239585 Radiographic findings from the National Institute for Occupational Safety and Health (NIOSH), Enhanced Coal Workers' Health Surveillance Program (ECWHSP)--2005-2009

Sunday, October 30, 2011

A. Scott Laney, PhD , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety, Morgantown, WV
Edward L. Petsonk, MD, FCCP , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety, Morgantown, WV
Anita Wolfe, BS , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety, Morgantown, WV
Janet Hale, MS , Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, National Institute for Occupational Safety, Morgantown, WV
Objective: Geographic clustering of a rapidly progressing form of coal workers' pneumoconiosis (CWP) was recently reported. NIOSH sought to better define the scope and magnitude of the problem, and identify plausible causes to facilitate prevention of occupational respiratory disease among coal miners.

Methods: Between 2005 and 2009, the NIOSH-administered ECWHSP utilized a mobile examination unit to obtain chest radiographs (CXRs) from US coal miners. NIOSH B Readers interpreted the CXRs according to the International Labour Office Classification of Radiographs of Pneumoconioses.

Results: A total of 6,658 miners from 15 states provided CXRs. The prevalence of CWP was higher in a three state region (Kentucky: 9.0%, Virginia: 8.0%, and West Virginia: 4.8%), compared to the 12 other coal mining states (RR=4.1; 95% CI=3.0ĘC5.5). Miners in these three states had high rates of r-type opacities on their CXRs (RR=7.3; 95% CI=3.7ĘC14.6), advanced CWP (small opacity profusion ≥2/1, RR=7.7; 95% CI=3.7ĘC16.0), and progressive massive fibrosis (PMF, the most severe form of CWP, RR=10.0; 95% CI=3.6ĘC27.8). Irrespective of mining region, workers currently at mines with fewer than 100 employees had a higher prevalence of CWP, PMF, r-type opacities, and advanced CWP, compared to mines with 100 or more employees.

Conclusion: Results from the NIOSH ECWHSP confirm the ongoing elevated prevalence of severe forms of CWP among Appalachian bituminous coal miners, and also the increased burden of disease among miners currently working in smaller mines. Coal miner dust exposures must be reduced to address the continuing problem of occupational lung disease.

Learning Areas:
Epidemiology
Occupational health and safety

Learning Objectives:
Discuss the current epidemic of coal workers' pneumoconiosis (CWP). Describe the elevated prevalence of progressive massive fibrosis and severe CWP among US coal miners.

Keywords: Occupational Disease, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I analyzed the data for this presentation.
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.