218702 Risk factors associated with progressive massive fibrosis among U.S. coal miners a case-control study

Wednesday, November 10, 2010 : 12:30 PM - 12:48 PM

Mei Lin Wang, MD, MPH , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV
John M. Wood, MS , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV
Janet Hale, MS , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV
Edward L. Petsonk, MD, FCCP , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV
Michael D. Attfield, PHD , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV
Rationale: Progressive Massive Fibrosis (PMF) is the most disabling form of pneumoconiosis. This study aims to investigate the risk factors associated with PMF in coal miners. Methods: PMF cases were determined by International Labour Office (ILO) classification of radiographs of pneumoconiosis based on final readings of last x-ray taken in the NIOSH Coal Workers' X-Ray Surveillance Program (CWXSP) during 1970 to 2000. A 1 to 1 matched case-control approach was used (controls having no PMF), yielding 314 pairs for assessment of PMF risk factors, including coal dust and quartz exposures, coal rank, and x-ray appearances. Results: Cumulative coal dust and quartz exposures were higher in cases (102.7 vs. 82.9 mg/m3-yrs, p<0.0001; and 2.48 versus 1.54 mg/m3-yrs, p = 0.0002, respectively). Cases were more likely from mines with higher coal rank than controls (21.4% vs. 13.9%, p=0.0023). The small opacity profusion on average was 4 minor categories higher in PMF cases (equivalent to category 2/2 versus 1/0, p< 0.0001). Among cases and controls with small opacities on chest radiograph, the small opacity r shape was present in 44% of cases versus 15% of controls (p<0.0001). The logistic regression for matched case-control analysis resulted that the odds of having PMF was 3.1, 1.6 and 2.4 times higher among miners in the fourth quartile of coal dust and quartz exposures, and in higher coal rank of coal mines, respectively. Conclusion: Coal dust and quartz exposures, higher coal rank, higher small opacity profusion and r shaped opacities were significantly related to PMF.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Occupational health and safety
Other professions or practice related to public health

Learning Objectives:
Progressive Massive Fibrosis (PMF) is the most disabling form of pneumoconiosis. This study aims to assess the risk factors associated with PMF in coal miners.

Keywords: Occupational Disease, Occupational Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I design, conduct the analysis of the data collected by NIOSH Coal Workers X-Ray Surveillance program
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.