Evaluation of the relationship between radiological abnormalities and both pulmonary function and pulmonary hypertension in coal workers’ pneumoconiosis

Yildiz, Öznur Akkoca; Gülbay, Banu Eriş; Saryal, Sevgi; Karabıyıkoğlu, Gülseren

doi:10.1111/j.1440-1843.2007.01031.x

Cited by 18 publications

(6 citation statements)

References 25 publications

(36 reference statements)

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“…30,34,36 The current findings differ from the widely held historical literature and modern medical text dictums that there is no relationship between radiographic profusion and lung function in those with simple CWP. 11–21 International studies have reported similar results, 24–28 but these findings build on the work of Wang and colleagues 38 by classifying small opacity profusion using ILO subcategories and by focusing on a modern sample of U.S. coal miners.…”

Section: Discussionsupporting

confidence: 55%

“…Research from the United Kingdom’s Medical Research Council Pneumoconiosis Research Unit during the 1950s and 1960s generally reported no association between increasing profusion of small opacities and worse lung function among those with simple CWP, 11–13 as did later studies of U.S. coal miners. 14–17 Medical textbooks have tended to perpetuate the early view, 18–21 despite much of that early work having been called into question, 22,23 and a number of international studies of coal miners in Britain, 24,25 China, 26 South Africa, 27 and Turkey 28 reporting lung function impairment among coal miners with simple CWP.…”

Section: Introductionmentioning

confidence: 99%

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Profusion of Opacities in Simple Coal Worker's Pneumoconiosis Is Associated With Reduced Lung Function

Blackley¹,

Laney

Halldin

et al. 2015

Chest

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Background A large body of evidence demonstrates dose-response relationships of cumulative coal mine dust exposure with lung function impairment and with small opacity profusion. However, medical literature generally holds that simple coal workers’ pneumoconiosis (CWP) is not associated with lung function impairment. This study examines the relationship between small opacity profusion and lung function in U.S. underground coal miners with simple CWP. Methods Miners were examined during 2005–2013 as part of the Enhanced Coal Workers’ Health Surveillance Program. Work histories were obtained, and chest radiographs and spirometry were administered. For those with multiple Program encounters, the most recent visit was used. Lung parenchymal abnormalities consistent with CWP were classified according to International Labour Organization guidelines, and reference values for FEV1 and FVC were calculated using reference equations derived from the 3rd National Health and Nutrition Examination Survey. Differences in lung function were evaluated by opacity profusion, and regression models were fit to characterize associations between profusion and lung function. Results A total of 8,230 miners were eligible for analysis; 269 had category 1 or 2 simple CWP. Decrements in FEV1 percent predicted were nearly consistent across profusion subcategories. Clear decrements in FVC percent predicted and FEV1/FVC were also observed, although these were less consistent. Controlling for smoking status, BMI, and mining tenure, each one-unit subcategory increase in profusion was associated with decreases of 1.5% (95% CI 1.0% to 1.9%), 1.0% (95% CI 0.6% to 1.3%), and 0.6% (95% CI 0.4% to 0.8%) in FEV1 percent predicted, FVC percent predicted, and FEV1/FVC, respectively. Conclusions We observed progressively lower lung function across the range of small opacity profusion. These findings address a longstanding question in occupational medicine, and point to the importance of medical surveillance and respiratory disease prevention in this workforce.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Profusion of Opacities in Simple Coal Worker's Pneumoconiosis Is Associated With Reduced Lung Function

Blackley¹,

Laney

Halldin

et al. 2015

Chest

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“…Morphologic changes in the vasculature, which may be attributable to chronic hypoxia, are commonly seen in PMF as the result of dust accumulation and fibrosis 26. In addition, the PAPm is correlated with the profusion score of small opacities and decreased DLCO in patients with simple pneumoconiosis, which indicates that the extent of interstitial involvement may be a factor in the development of PH in pneumoconiosis 27. In the current study, although the PaO 2 , FEV 1 /FVC ratio and DLCO of patients with PMF were significantly lower in the PH group, multiple logistic regression revealed that only reduced PaO 2 and DLCO were significantly associated with PH in PMF while they only had little influence on the development of PH.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary hypertension in patients with pneumoconiosis with progressive massive fibrosis

Fan

et al. 2022

Occup Environ Med

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ObjectivesThis study aims to explore the prevalence and clinical features of pulmonary hypertension (PH) in patients with progressive massive fibrosis (PMF) and its correlation with large opacities on CT scans.MethodsThis retrospective study collected 235 patients with PMF, and 199 were eligible for analysis. The probability of PH development was estimated based on tricuspid regurgitation velocity measured by echocardiogram. The size and the location of large opacities on chest CT were recorded. Potential risk factors for PH secondary to PMF were analysed using regression analysis.ResultsThe prevalence of a high or intermediate probability of PH was 39.7% in patients with PMF. Type C of large opacities (OR 6.99, 95% CI 2.34 to 23.00, p<0.001) and central type of the large opacities (OR 8.12, 95% CI 2.89 to 24.71, p<0.001) were identified as the risk factors for PH secondary to PMF. Over a median follow-up of 32.8 months, the survival rate was 73.3% in the PH group, significantly lower than that in the non-PH group (96.6%, p<0.001).ConclusionsOver one-third of patients with PMF developed PH. The increased size and the central distribution of large opacities were identified as the risk factors.

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“…Bauer et al did not find an association between perfusion score and pulmonary function or blood gas parameters [16]. On the other hand, there are studies showing that the perfusion score is associated with airway limitation [32,33]. It is also known that the presence of emphysema may reduce accuracy of reading of perfusion on chest radiographs [4,7].…”

Section: Discussionmentioning

confidence: 99%

Emphysema and Airflow Obstruction in Non-Smoking Coal Miners with Pneumoconiosis

et al. 2016

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BackgroundAccumulating evidence shows that functional impairment in subjects with coal workers’ pneumoconiosis (CWP) is principally due to emphysema and airflow obstruction, rather than underlying restrictive mechanisms. However, cigarette smoking has remained a major confounder. The aim of this study was to assess whether coal dust exposure was associated with emphysema and/or airflow obstruction in the absence of smoking history.Material/MethodThe subjects evaluated for possible pneumoconiosis between 2013 and 2015 were retrospectively enrolled into this study. After excluding those with history of smoking, tuberculosis, or lung cancer, the study population was a total of 57 subjects. The emphysema severity and airflow obstruction were quantified by computed tomographic densitometry analysis and spirometry, respectively. For comparability regarding emphysema, 9 age- and sex-matched nonsmoker (n=9) control subjects without known lung disease were randomly selected from a radiology database.ResultsEmphysema severity was significantly higher in the CWP group compared with the control group (15% vs. 4%, p<0.001). The median percent emphysema and percentage of those with FEV1/FVC <0.7 was 13% and 37% in subjects with simple CWP and 18% and 67% in subjects with complicated CWP, respectively. Percent emphysema and Perc15 (15th percentile of the attenuation curve) was correlated with FEV1/FVC (r=−0.45, r=−0.47) and FEF25–75 (r=−0.36, r=−0.56), respectively, but not with perfusion score. A linear regression analysis showed that factors associated with emphysema were FEV1/FVC (β=−0.24, p=0.009) and large opacity (β=−3.97, p=0.079), and factors associated with FEV1/FVC were percent emphysema (β=−0.51, p=0.018) and tenure (β=−0.63, p=0.044).ConclusionsOur results support the observation that coal dust exposure is associated with emphysema and airflow obstruction, independent of smoking status.

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Evaluation of the relationship between radiological abnormalities and both pulmonary function and pulmonary hypertension in coal workers’ pneumoconiosis

Cited by 18 publications

References 25 publications

Profusion of Opacities in Simple Coal Worker's Pneumoconiosis Is Associated With Reduced Lung Function

Profusion of Opacities in Simple Coal Worker's Pneumoconiosis Is Associated With Reduced Lung Function

Pulmonary hypertension in patients with pneumoconiosis with progressive massive fibrosis

Emphysema and Airflow Obstruction in Non-Smoking Coal Miners with Pneumoconiosis

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