BACKGROUND: A large body of evidence demonstrates dose-response relationships of cumulative coal mine dust exposure with lung function impairment and with small-opacity profusion. However, medical literature generally holds that simple coal worker's pneumoconiosis (CWP) is not associated with lung function impairment. Th is study examines the relationship between small-opacity profusion and lung function in US underground coal miners with simple CWP. METHODS: Miners were examined during 2005 to 2013 as part of the Enhanced Coal Workers' Health Surveillance Program. Work histories were obtained, and chest radiographs and spirometry were administered. Lung parenchymal abnormalities consistent with CWP were classifi ed according to International Labor Organization guidelines, and reference values for FEV 1 and FVC were calculated using reference equations derived from the third National Health and Nutrition Examination Survey. Differences in lung function were evaluated by opacity profusion, and regression models were fi t to characterize associations between profusion and lung function. RESULTS: A total of 8,230 miners were eligible for analysis; 269 had category 1 or 2 simple CWP. Decrements in FEV 1 % predicted were nearly consistent across profusion subcategories. Clear decrements in FVC % predicted and FEV 1/FVC were also observed, although these were less consistent. Controlling for smoking status, BMI, and mining tenure, each 1-unit subcategory increase in profusion was associated with decreases of 1.5% (95% CI, 1.0%-1.9%), 1.0% (95% CI, 0.6%-1.3%), and 0.6% (95% CI, 0.4%-0.8%) in FEV 1 % predicted, FVC % predicted, and FEV 1/FVC, respectively. CONCLUSIONS: We observed progressively lower lung function across the range of smallopacity profusion. Th ese fi ndings address a long-standing question in occupational medicine and point to the importance of medical surveillance and respiratory disease prevention in this workforce.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine