Pathology and Mineralogy Demonstrate Respirable Crystalline Silica Is a Major Cause of Severe Pneumoconiosis in US Coal Miners

dc.contributor.authorCohen, Robert A.en
dc.contributor.authorRose, Cecile S.en
dc.contributor.authorGo, Leonard H. T.en
dc.contributor.authorZell-Baran, Lauren M.en
dc.contributor.authorAlmberg, Kirsten S.en
dc.contributor.authorSarver, Emily A.en
dc.contributor.authorLowers, Heather A.en
dc.contributor.authorIwaniuk, Caylaen
dc.contributor.authorClingerman, Sidney M.en
dc.contributor.authorRichardson, Diana L.en
dc.contributor.authorAbraham, Jerrold L.en
dc.contributor.authorCool, Carlyne D.en
dc.contributor.authorFranko, Angela D.en
dc.contributor.authorHubbs, Ann F.en
dc.contributor.authorMurray, Jillen
dc.contributor.authorOrandle, Marlene S.en
dc.contributor.authorSanyal, Somaen
dc.contributor.authorVorajee, Naseema, Ien
dc.contributor.authorPetsonk, Edward L.en
dc.contributor.authorZulfikar, Rafiaen
dc.contributor.authorGreen, Francis H. Y.en
dc.description.abstractRationale: The reasons for resurgent coal workers' pneumoconiosis and its most severe forms, rapidly progressive pneumoconiosis and progressive massive fibrosis (PMF), in the United States are not yet fully understood. Objectives: To compare the pathologic and mineralogic features of contemporary coal miners with severe pneumoconiosis with those of their historical counterparts. Methods: Lung pathology specimens from 85 coal miners with PMF were included for evaluation and analysis. We compared the proportion of cases with pathologic and mineralogic findings in miners born between 1910 and 1930 (historical) with those in miners born in or after 1930 (contemporary). Results: We found a significantly higher proportion of silica-type PMF (57% vs. 18%; P < 0.001) among contemporary miners compared with their historical counterparts. Mineral dust alveolar proteinosis was also more common in contemporary miners compared with their historical counterparts (70% vs. 37%; P < 0.01). In situ mineralogic analysis showed that the percentage (26.1% vs. 17.8%; P < 0.01) and concentration (47.3310(8) vs. 25.8310(8) particles/cm(3); P = 0.036) of silica particles were significantly greater in specimens from contemporary miners compared with their historical counterparts. The concentration of silica particles was significantly greater when silica-type PMF, mineral dust alveolar proteinosis, silicotic nodules, or immature silicotic nodules were present (P < 0.05). Conclusions: Exposure to respirable crystalline silica appears causal in the unexpected surge of severe disease in contemporary miners. Our findings underscore the importance of controlling workplace silica exposure to prevent the disabling and untreatable adverse health effects afflicting U.S. coal miners.en
dc.description.notesSupported by Alpha Foundation for the Improvement of Mine Safety and Health grant AFC417-1. The findings and conclusions in this report 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, or Alpha Foundation for the Improvement of Mine Safety and Health, Inc. Any use of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the U.S. government.en
dc.description.sponsorshipAlpha Foundation for the Improvement of Mine Safety and Health [AFC417-1]en
dc.description.versionPublished versionen
dc.publisherAmerican Thoracic Societyen
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.subjectcoal workersen
dc.titlePathology and Mineralogy Demonstrate Respirable Crystalline Silica Is a Major Cause of Severe Pneumoconiosis in US Coal Minersen
dc.title.serialAnnals of the American Thoracic Societyen
dc.typeArticle - Refereeden


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