Estimates and Predictions of Coal Workers' Pneumoconiosis Cases among Redeployed Coal Workers of the Fuxin Mining Industry Group in China: A Historical Cohort Study

Incidence and influencing factors of occupational pneumoconiosis: a systematic review and meta-analysis

OBJECTIVES

To determine the incidence of pneumoconiosis worldwide and its influencing factors.

DESIGN

Systematic review and meta-analysis.

SETTING

Cohort studies on occupational pneumoconiosis.

PARTICIPANTS

PubMed, Embase, the Cochrane Library and Web of Science were searched until November 2021. Studies were selected for meta-analysis if they involved at least one variable investigated as an influencing factor for the incidence of pneumoconiosis and reported either the parameters and 95% CIs of the risk fit to the data, or sufficient information to allow for the calculation of those values.

PRIMARY OUTCOME MEASURES

The pooled incidence of pneumoconiosis and risk ratio (RR) and 95% CIs of influencing factors.

RESULTS

Our meta-analysis included 19 studies with a total of 335 424 participants, of whom 29 972 developed pneumoconiosis. The pooled incidence of pneumoconiosis was 0.093 (95% CI 0.085 to 0.135). We identified the following influencing factors: (1) male (RR 3.74; 95% CI 1.31 to 10.64; p=0.01), (2) smoking (RR 1.80; 95% CI 1.34 to 2.43; p=0.0001), (3) tunnelling category (RR 4.75; 95% CI 1.96 to 11.53; p<0.0001), (4) helping category (RR 0.07; 95% CI 0.13 to 0.16; p<0.0001), (5) age (the highest incidence occurs between the ages of 50 and 60), (6) duration of dust exposure (RR 4.59, 95% CI 2.41 to 8.74, p<0.01) and (7) cumulative total dust exposure (CTD) (RR 34.14, 95% CI 17.50 to 66.63, p<0.01). A dose-response analysis revealed a significant positive linear dose-response association between the risk of pneumoconiosis and duration of exposure and CTD (P-non-linearity=0.10, P-non-linearity=0.16; respectively). The Pearson correlation analysis revealed that silicosis incidence was highly correlated with cumulative silica exposure (r=0.794, p<0.001).

CONCLUSION

The incidence of pneumoconiosis in occupational workers was 0.093 and seven factors were found to be associated with the incidence, providing some insight into the prevention of pneumoconiosis.

PROSPERO REGISTRATION NUMBER

CRD42022323233.

Epidemiological characteristics and survival analysis on patients with occupational pneumoconiosis in Zhejiang Province from 1987 to 2019

Objective

To evaluate risk factors affecting survival in patients diagnosed with pneumoconiosis and propose strategies to improve the quality of life in these patients.

Methods

The basic patient information was obtained from the pneumoconiosis report card. Disease types, regions, and industry distribution of pneumoconiosis were analyzed. The Kaplan-Meier survival curves and the Cox proportional risk regression model was used for survival analysis.

Results

A total of 13,812 patients were diagnosed with pneumoconiosis in Zhejiang province from 1987 to 2019. The overall survival rate at the end of life table analysis was 83%. Kaplan-Meier analyses showed that there were significant differences between survival curves depending on the stage of first diagnosis, age at first diagnosis, type of pneumoconiosis, industry, and duration of dust exposure (P < 0.05). The results of Cox proportional hazards regression analysis showed that pneumoconiosis stage of first diagnosis, age at first diagnosis, industry, and duration of dust exposure were risk factors affecting patient survival (P < 0.05).

Conclusions

The patients with high stage of pneumoconiosis at first diagnosis, older age, and long duration of dust exposure should be followed up and monitored as key population, and the industries with high incidence of pneumoconiosis such as mining and construction should be supervised as key industries.

Prolonged Inhalation Exposure to Coal Dust on Irradiated Rats and Consequences

The purposes of this study were to research immune system changes and liver and lung tissues in irradiated rats after prolonged exposure to coal dust. A study was carried out on 30 male Wistar rats that were divided into 3 groups: group I, intact animals; group II, exposure to coal dust and 0.2 Gy γ-irradiation; and group III, combined exposure to 6 Gy γ-irradiation and coal dust. The combination of a low and sublethal dose of γ-irradiation with coal dust leads to a significant change in immunity at the remote period. Particularly, the increase in radioactivity at the combined effect causes weakening of phagocytosis, and reduction in T lymphocytes by a factor of 2, immunoglobulin imbalance, and cytokine dysfunction develop secondary immune failure. During prolonged inhalation with coal dust of irradiated animals with the dose of 0.2 Gy, fibrosis and perivascular sclerosis of the bronchial wall of the lungs are formed, and perivascular fibrosis is formed in the liver. The increase in exposure dose up to 6 Gy in combination with coal, in the distant period, caused pulmonary hypertension amid hypertrophy of light arterial vessels and fibrous changes in arteriole, and destructive changes and collection necrosis develop in liver parenchyma. In the case of dust radiation synergy, the increase in doses leads to a significant immune deficiency, which occurs according to the “dose effect” principle; increases damage to animal tissues; and leads to liver tissue necrosis, pulmonary fibrosis, and pulmonary hypertension.

A systematic review and meta-analysis on international studies of prevalence, mortality and survival due to coal mine dust lung disease

BACKGROUND

Coal mine dust lung disease comprises a group of occupational lung diseases including coal workers pneumoconiosis. In many countries, there is a lack of robust prevalence estimates for these diseases. Our objective was to perform a systematic review and meta-analysis of published contemporary estimates on prevalence, mortality, and survival for coal mine dust lung disease worldwide.

METHODS

Systematic searches of PubMed, EMBASE and Web of Science databases for English language peer-reviewed articles published from 1/1/2000 to 30/03/2021 that presented quantitative estimates of prevalence, mortality, or survival for coal mine dust lung disease. Review was conducted per PRISMA guidelines. Articles were screened independently by two authors. Studies were critically assessed using Joanna Briggs Institute tools. Pooled prevalence estimates were obtained using random effects meta-analysis models. Heterogeneity was measured using the I2 statistics and publication bias using Egger's tests.

RESULTS

Overall 40 studies were included, (31 prevalence, 8 mortality, 1 survival). Of the prevalence estimates, fifteen (12 from the United States) were retained for the meta-analysis. The overall pooled prevalence estimate for coal workers pneumoconiosis among underground miners was 3.7% (95% CI 3.0-4.5%) with high heterogeneity between studies. The pooled estimate of coal workers pneumoconiosis prevalence in the United States was higher in the 2000s than in the 1990s, consistent with published reports of increasing prevalence following decades of declining trends. Sub-group analyses also indicated higher prevalence among underground miners, and in Central Appalachia. The mortality studies were suggestive of reduced pneumoconiosis mortality rates over time, relative to the general population.

CONCLUSION

The ongoing prevalence of occupational lung diseases among contemporary coal miners highlights the importance of respiratory surveillance and preventive efforts through effective dust control measures. Limited prevalence studies from countries other than the United States limits our understanding of the current disease burden in other coal-producing countries.

A Nurse-Led Education Program for Pneumoconiosis Caregivers at the Community Level

Pneumoconiosis is an irreversible chronic disease. With functional limitations and an inability to work, pneumoconiosis patients require support from family caregivers. However, the needs of pneumoconiosis caregivers have been neglected. This study aimed to evaluate the effectiveness of a nurse-led education program, which involved four weekly 90-min workshops led by an experienced nurse and guided by Orem’s self-care deficit theory. A single-group, repeated-measure study design was adopted. Caregivers’ mental health (Hospital Anxiety and Depression Scale, HADS, four single items for stress, worriedness, tiredness, and insufficient support), caregiving burdens (caregiving burden scale, CBS), and unmet direct support and enabling needs (Carer Support Needs Assessment Tool, CSNAT) were measured at the baseline (T0), immediately after (T1), and one month after intervention (T2); 49, 41, and 28 female participants completed the T0, T1, and T2 measurements. Mean age was 65.9 years old (SD 10.08) with a range between 37 and 85 years old. The program improved the caregivers’ mental wellbeing, and reduced their caregiving burdens and their unmet support and enabling needs, both immediately (T1) and one-month after the intervention (T2). In particular, the intervention improved the caregivers’ mental wellbeing significantly, specifically depression symptoms, stress, and tiredness immediately after the intervention; and reduced most of their unmet support needs and unmet enabling needs one-month after the intervention. This was the first nurse-led program for pneumoconiosis caregivers and should serve as a foundation for further studies to test the program with robust designs.

Prediction of the length of service at the onset of coal workers' pneumoconiosis based on neural network

Three environmental parameters, i.e. dust concentrations, dust dispersion, and free silica content, were introduced into the traditional indices of the neural network model in order to construct a new prediction index and explore a new method for preventing the incidence of pneumoconiosis with intelligent accuracy and universality. Data of the pneumoconiosis patients from Huabei Mining Group (HBMG) of China from 1980 to 2017 were collected. SPSS22.0 was used to develop the combined models based on Back Propagation (BP) neural network model, Radial Basis Function (RBF) neural network model, and Multiple Linear Regression (MLR) model. The paired sample t-test was performed between the real and predicted values. According to this model, it was predicted that 382 coal workers in HBMG were likely to suffer from pneumoconiosis in 2022 and the incidence rate was 4.48%. It is necessary to take prevention measures and transfer these workers from their current positions. In four combined models, the BP-MLR combined model achieved the optimal error parameters and the most accurate prediction. This study provided a scientific basis for effective control and prevention of the incidence of the pneumoconiosis.

Focusing on the premature death of redeployed miners in China: an analysis of cause-of-death information from non-communicable diseases

Background

Reducing premature deaths is an important step towards achieving the World Health Organization’s sustainable development goal. Redeployed miners are more prone to disease or premature death due to the special occupational characteristics. Our aims were to describe the deaths of redeployed miners, assess the losses due to premature death and identify their main health problems. All the records of individuals were obtained from Fuxin Mining Area Social Security Administration Center. Year of life lost (YLL) and average year of life lost were used to assess the loss due to premature death. YLL rates per 1000 individuals were considered to compare deaths from different populations.

Results

Circulatory system diseases contributed the most years of life lost in the causes of death, followed by neoplasms. But average year of life lost in neoplasms was 6.85, higher than circulatory system diseases, 5.63. Cerebrovascular disease and ischemic heart disease were the main causes of death in circulatory system diseases. And average years of life lost in cerebrovascular disease and ischemic heart disease were 5.85 and 5.62, higher than those in other circulatory system diseases. Lung cancer was the principal cause of death in neoplasms. Average year of life lost in liver cancer was 7.92, the highest in neoplasms.

Conclusions

For redeployed miners, YLL rates per 1000 individuals in cerebrovascular disease, ischemic heart disease and lung cancer were higher than those in other populations, especially in men. It is important to attach importance to the health of redeployed miners, take appropriate measures to reduce premature death and achieve the sustainable development goal. Our findings also contribute to a certain theoretical reference for other countries that face or will face the same problem.

Electronic supplementary material

The online version of this article (10.1186/s12992-019-0450-5) contains supplementary material, which is available to authorized users.

Estimated economic costs of coal workers' pneumoconiosis among coal workers redeployed from the Fuxin mining group in China

Our research estimated the economic costs of possible cases of coal workers' pneumoconiosis (CWP) among redeployed coal workers from the Fuxin Mining Industry Group. The study cohort included 19,116 coal workers between 1965 and 2012. We estimated direct and indirect economic costs due to possible current and future CWP cases among redeployed coal workers. We found as of 2012 that 141 possible CWP cases might have resulted in economic costs of $37.52 million ($33.84 million were direct and $3.68 million indirect). Moreover, 221 possible future CWP cases would result in economic costs of $63.89 million ($57.20 million direct and $6.69 million indirect). Neither the Fuxin Mining Industry Group nor Fuxin could cover the costs of CWP screening and diagnosis, or social security payments for redeployed coal workers. We suggest that China's national government help Liaoning Province and Fuxin focus on health care and social security.