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Progressive Massive Fibrosis in Coal Miners From 3 Clinics in Virginia
Since 1970, the Coal Workers' Health Surveillance Program (CWHSP), administered by the National Institute for Occupational Safety and Health, has offered periodic chest radiographs to working US coal miners.1 The primary purpose of the CWHSP is early detection of coal workers' pneumoconiosis to prevent progression to disabling lung disease, including progressive massive fibrosis (PMF). By the late 1990s, PMF was rarely identified among miners participating in the CWHSP. However, a 2014 report documented an increase in the prevalence of PMF in Appalachia.2 On February 1, 2017, the director...
Coal miner participation in a job transfer program designed to prevent progression of pneumoconiosis, United States, 1986–2016
The Part 90 program was designed to prevent progression of pneumoconiosis in U.S. coal miners by establishing their right to transfer to a less dusty job in the mine. We calculated the proportion of Part 90-eligible miners who participated during 1986–2016, examined participation by region, and compared characteristics of miners by participation status. Of the 3,547 eligible miners, 14.4% exercised their Part 90 option. Miners working in states outside central Appalachia, and those with more severe pneumoconiosis, were more likely to participate. The primary goal of respiratory health surveillance...
Resurgence of Progressive Massive Fibrosis in Coal Miners - Eastern Kentucky, 2016
The prevalence of coal workers' pneumoconiosis fell precipitously after implementation of the Coal Mine Health and Safety Act and reached historic lows in the 1990s, with the most severe form, progressive massive fibrosis (PMF), nearly eradicated. Since that time, increases in the prevalence and severity of coal workers' pneumoconiosis have occurred, especially in central Appalachia. During January 1, 2015–August 17, 2016, a total of 60 patients identified through a single radiologist's practice had radiographic findings consistent with PMF; 49 had their radiograph taken during...
Debilitating Lung Disease Among Surface Coal Miners With No Underground Mining Tenure
Objective: To characterize exposure histories and respiratory disease among surface coal miners identified with progressive massive fibrosis from a 2010 to 2011 pneumoconiosis survey. Methods: Job history, tenure, and radiograph interpretations were verified. Previous radiographs were reviewed when available. Telephone follow-up sought additional work and medical history information. Results: Among eight miners who worked as drill operators or blasters for most of their tenure (median, 35.5 years), two reported poor dust control practices, working in visible dust clouds as recently as 2012. Chest...
Expression Levels of Surfactant-Associated Proteins and Inflammation Cytokines in Serum and Bronchoalveolar Lavage Fluid Among Coal Miners
A Case-Control Study Objective: To investigate whether the Th1/Th2 balance and expressions of surfactant-associated proteins and cytokines in serum and bronchoalveolar lavage fluid (BALF) are associated with the development of coal workers' pneumoconiosis (CWP). Methods: A case-control study was conducted among 72 CWP cases and 68 controls. Th1 and Th2 populations were measured by flow cytometry. Expressions of surfactant-associated proteins A and D (SPA and SPD) and cytokines in serum and BALF were detected by enzyme-linked-immunosorbent serologic assay. Data were analyzed by t test and logistic...
Pneumoconiosis and Advanced Occupational Lung Disease Among Surface Coal Miners
16 States, 2010–2011 Coal workers' pneumoconiosis (CWP) is a chronic occupational lung disease caused by long-term inhalation of dust, which triggers inflammation of the alveoli, eventually resulting in irreversible lung damage. CWP ranges in severity from simple to advanced; the most severe form is progressive massive fibrosis (PMF). Advanced CWP is debilitating and often fatal. To prevent CWP, the Coal Mine Health and Safety Act of 1969 established the current federal exposure limit for respirable dust in underground and surface coal mines. The Act also established a surveillance system...

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