Comparison of the Cumulative Incidence Rates of Coal Workers' Pneumoconiosis between 1970 and 2013 among Four State-Owned Colliery Groups in China

Incidence and prevalence of interstitial lung diseases worldwide: a systematic literature review

Interstitial lung disease (ILD) is a collective term representing a diverse group of pulmonary fibrotic and inflammatory conditions. Due to the diversity of ILD conditions, paucity of guidance and updates to diagnostic criteria over time, it has been challenging to precisely determine ILD incidence and prevalence. This systematic review provides a synthesis of published data at a global level and highlights gaps in the current knowledge base. Medline and Embase databases were searched systematically for studies reporting incidence and prevalence of various ILDs. Randomised controlled trials, case reports and conference abstracts were excluded. 80 studies were included, the most described subgroup was autoimmune-related ILD, and the most studied conditions were rheumatoid arthritis (RA)-associated ILD, systemic sclerosis associated (SSc) ILD and idiopathic pulmonary fibrosis (IPF). The prevalence of IPF was mostly established using healthcare datasets, whereas the prevalence of autoimmune ILD tended to be reported in smaller autoimmune cohorts. The prevalence of IPF ranged from 7 to 1650 per 100 000 persons. Prevalence of SSc ILD and RA ILD ranged from 26.1% to 88.1% and 0.6% to 63.7%, respectively. Significant heterogeneity was observed in the reported incidence of various ILD subtypes. This review demonstrates the challenges in establishing trends over time across regions and highlights a need to standardise ILD diagnostic criteria.PROSPERO registration number: CRD42020203035.

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.

Prevalence of coal worker's pneumoconiosis: a systematic review and meta-analysis

Global prevalence trend and regional differences of coal worker's pneumoconiosis (CWP) remain unclear. This study aimed to provide systematic and comprehensive evidence for the global prevalence of CWP. Literature research for studies that reported prevalence of CWP was conducted in PubMed, CNKI, and Web of Science. The identified studies were strictly screened according to predetermined inclusion and exclusion criteria. The pooled prevalence of CWP in different periods and regions was calculated. A total of 37 studies were included after screening, and data from the Coal Workers' Health Surveillance Program was additionally included in the meta-analysis. The global pooled prevalence of CWP decreased from 23.33% (95% confidence interval [CI]: 18.03%, 28.62%) before 1970 to 6.00% (95% CI: 4.11%, 7.90%) in 1981-1990, but indicated a rebound (10.35%, 95% CI: 8.08%, 12.62%) in 1991-2000 and finally dropped to 2.29% (95% CI: 2.06%, 2.51%) in 2011-2020. In the recent 30 years, the top three pooled prevalence of CWP was found in Europe, China, and the USA, respectively. Few articles have reported the prevalence in developing regions, but available evidence indicated that the prevalence in developing regions was much higher than that in developed regions. Higher pooled prevalence was observed in studies which reported larger number of miners in collieries, older average age of miners, underground collieries, and longer dust exposure time. The global prevalence of CWP indicates a rebound in 1990s, but the overall trend is downward in the recent 60 years. The prevention and treatment of CWP should be currently emphasized in developing countries.

Cost-effectiveness of comprehensive preventive measures for coal workers' pneumoconiosis in China

Background

Coal workers’ pneumoconiosis (CWP) remains one of the most severe occupational diseases in China. Despite the implementation of CWP comprehensive preventive measures, the unreasonable allocation of investment by coal enterprises limits the effect of preventing CWP, especially when the health resources are inadequate. This study aims to evaluate the cost-effectiveness of comprehensive measures for CWP from the perspective of coal enterprises.

Methods

Comprehensive measures and two primary interventions (engineering controls and individual protective equipment) were selected. A time-dependent Markov model was developed to evaluate cost and quality-adjusted life-years (QALYs). The input data were collected from the survey and literature. A hypothetical null situation, in which the currently implemented interventions were eliminated, was used as a comparator based on the generalised cost-effectiveness analysis (GCEA) recommended by the World Health Organization (WHO). The primary outcomes of the model were reported in terms of incremental cost-effectiveness ratios (ICERs). Uncertainty was verified using one-way and probabilistic sensitivity analyses.

Results

The QALYs of the comprehensive measures, engineering controls, and individual protective equipment were 17.60, 17.50, and 16.85 years, respectively. Compared with null, the ICERs of the interventions were 65,044.73, 30,865.15, and 86,952.41 RMB/QALY, respectively. Individual protective equipment was dominated by an ICER of -11,416.02 RMB/QALY compared to engineering controls. Sensitivity analysis suggested the robustness of the results.

Conclusions

The comprehensive preventive measures for CWP that are currently implemented in Chinese state-owned mines are cost-effective. In comprehensive measures, engineering controls are more cost-effective than individual protective equipment. Investment in engineering controls should be increased to improve the cost-effectiveness of preventing CWP.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07654-7.

Wetting Mechanism and Experimental Study of Synergistic Wetting of Bituminous Coal with SDS and APG1214

To solve the problem of poor dust wettability during coal mine dust treatment, sodium dodecyl sulfate (SDS) and alkyl glycoside (APG1214) were selected for compounding. An efficient, environmentally friendly, economical wetting agent was prepared. First, through molecular dynamics simulation studies, it was determined that the tail group C of SDS and APG1214 was adsorbed on the surface of bituminous coal, and the head groups S and O were adsorbed on the surface of water. The simulation result is found to be consistent with the surfactant solution dust removal theory, which proves the confidence of simulation. Then, by comparing the interaction of water-SDS and APG1214-bituminous coal and water-bituminous coal systems and the number of hydrogen bonds, the wetting mechanism of the SDS and APG1214 solution on bituminous coal was revealed. Finally, the surface tension, contact angle, and wetting time of different SDS and APG1214 solutions were determined by experiments and they decreased with decreasing mass fraction of SDS at the same concentration. The surface tension of the SDS and APG1214 solution and the number of micelles affected the wettability of bituminous coal. The optimal concentration of the SDS and APG1214 solution was 0.7%, and the optimal ratio was SDS/APG1214 = 1:3.

Association between the IL-6 polymorphisms and coal workers’ pneumoconiosis in a Chinese Hui population

Objective

To determine whether polymorphisms in IL-6 and IL-12 contribute to the etiology of coal workers’ pneumoconiosis (CWP) in a Chinese Hui population, and to evaluate the efficacy and safety of high frequency oscillatory ventilation (HFOV) in the treatment of CWP.

Introduction

Genes and the environments interplay in the development of CWP, and the association between the potential functional polymorphisms in many genes and CWP have been reported.

Methods

We genotyped the IL-6-634C/G (rs1800796) and IL-12B-1188A/C (rs3212227) polymorphisms in a case-control study including 160 CWP patients and 150 dust-exposed control subjects of Chinese Hui population, and analyzed the associations between these genetic variants and CWP risk. We also evaluated the efficacy and safety of HFOV for whole lung lavage (WLL) in the treatment of CWP.

Results

Carrying the C allele of IL-6-634C/G (rs1800796) was associated with decreased risk of CWP ( p < 0.05). No significant differences in allele or genotype frequencies of IL-12B-1188A/C was found between the CWP cases and control subjects ( p > 0.05). Compared with CWP patients with routine WLL, CWP patients received HFOV showed better pulmonary functions. HFOV treatment also yield a significant higher efficient rate (97.50%) than WLL treatment (81.25%, p = 0.001). CWP patients receiving HFOV and WLL treatment both showed significantly increased serum contents of Clara cell protein 16 (CC16) and superoxide dismutase (SOD), and decreased serum contents of serum malonaldehyde (MDA). While the increasing of CC16 and SOD, and decreasing of MDA in patients receiving HFOV was more noticeable than patients receiving WLL.

Conclusions

Taking together, the −634C/G polymorphisms in IL-6 play a role in the etiology of CWP. HFOV, when applied in CWP patients, significant improves their pulmonary functions.

Mining is bad for health: a voyage of discovery

Mining continues to be a dangerous activity, whether large-scale industrial mining or small-scale artisanal mining. Not only are there accidents, but exposure to dust and toxins, along with stress from the working environment or managerial pressures, give rise to a range of diseases that affect miners. I look at mining and health from various personal perspectives: that of the ordinary man (much of life depends on mined elements in the house, car and phone); as a member of the Society for Environmental Geochemistry and Health (environmental contamination and degradation leads to ill health in nearby communities); as a public health doctor (mining health is affected by many factors, usually acting in a mix, ranging from individual inheritance-genetic makeup, sex, age; personal choices-diet, lifestyle; living conditions-employment, war; social support-family, local community; environmental conditions-education, work; to national and international constraints-trade, economy, natural world); as a volunteer (mining health costs are not restricted to miners or industry but borne by everyone who partakes of mining benefits-all of us); and as a lay preacher (the current global economy concentrates on profit at the expense of the health of miners). Partnership working by academics with communities, government and industry should develop evidence-based solutions. Employment, health, economic stability and environmental protection need not be mutually exclusive. We all need to act.

Pulmonary rehabilitation for pneumoconiosis: protocol for a systematic review and meta-analysis

INTRODUCTION

Pneumoconiosis is characterised by diffuse fibrosis in lung tissue, and its incidence is on the rise. At present, there are limited therapeutic options for pneumoconiosis. Pulmonary rehabilitation (PR) has been widely used to treat pneumoconiosis，however, there is limited evidence concerning its efficacy. Therefore, we plan to conduct a systematic review to investigate the efficacy and safety of PR for pneumoconiosis.

METHODS AND ANALYSIS

The following databases will be searched from their inception to 1 April 2019: PubMed, Embase, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chongqing VIP and Wanfang Data. Randomised controlled trials of PR for pneumoconiosis will be included. Primary outcomes will include 6 min walk distance and St. George's Respiratory Questionnaire. Study selection, extraction of data and assessment of study quality each will be independently undertaken. Statistical analysis will be conducted using Review Manager software.

ETHICS AND DISSEMINATION

This systematic review will provide up-to-date information on PR for pneumoconiosis. The review does not require ethical approval and will be disseminated electronically through a peer-reviewed publication or conference presentations.

PROSPERO REGISTRATION NUMBER

CRD42018095266.

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.

Time trends and future prediction of coal worker's pneumoconiosis in opencast coal mine in China based on the APC model

BACKGROUND

The opencast coal mine is a specific mine differing from the underground mine. There are differences in the way into the ore body, the organization of production, transport technology and other aspects. This study aimed to describe the prevalence of CWP among ex-dust miners in opencast coal mines and estimate the incidence trend of CWP by APC model in the future.

METHODS

All opencast miners who had been exposed to dust for at least 1 year in opencast mines were enrolled in this study. The database included demographic details, occupational history records with the date of dust exposure, physical examination records and pneumoconiosis diagnosis records. An age-period-cohort (APC) model has been carried out in order to explore the effects of the age, period and cohort on the prevalence of CWP among ex-dust opencast miners.

RESULTS

8191 opencast miners were enrolled in the study, including 259 miners with CWP and 7932 miners without CWP. The incidence density of CWP would have an increasing trend in opencast mines from 2005 to 2024. The number of possible CWP patients predicted in this period was approximately 492. Of them, 275 miners could have suffered from CWP in 2005-2014 and 217 miners would suffer from CWP in 2015-2024 among the ex-dust opencast miners.

CONCLUSIONS

The APC model had a goodness of fit in predicting the incidence trend of CWP in opencast coal mines. By this model, we predicted that 492 opencast miners could be diagnosed as CWP from 2005 to 2024. Therefore ex-dust opencast miners cannot be ignored and they should have regular physical examinations and detection for CWP.

Establishment and application of an index system for prevention of coal workers' pneumoconiosis: a Delphi and analytic hierarchy process study in four state-owned coal enterprises of China

OBJECTIVE

To explore the difference of cumulative incidence rate of coal workers' pneumoconiosis (CWP) among four large state-owned coal enterprises in northern China, we created an index system for evaluating the quality of comprehensive measures against CWP and applied the system to evaluate and compare the measures of the four coal enterprises.

METHODS

A two-round Delphi investigation was conducted to identify the indicators in the index system. The weight values of the indicators were calculated with analytic hierarchy process methods. Measures of CWP, mine annals, records and other information in each coal mine of the four enterprises were collected. The evaluation scores, which ranged from 0 to 100, were calculated and compared with.

RESULTS

A three-grade index system with 3 first-grade indicators, 9 second-grade indicators and 44 tertiary-grade indicators was established. The expert authority coefficient (C_r ) was 0.75 and the Kendall's coefficient of concordance (Kendall's W) was 0.15 (χ²=193.30, P<0.001). The weight value of 'Geological conditions' was 0.43, equal to 'Dust control engineering technology', and that of 'Occupational health management' was 0.14. The medians and quartiles of the evaluation scores of comprehensive measures against CWP of the four enterprises were 58.38 (54.60~63.02), 64.63 (60.83~67.06), 72.99 (68.92~77.67) and 75.07 (70.73~79.20), respectively.

CONCLUSIONS

The index system could be effectively used for evaluation and comparison of the comprehensive measures against CWP among different enterprises. The geological conditions and dust control engineering technology played an important role in preventing and controlling CWP.

Mannan-binding lectin, a serum collectin, suppresses T-cell proliferation via direct interaction with cell surface calreticulin and inhibition of proximal T-cell receptor signaling

Mannan binding lectin (MBL), initially reported to activate the complement pathway, is also known to be involved in the pathogenesis of autoimmune diseases. We report a thus far unknown function of MBL as a suppressor of T-cell activation. MBL markedly inhibited T-cell proliferation induced by anti-CD3 and anti-CD28 antibodies. Moreover, the presence of MBL during T-cell priming interfered with proximal T-cell receptor signaling by decreasing phosphorylation of Lck, ZAP-70, and LAT. MBL bound to T cells through interaction between the collagen-like region of MBL and calreticulin (CRT) expressed on the T-cell surface. The neutralizing antibody against CRT abrogated MBL-mediated suppression of T-cell proliferation, suggesting that MBL down-modulates T-cell proliferation via cell surface CRT. We further demonstrated that the feature of MBL-mediated T-cell suppression is shared by other serum collectins (e.g., C1q and collectin 11). The concentrations of MBL correlated negatively with in vivo T-cell activation status in patients with early-stage silicosis. Furthermore, MBL efficiently inhibited activation and proliferation of autoreactive T cells derived from patients with silicosis, indicating that MBL serves as a negative feedback control of the T-cell responses.-Zhao, N., Wu, J., Xiong, S., Zhang, L., Lu, X., Chen, S., Wu, Q., Wang, H., Liu, Y., Chen, Z., Zuo, D. Mannan-binding lectin, a serum collectin, suppresses T-cell proliferation via direct interaction with cell surface calreticulin and inhibition of proximal T-cell receptor signaling.