines. The cumulative anthracite, bituminous coal, and lignite dust exposure specific cumulative prevalence rates of pneumoconiosis were calculated by life table method, respectively. The linear regression equations were used to control the unilateral interval to obtain the exposure concentration limits of the respirable coal dust, respectively. Results: A total of 21 000 coal miners in the 9 coal mines were included in the study. The detection rates of pneumoconiosis in coal miners in anthracite, bituminous coal and lignite mines were 11.27%, 21.32%, and 6.00%. The average lengths of exposure to coal dust at pneumoconiosis onset were 20.12 years, 22.88 years, and 25.21 years, respectively and the dose-response relationships between the cumulative respirable coal dust exposure and the cumulative prevalence rates were all linear regression equations, which are y=5.788x-16.043 (R(2)=0.949), y=5.679x-16.837 (R(2)=0.904), and y=6.465x-19.573 (R(2)=0.944), respectively. Supposing that the safety coefficient is 1.2, when the cumulative prevalence rate of pneumoconiosis after 30 years of exposure to dust is not higher than 1%, the exposure concentration limits of the three types of respirable coal dust are 1.7, 2.3, and 3.9 mg/m(3), respectively. Conclusions: The results of this study shows that the detection rate of pneumoconiosis, the average length of exposure to coal dust at pneumoconiosis onset, and the exposure concentration limits of the respirable coal dust varied with coal types. In the case of the same cumulative level of coal dust exposure, the lower the coal volatiles is (i.e. the higher the carbon content is), the higher the cumulative prevalence rate of pneumoconiosis is (anthracite>bituminous coal>lignite). It is suggested to develop national occupational health standards of coal dust exposure according to the grades of coal.

Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016

OBJECTIVES

This paper presents detailed analysis of the global and regional burden of chronic respiratory disease arising from occupational airborne exposures, as estimated in the Global Burden of Disease 2016 study.

METHODS

The burden of chronic obstructive pulmonary disease (COPD) due to occupational exposure to particulate matter, gases and fumes, and secondhand smoke, and the burden of asthma resulting from occupational exposure to asthmagens, was estimated using the population attributable fraction (PAF), calculated using exposure prevalence and relative risks from the literature. PAFs were applied to the number of deaths and disability-adjusted life years (DALYs) for COPD and asthma. Pneumoconioses were estimated directly from cause of death data. Age-standardised rates were based only on persons aged 15 years and above.

RESULTS

The estimated PAFs (based on DALYs) were 17% (95% uncertainty interval (UI) 14%-20%) for COPD and 10% (95% UI 9%-11%) for asthma. There were estimated to be 519 000 (95% UI 441,000-609,000) deaths from chronic respiratory disease in 2016 due to occupational airborne risk factors (COPD: 460,100 [95% UI 382,000-551,000]; asthma: 37,600 [95% UI 28,400-47,900]; pneumoconioses: 21,500 [95% UI 17,900-25,400]. The equivalent overall burden estimate was 13.6 million (95% UI 11.9-15.5 million); DALYs (COPD: 10.7 [95% UI 9.0-12.5] million; asthma: 2.3 [95% UI 1.9-2.9] million; pneumoconioses: 0.58 [95% UI 0.46-0.67] million). Rates were highest in males; older persons and mainly in Oceania, Asia and sub-Saharan Africa; and decreased from 1990 to 2016.

CONCLUSIONS

Workplace exposures resulting in COPD, asthma and pneumoconiosis continue to be important contributors to the burden of disease in all regions of the world. This should be reducible through improved prevention and control of relevant exposures.

The utility of health belief model to explain self-protective behaviour against pneumoconiosis in Chinese underground coal miners: a cross-sectional study

OBJECTIVES

Coal workers' pneumoconiosis is caused by exposure to respirable coal mine dust. The self-protection of underground coal miners (UCM) plays an irreplaceable role against this threat. The purpose of this study was to evaluate the predictors of self-protective behaviour (SPB) in Chinese UCM based on the health belief model (HBM).

METHODS

A cross-sectional study was conducted among 341 UCM in January 2016 in Pingdingshan City, Henan Province, People's Republic of China. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, HBM variables and SPB. An exploratory factor analysis of the principal components with varimax rotation was carried out on the HBM-related items. Pearson's correlation and multiple linear regression analysis were used to assess the relationship between sociodemographic characteristics, HBM variables and SPB.

RESULTS

Multiple regression analysis demonstrated the monthly income (B=0.403, p=0.001), the internal cues to action (B=0.380, p<0.001) and external cues to action (B=0.401, p<0.001) as the predictors of UCM's SPB, accounting for 24.8% of total variance (F=34.96, p<0.001), while the cognition variables of HBM were not significantly associated with SPB.

CONCLUSION

The results suggested that both internal and external cues to action were powerful predictors for SPB. These findings highlight that further efforts are required to provide the UCM with periodic health check-up reports and promote the active role of doctors and family members in miners' decision-making to simulate them for better SPB.

ETHICS APPROVAL

All data collection procedures received ethical approval from the Ethics Committee of Xuhui District Centre for Disease Control and Prevention (XHHEC-2016-7).

Patterns of progressive massive fibrosis on modern coal miner chest radiographs

Clinical teaching generally asserts that large opacities of progressive massive fibrosis (PMF) on chest radiographs present primarily bilaterally in the upper lung zones, and with an elevated background profusion of small opacities. However, the contemporary basis for these descriptions is limited.Radiographs taken for the Coal Workers' Health Surveillance Program during 2000-2015 and previously determined to have large opacities ("PMF radiographs", n = 204), and a random sample previously deemed free of large opacities (n =22), were independently reevaluated by three National Institute for Occupational Safety and Health (NIOSH) B Readers. Large opacities were noted primarily in the upper right (41%) or upper left (28%) lung zone, but 31% were in middle or lower zones. Unilateral involvement was observed in 34% of readings, with right lung predominance (82%). The median small opacity profusion category for the radiographs with PMF was 2/1. The number of large opacities was not correlated with small opacity profusion category. The "classic" descriptions of PMF as bilateral, associated with elevated background profusions of small pneumoconiotic opacities, were each absent in a third of miners.

Prevalence of pneumoconiosis among young adults aged 24-44 years in a heavily industrialized province of China

Objectives

The purposes of this study were to clarify (i) the prevalence of pneumoconiosis among young adults and (ii) the factors associated with pneumoconiosis among young adults to explore targeted solution for control of pneumoconiosis among young adults (aged 24‐44 years).

Methods

The new cases diagnosed from 2001 to 2015 (extracted from the National Occupational Disease and Occupational Health Information Monitoring System) were involved in this research, including information of employer, patient's name, date of birth, gender, date of diagnosis, first year of dust exposure, duration of exposure, aggregation etc

Results

A total of 1519 pneumoconiosis cases were diagnosed among young adults (21.6% of overall cases). Silicosis was the most common type with acute process of disease. Compared with overall cases, the young patients had shorter duration of exposure, more stage II/III cases and higher aggravation rate; and were even more concentrated in small and medium enterprises where more migrant workers were employed and insufficient protective measures were used. Without further regulation, the prevalence of pneumoconiosis among young adults would bring not only disease suffering for 3000 individuals and their families, but also an annual economic loss up to 180 million yuan for Hebei province till 2025.

Conclusions

As a typical heavily industrialized province of China, Hebei has severe situation on pneumoconiosis among young adults. Special attention and effort on silica‐contacting industries, small and medium enterprises, and migrant workers should be focused in future occupational supervision and regulation among young adults.

Mixed-dust pneumoconiosis: Review of diagnostic and classification problems with presentation of a work-related case

Environmental aerosolized particulates pose a potential risk to human health worldwide. Among others, high amounts of contaminants are generated especially in newly industrializing countries in the vicinity of industrial manufacturing, mining operations, but also during agricultural and natural processes. As an example of the needed multi-disciplinary diagnostic and differential diagnostic approach, we report a case of a 59-year old industrial worker who has suffered from chronic bronchitis and progressive dyspnea on exertion for 8years. He showed severe lung function impairment, a cavity in his right upper lung lobe, nodular and irregular opacities, fibrotic pleural changes and emphysema. According to the occupational history and the industrial hygiene report, he had been engaged in the production of various refractory materials and been exposed to very high levels of inorganic dust, especially to silica, silicon carbide and aluminum compounds, but also to carbon and other dusty materials for 28years. Histopathology of the two resected lung segments showed focally infarcted granulomas and chronic inflammation. Stains for organisms were negative. The lung tissue away from the granulomas showed significant dust deposition including dust macules. In spite of the inorganic dust deposits, with adjacent tissue lesions evident from the radiological findings (which were interpreted as atypical for pneumoconiosis) and the presence of granulomas in lung tissue, a diagnosis of necrotizing sarcoid granulomatosis was made, which was later changed to mixed-dust pneumoconiosis on further detailed examination. Scanning Electron Microscopy/Energy-Dispersive X-ray Spectroscopy (SEM/EDS) analysis of individual particles showed predominantly Si (silica or silicon carbide [SiC]) and Al particles (consistent with aluminum metal and/or oxide), as well as numerous Al silicates, Ti, and occasional Zr, Nb, V, steel, including Si fibers (consistent with SiC). We present the controversy about the pathogenesis of the lung disorder and whether it represents an occupational disease - which is more or less representative for many such cases.

Characteristics and Trends of Pneumoconiosis in the Jiangsu Province, China, 2006⁻2017

This study aims to describe the characteristics and trends of pneumoconiosis in the Jiangsu Province, China, and provide information for the occupational diseases control. We collected and analyzed the data of pneumoconiosis cases reported annually from 2006 to 2017. The information of the cases mainly includes case distributions, clinical types and stages, enterprise types and scales, as well as diagnosis age and exposure duration. A total of 9243 pneumoconiosis cases were reported between 2006 and 2017, among which silicosis and coal workers’ pneumoconiosis accounted for the vast majority (87.5%). The incidence of pneumoconiosis was relatively higher in Wuxi, Yancheng, Suzhou and Xuzhou, compared to the other district. Most pneumoconiosis cases occurred in the state-owned (58.4%) and collective enterprises (23.8%). Most cases worked in industries related to geology and coal production. The median exposure duration and diagnosis age of the total pneumoconiosis cases was 13.2 and 61.0 years, respectively. Therefore, more measurements are needed to control pneumoconiosis in the Jiangsu Province.

[International incidence trend of coal workers' pneumoconiosis and silicosis]

Pneumoconiosis is a group of occupational disease that seriously threaten the health of workers, which was regard as incurable for the irreversibility of pulmonary fibrotic lesions. It was successfully controlled in a few countries but resurgent in resent years. At the same time, the silicosis in the emerging industries has gradually appeared in many countries. In this article, the process aforementioned were described and the lessons were summarized to give some suggestions for promoting the prevention of pneumoconiosis in our country.

Evaluation of the exposure to coal dust and prevalence of pneumoconiosis in underground mining in three Colombian departments

Introduction: Coal workers’ pneumoconiosis is a chronic and irreversible disease representing a public health problem. Objective: To estimate the prevalence of pneumoconiosis and its associated factors among underground coal miners in the Colombian departments of Boyacá, Cundinamarca and Norte de Santander. Materials and methods: We conducted a cross-sectional study of 476 miners to measure the prevalence of pneumoconiosis and its associated factors such as coal dust and silica levels, as well as the occupational conditions. The medical assessment and a chest x-ray were performed according to the International Labor Organization criteria, along with spirometry and the identification of glutathione S-transferase and repair enzyme polymorphisms.The associations were explored using Cox regression models. Results: We performed a total of 479 environmental monitoring sessions in 31 companies and we evaluated 476 workers with 10 to 57 years of mining work experience. The prevalence of pneumoconiosis was 33.8% (95% CI: 27.0 - 41.3%). In the Cox multivariate regression model with a constant risk time, pneumoconiosis was significantly associated with working in medium-sized companies (PR=2.00, 95% CI: 0.995 - 2.690; p=0.052), the level of severe exposure to coal dust (PR=2.055, 95% CI: 1.043 - 4.048; p=0.038), and working in underground mining for 25 years or more (for those with 25.0-29.9 years: PR=2.199, 95% CI: 1.449 - 3.338; p=0.001). Conclusions: The prevalence of pneumoconiosis was very high and was found to be associated with severe exposure to coal dust, work exposure for 25 years or more and working in medium-sized enterprises

Focusing on Coal Workers' Lung Diseases: A Comparative Analysis of China, Australia, and the United States

China has high and increasing annual rates of occupational lung diseases such as pneumoconiosis and silicosis. In contrast, Australia and the United States of America (USA) have greatly lowered their annual rates of lung diseases since the 1970s. This paper systematically compared and analysed the multi-elements of coal dust management and health management in these three countries to provide a reference for China. Regarding coal dust management, this paper found that coal workers in China are more susceptible to lung diseases compared to workers in the USA and Australia, considering fundamental aspects such as mine type, coal rank, and geological conditions. In addition, the controllable aspects such as advanced mitigation, monitoring methods, and the personal protective equipment of coal dust were relatively inadequate in China compared to the USA and Australia. Health management in China was found to have multiple deficiencies in health examination, co-governance, and compensations for coal workers suffering from lung diseases and healthcare for retired coal workers. These deficiencies may be attributed to insufficient medical resources, the Chinese government-dominated governance, ineffective procedures for obtaining compensation, and the lack of effective and preventive healthcare programs for the retired coal workers. Based on the USA and Australia experience, some suggestions for improvement were proposed.

[Expression of type 1 and type 2 cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis at earlier stage]

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1β, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1β, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1β, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion: There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.

Assessing the chronic respiratory health risk associated with inhalation exposure to powdered toner for printing in actual working conditions: a cohort study on occupationally exposed workers over 10 years

BACKGROUND

Little epidemiological evidence exists regarding the chronic respiratory effects of inhaled powdered toner exposure in humans, although several case reports have suggested the existence of lung disorders that might be related to exposure to toner dust.

OBJECTIVE

We aimed to estimate the chronic health risk to humans associated with routine toner dust exposure in copier industry workers under current actual work conditions.

DESIGN

A prospective observational cohort study of occupational population.

METHODS

Changes in chest radiogram, spirometry measurements and serum and urine biomarkers of biomedical responses to extrinsic stress, as well as subjective symptoms were longitudinally observed for up to 10 years in Japanese copier industry workers responsible for the manufacturing, maintenance or recycling of powdered toner or toner-using machines. A total of 694 subjects who did not change their work category during the follow-up and were free from chronic respiratory diseases at the baseline survey provided reliable results on at least three survey occasions during 3 years or more of follow-up.

RESULTS

Typical fibrosis findings associated with pneumoconiosis was not observed on chest radiograms. No significant differences associated with toner exposure were noted in the frequency of new incidence of either non-specific findings on chest radiogram or serum fibrosis biomarkers (sialylated carbohydrate antigen KL-6 and surfactant protein D). However, the exposed subjects tended to show increases in the frequency of respiratory symptoms and reduced spirometry results during the follow-up compared with the control group, although significant differences were only seen in chronic cough.

CONCLUSIONS

Under the current reasonably controlled work environmental conditions, lung fibrotic changes caused by inhaled dust exposure, including powdered toner, appear to be relatively uncommon; however, non-specific temporal irritation causing subjective symptoms and inflammatory responses might exist.

Radiographic features of importance in the National Institute for Occupational Safety and Health-administered Coal Workers' Health Surveillance Program: characterising the use of the 'other symbols'

OBJECTIVE

The National Institute for Occupation Safety and Health-administered Coal Workers' Health Surveillance Program (CWHSP) provides radiographic pneumoconiosis screening for US coal miners. Radiographs are classified by readers according to International Labour Office criteria. In addition to pneumoconiotic parenchymal and pleural lung abnormalities, readers document radiographic features of importance (other symbols). Other symbols are not meant to imply a diagnosis or interpretation but are relevant as they provide information beyond a pneumoconiosis classification for features related to dust exposure and other aetiologies. Our objective was to summarise other symbol data from 48 years of CWHSP participants.

METHODS

Chest radiograph classifications obtained from CWHSP participants between July 1968 and July 2016 were analysed. Any 'other symbol' indication from any of the readings were counted. Frequencies were tabulated by individual reader and those identified by any reader.

RESULTS

Of the 469 922 radiographs included in this study, nearly 15% had at least one reader identify a radiographic feature of importance. The most commonly identified other symbol was cancer (excluding mesothelioma) (6.83%), followed by emphysema (1.68%). Some features were rarely identified over the 48 years of data collection such as rheumatoid pneumoconiosis (n=46), pneumothorax (n=32), mesothelioma (n=12) and rounded atelectasis (n=4).

CONCLUSIONS

This is the largest study to date describing radiographic features of importance as part of routine chest radiographic surveillance. While these symbols are not diagnostic they can be used to describe features associated with dust exposure. One of the most commonly identified radiographic features in our population is emphysema which is associated with respirable dust exposure. These results can be compared with other dust exposed populations.

[A trend analysis of the incidence of occupational diseases in Chongqing, China, from 2006 to 2014]

Objective: To investigate the incidence of occupational diseases in Chongqing, China, from 2006 to 2014, and to analyze the harm, features, and trend of occupational diseases in Chongqing. Methods: The data of new cases of occupational diseases from 2006 to 2014 were collected, and the patients with a confirmed diagnosis of occupational diseases were selected as study subjects to analyze the incidence of occupational diseases in Chongqing. Results: There were 17499 cases of occupational diseases in total in Chongqing from 2006 to 2014. Among these patients, 17124 (97.86%) were male, most of whom (95.40%) had occupational pneumoconiosis, and 375 (2.14%) were female, most of whom (72.80%) had occupational chemical poisoning. There were 16400 cases (93.72%) of occupational pneumoconiosis in total, mainly coal workers' pneumoconiosis (55.87%) and silicosis (43.02%) , and the main industries involved were coal mining and washing, railway transport equipment manufacturing, and mining and washing of bituminous coal and anthracite. There were 724 cases of occupational poisoning in total; there were 281 cases of acute occupational poisoning, mainly gas poisoning (39.86%) and carbon monoxide poisoning (33.10%) ; there were 443 cases of chronic occupational poisoning, mainly poisoning caused by benzene (47.63%) , mercury and its inorganic compounds (32.74%) , and lead and its inorganic compounds (9.03%) . Conclusion: Occupational diseases in Chongqing are mainly occupational pneumoconiosis, and occupational health supervision should be enhanced in the industries of coal mining and washing and railway transport equipment manufacturing to protect workers' health.

[Incidence and trend of occupational diseases in Ningbo, China, from 2006 to 2015]

Objective: To investigate the incidence, distribution features, and incidence trend of occupational diseases in Ningbo, China, from 2006 to 2015. Methods: In February 2016, the data on occupational disease report cards in the occupational disease and occupational health information system from 2006 to 2015 were collected to perform a comprehensive analysis of the types, incidence trend, population characteristics, and enterprise characteristics of occupational diseases. Results: There were 845 new cases of occupational diseases in Ningbo from 2006 to 2015, among which 596 (70.53%) were pneumoconiosis; there were 445 (74.66%) cases of stage I pneumoconiosis, 73 (12.25%) cases of stage II pneumoconiosis, and 78 (13.09%) cases of stage III pneumoconiosis; silicosis (59.76%) was the most common type of pneumoconiosis. Of all patients with occupational diseases, 84.97% were male, 64.50%were aged 35-55 years, and 63.67% had 5-20 working years. Most of the patients with occupational diseases worked in small and medium-sized private (or foreign) enterprises; the most common industries were black metal smelting and rolling (38.76%) , construction (17.11%) , and non-metallic ore mining (13.09%) . A total of 51.28%, 10.26%, and 7.69% of the patients with occupational poisoning worked in the electric apparatus manufacturing industry, furniture manufacturing industry, and chemical raw material and chemical product manufacturing industry, respectively. The cases of occupational diseases are mainly distributed in Yuyao City (24.62%) , Yinzhou District (23.91%) , and Ninghai County (15.62%) . Conclusion: Pneumoconiosis is the most common type of occupational disease in Ningbo and most of these patients work in small and medium-sized private (or foreign) enterprises. The supervision of small and medium-sized private enterprises should be enhanced to protect workers' health.

[Application of means of surfaces with nonhomogeneity in estimating the incidence of pneumoconiosis]

Objective: To investigate the value of means of surfaces with nonhomogeneity (MSN) in esti-mating the incidence of pneumoconiosis. Methods: Based on the principal component analysis, all counties (districts) of Hebei Province, China, were divided into three categories according to the degree of pneumoconiosis hazards and the MSN model was used to estimate the incidence rate of pneumoconiosis and the number of pneu-moconiosis cases using the data of the incidence of pneumoconiosis in 2010. Results: With reference to the appli-cation requirements of the MSN model, results of the principal component analysis, and expert experience, the 172 counties (districts) in Hebei Province were divided into three categories with mild, moderate, and severe pneumoconiosis hazards. There were 74, 61, and 49 counties in the above categories, respectively, and 12, 12, and 25 counties were selected from them, respectively. The estimated number of pneumoconiosis cases in Hebei Province was 2105, and the incidence rate was 261.5 per hundred thousand, with a standard error of esti-mation of 389.9 per hundred thousand. Conclusion: The MSN model provides a new thought and method for es-timating the number of pneumoconiosis cases.

Chronic obstructive pulmonary disease in Welsh slate miners

BACKGROUND

Exposure to respirable crystalline silica (RCS) causes emphysema, airflow limitation and chronic obstructive pulmonary disease (COPD). Slate miners are exposed to slate dust containing RCS but their COPD risk has not previously been studied.

AIMS

To study the cumulative effect of mining on lung function and risk of COPD in a cohort of Welsh slate miners and whether these were independent of smoking and pneumoconiosis.

METHODS

The study was based on a secondary analysis of Medical Research Council (MRC) survey data. COPD was defined as forced expiratory volume in 1 s/forced vital capacity (FEV₁/FVC) ratio <0.7. We created multivariable models to assess the association between mining and lung function after adjusting for age and smoking status. We used linear regression models for FEV₁ and FVC and logistic regression for COPD.

RESULTS

In the original MRC study, 1255 men participated (726 slate miners, 529 unexposed non-miners). COPD was significantly more common in miners (n = 213, 33%) than non-miners (n = 120, 26%), P < 0.05. There was no statistically significant difference in risk of COPD between miners and non-miners when analysis was limited to non-smokers or those without radiographic evidence of pneumoconiosis. After adjustment for smoking, slate mining was associated with a reduction in %predicted FEV₁ [β coefficient = -3.97, 95% confidence interval (CI) -6.65, -1.29] and FVC (β coefficient = -2.32, 95% CI -4.31, -0.33) and increased risk of COPD (odds ratio: 1.38, 95% CI 1.06, 1.81).

CONCLUSIONS

Slate mining may reduce lung function and increase the incidence of COPD independently of smoking and pneumoconiosis.

Pneumoconiosis in different sectors and their differences in Turkey

INTRODUCTION

Pneumoconiosis which is one of the ancient diseases, still affects many workers throughout the world despite "existing" control programs. We add data from a single center reviewing risk factors for pneumoconiosis; evaluate functional and radiological findings in different sectors.

MATERIALS AND METHODS

We reviewed medical records of patients diagnosed with pneumoconiosis who were admitted to our center between the years 2013 and 2015. Several personal and occupational features, together with functional and radiologic data, were collected.

RESULT

60 were young males. Twenty-four of the cases (39.3%) worked at dental technician, 24 cases (39.3%) were ceramic workers, 5 cases (8.2%) were sandblasters, 2 cases (3.3%) were welders, 3 cases (4.9%) were miners, and 3 cases (4.9%) were marble cutters. The sectors in which the exposure started at the earliest ages were dental technicians and sandblasters, while the shortest working time was in sandblasting. The dental technicians were younger than the ceramic workers at the age of diagnosis (Kruskall-Wallis p= 0.003). The exposure time of the sandblasters was significantly shorter, especially than the ceramic workers (Kruskall-Wallis p= 0.002). The cases have been referred to us with pneumoconiosis suspicion based on the radiographic findings in the PA chest roentgenogram performed during the periodic examinations at their work place; but unlike other studies, in our study, following the HRCT assessment, cases which did not present any visible pathology in the re-evaluation of their PA chest roentgenogram, but had HRCT findings have been diagnosed as pneumoconiosis. Among the 44 cases in which micro-nodules had been detected at their HRCT, 15 of them had been previously classified as profusion of small opacities 0/1 according to their PA chest roentgenogram findings. It has been seen that the HRCT findings differ among sectors. Ceramics workers and sandblasters had significantly more micro-nodules, while dental technicians had significantly more mediastinal lymphadenopathies (Chi square, p= 0.004 and p= 0.007 respectively). When the relationship between the existence of big opacities and complaints was studied, statistically significant weight loss was detected in cases which had C opacities (chi square p= 0.01). Statistically significant FEV1 decrease was observed in cases which had weight loss (independent samples t-test p= 0.046). It has been observed that when the profusion of small opacities increased, while there was no statistically significant functional status change in non-smokers, a significant functional impairment was observed in smokers.

CONCLUSIONS

Pneumoconiosis still exists in Turkey. Even a short exposure time as 2 years can cause pneumoconiosis. Workers in different sectors had different functional, radiological properties and smoking can affect the diseases' course. There are serious limitations related to the surveillance of both the workplace environment and the employees' health in Turkey. Without institutional preventive measures, personal protection and surveillance examinations, occupational hazards will continue to cause premature deaths. Pneumoconiosis in different sectors is a prototype of uncontrolled industry in the developing world.

[Autocorrelation analysis of pneumoconiosis in China]

Objective: Using spatial autocorrelation analysis to study spatial distribution characteristics of pneumoconiosis in China. Methods: The incidence of pneumoconiosis of each province from 2009 to 2013 was calculated by reported data of pneumoconiosis and the number of employment in mining and manufacturing of each province from Chinese statistical yearbook. The global and local spatial autocorrelation analysis was im-plemented by global and local's Moran's I index respectively. Results: A total of 112 066 new cases of pneumo-coniosis were reported from 2009 to 2013 in China, Global Moran's I from 2009 to 2013 was -0.114、0.179、0.199、0.259 and 0.241 respectively. A total of 15 space units with statistical significance were detected by local spatial autocorrelation analysis, which were mainly high-high regions. Conclusion: There was weak global spa-tial autocorrelation relationship of the incidence of pneumoconiosis from 2010 to 2013 among the provinces in China. The results of local spatial autocorrelation analysis suggested that there were clustering regions of pneumo-coniosis in the southwest and central south of China.

Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study

The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF).We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m).The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P < 0.001). The HR for CHF was 1.38-fold greater in the pneumoconiosis cohort than in the nonpneumoconiosis cohort (P < 0.001) after the model was adjusted for age, sex, various comorbidities, and air pollutants (μg/m). The relative risk for CHF in the sex-specific pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21-1.62, P < 0.001). The incidence density rates of CHF increased with age; pneumoconiosis patients had a higher relative risk of CHF for all age group.Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease.

[Development of pneumoconiosis and outsourcing work in peruvian miners]

OBJETIVES

The aim of this study is to evaluate the association between the time of outsourced work and the development of pneumoconiosis in Peruvian miners who attended the "Centro Nacional de Salud Ocupacional y Protección al Ambiente para la Salud" between 2008 and 2011.

MATERIALS AND METHODS

Retrospective case-control study. Cases were defined as workers diagnosed of pneumoconiosis under standardized criteria. Outsourced work was defined as the time (in months) of work in a company that does not own the primary mining project. The project owner company was registered in the Mining Companies Directory (Ministerio de Energía y Minas). We used multiple logistic regression with crude and adjusted ORs.

RESULTS

The study comprised 391 cases and 1519 controls. In both groups, most of the study subjects had a level of education lower than complete high school and were born and currently lived in the Peruvian highlands. There was statistically significant association between more frequency of pneumoconiosis and working 10 or more years in an outsourced company (OR: 1.50; 95%CI: 1.05-1.14; p=0.026). Miners with pneumoconiosis were more likely not to have education (OR: 3.07; 95%CI: 1.55-6.08; p=0.001), be currently living at the Peruvian highlands (OR: 1.40; 95%CI: 1.10-1.78; p=0.007) and to have more than 20 years of underground work history (OR: 8.92; 95%CI: 4.53-18.25; p<0.001).

CONCLUSIONS

A statistically significant association was found between pneumoconiosis and the time of outsourced work. Not having education, residing in the Peruvian highlands and the time of underground work were associated risk factors.

Cost-Effectiveness of Coal Workers' Pneumoconiosis Prevention Based on Its Predicted Incidence within the Datong Coal Mine Group in China

We aimed to estimate the economic losses currently caused by coal workers’ pneumoconiosis (CWP) and, on the basis of these measurements, confirm the economic benefit of preventive measures. Our cohort study included 1,847 patients with CWP and 43,742 coal workers without CWP who were registered in the employment records of the Datong Coal Mine Group. We calculated the cumulative incidence rate of pneumoconiosis using the life-table method. We used the dose-response relationship between cumulative incidence density and cumulative dust exposure to predict the future trend in the incidence of CWP. We calculate the economic loss caused by CWP and economic effectiveness of CWP prevention by a step-wise model. The cumulative incidence rates of CWP in the tunneling, mining, combining, and helping cohorts were 58.7%, 28.1%, 21.7%, and 4.0%, respectively. The cumulative incidence rates increased gradually with increasing cumulative dust exposure (CDE). We predicted 4,300 new CWP cases, assuming the dust concentrations remained at the levels of 2011. If advanced dustproof equipment was adopted, 537 fewer people would be diagnosed with CWP. In all, losses of 1.207 billion Renminbi (RMB, official currency of China) would be prevented and 4,698.8 healthy life years would be gained. Investments in advanced dustproof equipment would be total 843 million RMB, according to our study; the ratio of investment to restored economic losses was 1:1.43. Controlling workplace dust concentrations is critical to reduce the onset of pneumoconiosis and to achieve economic benefits.

[Analyses on the characteristics and the trends of pneumoconiosis notified between 2001 and 2012 in Hebei Province]

OBJECTIVE

To describe the incidence, development and death of pneumoconiosis reported in Hebei from 2001 to 2012 and investigate the epidemiological trends and characteristics of pneumoconiosis to provide basic data for formulating the guidelines and policies for control of pneumoconiosis.

METHODS

The Hebei database of new cases of pneumoconiosis reposed from 2001 to 2012 were subjected to systematic arrangement. Clean data and descriptive analysis using SPSS 17.0. The statistical indices included number of new and death pneumoconiosis cases in each year.

RESULTS

From 2001 to 2012 a total of 4558 new cases of pneumoconiosis were reported. The situation was same to coal-workers' pneumoconiosis and silicosis. (2) The pneumoconiosis cases were distributed mainly in the city of Tang Shan, Cheng De, Zhang Jia Kou and Han Dan (88.24%). (3) Most cases were centerred in coal industry, metallurgical industry, nonferrous metals industry, architectural material industry and light industry. (4) The mean age of onset in new cases was shorted each year for silicosis, coal-workers' pneumoconiosis, potter pneumoconiosis and electric welder pneumoconiosis, especially for 2010 to 2012 (9 years). (5) The work types of these cases mainly included drilling (26.72%), mining as the main work (6.67%), hybrid coal mine work (6.95%), molding worker (5.24%) and berterring worker (4.82%). (6) The new cases of pneumoconiosis reposed from 2001 to 2012 were diagnosissed I (3415, 74.92%), II (782, 17.16%), III (361, 7.92%). (7) The death cases of pneumoconiosis reposed from 2001 to 2012 were 1182, most of them were distributed mainly in the city of Tang Shan, Cheng De, Zhang Jia Kou and Han Dan (88.24%).

CONCLUSION

The incidence of pneumoconiosis is still high: the new cases of pneumoconiosis is still rising. The mean age of onset in new cases was shorted each year. The new cases of pneumoconiosis reposed from 2001 to 2012 were diagnosed II was above 25%. The prevention and control of pneumoconiosis should be enhanced in key industries and for people engaging in key regions, industries, types of work according to the epidemiological characteristics of pneumoconiosis. Most cases were centerred in coal-workers' pneumoconiosis and silicosis.

Pneumoconiosis increases the risk of peripheral arterial disease: a nationwide population-based study

This nationwide population-based retrospective cohort study was used to evaluate the association between pneumoconiosis and peripheral arterial disease (PAD). We identified 3374 patients with pneumoconiosis from the catastrophic illness registry who were newly diagnosed from 2000 to 2005; 13,496 patients without pneumoconiosis from Longitudinal Health Insurance Database 2000 (LHID2000) were randomly frequency matched according to sex, age, and index year and used as a nonpneumoconiosis group. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) of PAD in the pneumoconiosis group compared with the nonpneumoconiosis group. The mean follow-up years were 7.44 years in the pneumoconiosis group and 8.17 years in the nonpneumoconiosis group. The incidence density rate of PAD was 1.25 times greater in the pneumoconiosis group than in the nonpneumoconiosis group (8.37 vs 6.70 per 1000 person-years). After adjusting for sex, age, and comorbidities, the adjusted HRs of PAD for the pneumoconiosis group were 1.30 (95% CI = 1.08-1.57), compared with the nonpneumoconiosis group. The combined impacts of patients with pneumoconiosis and diabetes, hyperlipidemia, hypertension, ischemic heart disease, chronic obstructive pulmonary disease, and asthma showed a significant by joint association with PAD risk compared with patients with no pneumoconiosis and no counterpart comorbidity. Patients with pneumoconiosis have an independently higher risk of developing PAD. Physicians should include pneumoconiosis in evaluating PAD risk.

[A study of GM (1, 1) model for predicting the incidence trends of pneumoconiosis cases of an area]

OBJECTIVE

To explore the application of the gray series model GM (1, 1) in predicting trends in the incidence of pneumoconiosis and evaluate its degree of predicted precision.

METHODS

Analyzing the incidence of pneumoconiosis in this region from 2009 to 2013, and predicting the incidence of pneumoconiosis of the area in 2014-2016 by establishing GM (1, 1) according to the gray system theory.

RESULTS

Using occupational pneumoconiosis population data from 2009 to 2013, to establish GM (1, 1) model: yt = 1396.89e(0.12(t-1)), α = -0.12, µ = 147.2. The pneumoconiosis in 2014, 2015, 2016 were predicted respectively 51, 47, 43 cases based on the GM (1, 1) model, and C value of model is 0.15, P value is 1, all of them meet the requirements of model predictions. It shows the cases of pneumoconiosis are rising significantly.

CONCLUSION

GM (1, 1) model can be used to predict the recent trend in the incidence of pneumoconiosis.

Prevalence of pneumoconiosis in Hubei, China from 2008 to 2013

We have investigated newly reported pneumoconiosis cases in the province of Hubei, China from 2008 to 2013, to identify the major problems and challenges, and explore possible solutions for its prevention and control. We analyzed the data on new cases of pneumoconiosis from annual reports, including case distributions, patient ages, exposure duration, disease stages, and enterprise types. A total of 3665 new pneumoconiosis cases were reported between 2008 and 2013 in Hubei Province. Coal workers' pneumoconiosis and silicosis, which accounted for 97.19% of the total, were the most common types. The duration of exposure of 33.32% cases was less than 10 years. Most of the new pneumoconiosis cases worked in industries that produced coal, nonferrous metal, or building materials. About 42.46% of pneumoconiosis cases were from small and medium-sized enterprises. The proportion of cases with combined pneumoconiosis and tuberculosis was 6.6%, and the incidence of tuberculosis was highest in workers with silicosis. The current situation of pneumoconiosis in China is serious. Lack of attention to occupational health, inefficient surveillance, and weak occupational health services may have contributed to the increased new pneumoconiosis cases.

[Well-digger's lung in Mali during the decade of 2001-2010]

INTRODUCTION

The well-digger is a craftsman who hollows wells often manually; this trade can be source of inhalation of the particles of silica. The whole of the radio clinical signs linked to this profession is known under the term "Well-digger's lung". The goal was to study the radio clinical aspects and progression in black African's pulmonological environment.

METHODS

Retrospective and descriptive study concerning the respiratory involvement of well-diggers in the Pulmonology service of the Teaching Hospital of Bamako, from January 2001 to December 2010. The admission registers were used as data verification support.

RESULTS

Among 4158 admissions for lung affection, we have collected 39 cases of well-digger's lung (0.9%), all young male adults. The average of exposition period was 13 ± 9 years, correlated to the patient's age (p<0.001). The principal reason of consultation was dyspnea (94.8%). The complications were frequent (cardiac, infectious, pleural). The radiological pictures were made of bilateral big opacities associated with small opacities. The evolution was unfavorable in the majority of the cases.

CONCLUSION

The well-digger's lung is a young adult pneumoconiosis linked to the inhalation of the particles of silica during the trade (profession) of well-digger that complicates frequently in chronic respiratory insufficiency.

[ARIMA models to predict new-diagnosing cases of pneumoconiosis in Nanjing]

OBJECTIVE

The primary goal of our study was to evaluate and predict the epidemiological trend of pneumoconiosis.

METHODS

We established a new database on new-diagnosing cases of pneumoconiosis in Nanjing during 1955-2007. The database was analyzed by using SAS9.1.3 statistical software, Data sequence was stabilized by using the process of differencing. Goodness of Fit Test verified that the residual-error sequence was white noise sequence. We determined the Autoregressive Integrated Moving Average models (ARIMA models) as an appropriate model. By Taking advantage of back-substitution model, we predicted new cases of pneumoconiosis during 2008-2012. We then compared the predicted value with the actual value to test and verify the predicting function.

RESULTS

We finally had chosen out ARIMA (2, 1, 0) models to fit the original sequence, which led to the results that the observed values are basically comparable with the predicted values. The past 5-year predicted-value was similar to the actual value. We then built a new model by new cases during 1955-2012, predicting that the trend of pneumoconiosis in the next 5 years will tend to approach plateau with approximately 10∼13 new cases per year.

CONCLUSION

ARIMA models is suitable for fitting large sample series of new diagnosed pneumoconiosis over the years and for the predicting the incidence of pneumoconiosis.

[Structure and dynamics of occupational lung diseases in workers of Moscow region under longstanding 50 years of observation]

The article covers data on occupational morbidity in Moscow region over last 50 years. Stable number of newly diagnosed occupational diseases was seen up to first half of 1990s. Afterwards, steady decrease in occupational morbidity is seen with closure of major industrial enterprises. Among occupational pulmonary diseases, dust fibrosis (pneumoconiosis--44%) prevail. Tuberculosis complication of silicosis decreased, additional general somatic concomitants (arterial hypertension, ischemic heart disease, malignancies) are more frequent. Prevalence of occupational bronchial asthma has increased 16 times vs. that in 1976.

[Life quality in individuals having occupational diseases caused by various occupational factors]

The article presents main results of studies concerning life quality in individuals having chronic occupational diseases of important social value. Life quality in patients with chronic mercurial intoxication and dust bronchitis appeared to result from personal, social and psychologic features.

[Experience of Pneumo 23 vaccine in patients with combination of COLD with pneumoconiosis]

The most well-studied, but not single factor of COLD development is smoking. Occupational hazards as organic and inorganic dust are underevaluated risk factor of COLD. Smoking increased unfavorable effects of occupational hazards. Interesting for the study are the patients with combination of pneumoconiosis and COLD, severe concomitant diseases and decompensated complications--chronic cardiac failure and chronic lung failure. These patients have lower life quality, more frequent infectious exacerbations of COLD and pneumonias--that remains a significant medical and social problem. At present, pneumonia occupies 4-5th place in lethal outcomes structure. Pneumo 23--polysaccharide 23-valent vaccine--covers main serotypes of pneumococcus causing diseases of severe clinical course. In the study, the patients were injected with Pneumo 23 along with basic COLD therapy, were observed over 5 years and demonstrated reliable decrease of acute respiratory infections, COLD exacerbations and pneumonias. Those exacerbations and pneumonias had less severe course. Number of the exacerbations requiring hospitalization also decreased.

Risk identification and prediction of coal workers' pneumoconiosis in Kailuan Colliery Group in China: a historical cohort study

BACKGROUND

Prior to 1970, coal mining technology and prevention measures in China were poor. Mechanized coal mining equipment and advanced protection measures were continuously installed in the mines after 1970. All these improvements may have resulted in a change in the incidence of coal workers' pneumoconiosis (CWP). Therefore, it is important to identify the characteristics of CWP today and trends for the incidence of CWP in the future.

METHODOLOGY/PRINCIPAL FINDINGS

A total of 17,023 coal workers from the Kailuan Colliery Group were studied. A life-table method was used to calculate the cumulative incidence rate of CWP and predict the number of new CWP patients in the future. The probability of developing CWP was estimated by a multilayer perceptron artificial neural network for each coal worker without CWP. The results showed that the cumulative incidence rates of CWP for tunneling, mining, combining, and helping workers were 31.8%, 27.5%, 24.2%, and 2.6%, respectively, during the same observation period of 40 years. It was estimated that there would be 844 new CWP cases among 16,185 coal workers without CWP within their life expectancy. There would be 273.1, 273.1, 227.6, and 69.9 new CWP patients in the next <10, 10-, 20-, and 30- years respectively in the study cohort within their life expectancy. It was identified that coal workers whose risk probabilities were over 0.2 were at high risk for CWP, and whose risk probabilities were under 0.1 were at low risk.

CONCLUSION/SIGNIFICANCE

The present and future incidence trends of CWP remain high among coal workers. We suggest that coal workers at high risk of CWP undergo a physical examination for pneumoconiosis every year, and the coal workers at low risk of CWP be examined every 5 years.