Quantified pathology of emphysema, pneumoconiosis, and chronic bronchitis in coal workers

Abstract

ABSTRACr From a continuous series of 886 postmortem examinations on coal mine workers in New South Wales, Australia, from 1949 to 1982 and their histories the following data were obtained: age at death (886 cases), percentage of emphysema in both lungs (Heard method) (870 cases), bronchial gland wall (G-W) ratio (Reid Index) (412 cases), chest radiograph within 10 years of death (792 cases), history of work at the coal face (844 cases), history of amount of tobacco smoked (606 cases), and FEV, five years before death (278 cases). Linear regression analysis showed the following: (1) The severity of emphysema had a significant positive regression on years of face work independently of age at death. (2) The severity of emphysema had a significant positive regression on the severity of x-ray pneumoconiosis, which was best defined in the non-smoking group and the non-bronchitic group. (3) There was a significant multiple linear regression relationship between severity of emphysema (dependent variable) and pneumoconiosis and G-W (independent variables). The ratio of standardised regression coefficients was pneumoconiosis: G-W = 3:1. (4) The severity of x-ray pneumoconiosis had a significant positive regression on years of face work and a negative regression on smoking amount. (5) G-W ratio had significant positive regressions on age of death and severity of emphysema but not years of face work or severity of pneumoconiosis. (6) Smoking was not correlated with severity of emphysema or G-W ratio. (7) FEV, (% predicted) was significantly negatively correlated with bronchitis, emphysema, and pneumoconiosis. (8) Severity of pneumoconiosis and emphysema have declined slightly but significantly over the 33 year period, but there has been no significant change in G-W ratio during 1960-82.The analyses of postmortem data obtained from the lungs of 186 coal workers and associated clinical and physiological data from the same workers have allowed several conclusions to be drawn about pneumoconiosis, emphysema, and bronchitis in the coal industry.' The main conclusions were:(1) There is a quantitative relationship between the severity of emphysema postmortem and the postmortem severity of pneumoconiosis or x-ray pneumoconiosis in radiographs taken less than five years before death.(2) Both postmortem emphysema and postmortem pneumoconiosis are quantitatively related to

Respiratory outcomes among South African coal miners at autopsy

“…Cockroft et al [1982] showed an OR of 10.9 for emphysema, comparing coal workers to non-coal workers. Dose-response relationships between emphysema and dust, adjusting for smoking, have been also reported [Leigh et al, 1983;Ruckley et al, 1984]. None of these exposure variables are directly comparable to those used in our study.…”

“…Significant dose response relationships have been described in studies using different metrics of exposure, viz. cumulative exposure to respirable dust [Ruckley et al, 1984] and years worked at the coal face [Leigh et al, 1983].…”

Understanding the Chemical Properties of Macerals and Minerals in Coal and its Potential Application for Occupational Lung Disease Prevention

“…Among the respiratory diseases, CWP received the most attention because of its clear occupational association. Asthma, emphysema, and chronic bronchitis in coal workers show a significant positive correlation with (a) the number of years worked at the coal mine independent of age at death; and (b) the severity of pneumoconiosis (Leigh et al, 1983(Leigh et al, , 1994. While mining exposures contribute significantly to lung disease, smoking is an important factor in the development of lung cancer and COPD, thus necessitating a comprehensive approach for prevention and control of mining-related occupational lung disease Ross & Murray, 2004).…”

Contributions of Dust Exposure and Cigarette Smoking to Emphysema Severity in Coal Miners in the United States

“…Emphysema develops in coal miners in association with pneumoconiosis (9, 10, 21). Leigh and colleagues (36) found that emphysema severity was significantly higher among individuals with pneumoconiosis compared with those with minimal or no pneumoconiosis (36). Ruckley and colleagues (9) showed positive associations between coal dust lung burden and the presence of emphysema in miners at autopsy, which increased with the severity of pneumoconiosis but achieved significance only among those with progressive massive fibrosis.…”