TY - JOUR
T1 - Progressive massive fibrosis resurgence identified in U.S. Coal miners filing for black lung benefits, 1970-2016
AU - Almberg, Kirsten S.
AU - Halldin, Cara N.
AU - Blackley, David J.
AU - Scott Laney, A.
AU - Storey, Eileen
AU - Rose, Cecile S.
AU - Go, Leonard H.T.
AU - Cohen, Robert Andrew
N1 - Funding Information:
Supported by National Occupational Research Agenda intramural funding from the National Institute for Occupational Safety and Health and a grant from the Alpha Foundation for the Improvement of Mining Safety and Health, Inc. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. The views, opinions, and recommendations addressed herein are solely those of the authors and do not imply any endorsement by the Alpha Foundation, its directors, and staff.
Publisher Copyright:
Copyright © 2018 by the American Thoracic Society.
PY - 2018/12
Y1 - 2018/12
N2 - Rationale: There has been a resurgence of progressive massive fibrosis (PMF) in the United States, particularly among central Appalachian miners. Objectives: We characterized the proportion of PMF among former U.S. coal miners applying for Federal Black Lung Program benefits, 1970-2016. Methods: Data from the U.S. Department of Labor were used to characterize trends in proportion of PMF cases, defined as an approved black lung claim with a determination of PMF, among all miners who filed for federal benefits between January 1, 1970, and December 31, 2016. Joinpoint, logistic, and linear regression models were used to identify changes in the proportion of claimants with PMF over time. Results: There were 4,679 unique PMF cases among claimants for federal black lung benefits between 1970 and 2016, with 2,474 miners determined to have PMF since 1996. The number of PMF cases among Federal Black Lung Program claimants fell from 404 (0.5% of claimants) in 1978 to a low of 18 cases (0.6%) in 1988, and then increased to 353 cases (8.3%) in 2014. The proportion of federal black lung benefits claimants with PMF has been increasing since 1978 (0.06% annual percent change [APC]; 95% confidence interval [CI], 0.05-0.07%; P, 0.0001), and began increasing at a significantly increased rate after 1996 (0.26% APC; 95% CI, 0.25-0.28%; P, 0.0001). Most miners with PMF (84%) last mined in West Virginia, Kentucky, Pennsylvania, or Virginia. Since 1970, the proportion of claimants with PMF has increased significantly among miners who last worked in Kentucky (16.6% APC; 95% CI, 16.5-16.7%), Pennsylvania (4.7% APC; 95% CI, 4.6-4.8%), Tennessee (16.1% APC; 95% CI, 15.7-16.4%), West Virginia (16.8% APC; 95% CI, 16.6-16.9%), and most sharply among miners last working in Virginia (31.5% APC; 95% CI, 31.2-31.7%), where in 2009, more than 17% of claimants received a PMF determination. The proportion of PMF determinations for the rest of the United States has not exceeded 4%. Conclusions: There has been a resurgence of PMF, particularly in central Appalachian miners. The resurgence of this preventable disease points to the need for improved primary and secondary prevention of dust-related lung disease in U.S. coal miners.
AB - Rationale: There has been a resurgence of progressive massive fibrosis (PMF) in the United States, particularly among central Appalachian miners. Objectives: We characterized the proportion of PMF among former U.S. coal miners applying for Federal Black Lung Program benefits, 1970-2016. Methods: Data from the U.S. Department of Labor were used to characterize trends in proportion of PMF cases, defined as an approved black lung claim with a determination of PMF, among all miners who filed for federal benefits between January 1, 1970, and December 31, 2016. Joinpoint, logistic, and linear regression models were used to identify changes in the proportion of claimants with PMF over time. Results: There were 4,679 unique PMF cases among claimants for federal black lung benefits between 1970 and 2016, with 2,474 miners determined to have PMF since 1996. The number of PMF cases among Federal Black Lung Program claimants fell from 404 (0.5% of claimants) in 1978 to a low of 18 cases (0.6%) in 1988, and then increased to 353 cases (8.3%) in 2014. The proportion of federal black lung benefits claimants with PMF has been increasing since 1978 (0.06% annual percent change [APC]; 95% confidence interval [CI], 0.05-0.07%; P, 0.0001), and began increasing at a significantly increased rate after 1996 (0.26% APC; 95% CI, 0.25-0.28%; P, 0.0001). Most miners with PMF (84%) last mined in West Virginia, Kentucky, Pennsylvania, or Virginia. Since 1970, the proportion of claimants with PMF has increased significantly among miners who last worked in Kentucky (16.6% APC; 95% CI, 16.5-16.7%), Pennsylvania (4.7% APC; 95% CI, 4.6-4.8%), Tennessee (16.1% APC; 95% CI, 15.7-16.4%), West Virginia (16.8% APC; 95% CI, 16.6-16.9%), and most sharply among miners last working in Virginia (31.5% APC; 95% CI, 31.2-31.7%), where in 2009, more than 17% of claimants received a PMF determination. The proportion of PMF determinations for the rest of the United States has not exceeded 4%. Conclusions: There has been a resurgence of PMF, particularly in central Appalachian miners. The resurgence of this preventable disease points to the need for improved primary and secondary prevention of dust-related lung disease in U.S. coal miners.
KW - Black lung benefits
KW - Coal mine dust
KW - Coal workers' pneumoconiosis
KW - Progressive massive fibrosis
UR - http://www.scopus.com/inward/record.url?scp=85057533595&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85057533595&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.201804-261OC
DO - 10.1513/AnnalsATS.201804-261OC
M3 - Article
C2 - 30114941
AN - SCOPUS:85057533595
SN - 2325-6621
VL - 15
SP - 1420
EP - 1426
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 12
ER -