Underground U.S. coal miners were studied cross-sectionally for the association of respirable coal mine dust exposure with pulmonary function and symptoms of airways obstruction. The study group included 1,185 miners participating in Round 4 of the National Study of Coal Workers' Pneumoconiosis who had started mining in or after 1970 when comprehensive exposure regulations first came into effect. Quantitative estimates of cumulative exposure, derived using respirable dust measurements taken by the Mine Safety and Health Administration over the entire study period, were used in linear and logistic regression models on indicators of pulmonary function and chest symptoms while controlling for smoking status, pack-years, and other potential confounders. Statistically significant associations between log cumulative exposure and decrements in FVC, FEV1, and FEV1/FVC were observed. In logistic models, statistically significant associations of cumulative exposure with increasing prevalence of FEV1 and FEV1/FVC less than 80% predicted and symptoms including chronic phlegm, chronic bronchitis, breathlessness, wheeze, and wheeze with shortness of breath were found. It is concluded that exposures to respirable coal mine dust present in U.S. mines since 1970 continue to affect respiratory health in underground miners.

Deals with interstitial lung diseases and includes clinical, pathologic, radiologic and physiologic evaluation of the patient with ILD. This book covers a wide array of disorders, sarcoidosis, asbestosis, hypersensitivity pneumonitis, drug induced lung disease, connective tissue disease and pulmonary vasculitis, to name but a few.

"Respirable dust exposure has long been known to be a serious health threat to workers in many industries. In coal mining, overexposure to respirable coal mine dust can lead to coal workers' pneumoconiosis (CWP). CWP is a lung disease that can be disabling and fatal in its most severe form. In addition, miners can be exposed to high levels of respirable silica dust, which can cause silicosis, another disabling and/or fatal lung disease. Once contracted, there is no cure for CWP or silicosis. The goal, therefore, is to limit worker exposure to respirable dust to prevent development of these diseases. The passage of the Federal Coal Mine Health and Safety Act of 1969 established respirable dust exposure limits, dust sampling requirements for inspectors and mine operators, a voluntary x-ray surveillance program to identify CWP in underground coal miners, and a benefits program to provide compensation to affected workers and their families. The tremendous human and financial costs resulting from CWP and silicosis in the U.S. underground coal mine workforce are shown by the following statistics: 1. During 1970-2004, CWP was a direct or contributing cause of 69,377 deaths of U.S. underground coal mine workers. 2. During 1980-2005, over $39 billion in CWP benefits were paid to underground coal miners and their families. 3. Recent x-ray surveillance data for 2000-2006 show an increase in CWP cases. Nearly 8% of examined underground coal miners with 25 or more years of experience were diagnosed with CWP. 4. "Continuous miner operator" is the most frequently listed occupation on death certificates that record silicosis as the cause of death. In light of the ongoing severity of these lung diseases in coal mining, this handbook was developed to identify available engineering controls that can help the industry reduce worker exposure to respirable coal and silica dust. The controls discussed in this handbook range from long-utilized controls that have developed into industry standards to newer controls that are still being optimized. The intent was to identify the best practices that are available to control respirable dust levels in underground and surface coal mining operations. This handbook provides general information on the control technologies along with extensive references. In some cases, the full reference(s) will need to be consulted to gain in-depth information on the testing or implementation of the control of interest. The handbook is divided into five chapters. Chapter 1 discusses the health effects of exposure to respirable coal and silica dust. Chapter 2 discusses dust sampling instruments and sampling methods. Chapters 3, 4, and 5 focus on dust control technologies for longwall mining, continuous mining, and surface mining, respectively. Finally, it must be stressed that after control technologies are implemented, the ultimate success of ongoing protection for workers depends on continued maintenance of these controls. NIOSH researchers have often seen appropriate controls installed, but worker overexposures occurred because of the lack of proper maintenance of these controls." - NIOSHTIC-2

"Information relating to occupational pulmonary disease morbidity and mortality of coal miners available up to 1995 was reviewed in the NIOSH publication: Criteria for a Recommended Standard - Occupational Exposure to Respirable Coal Mine Dust, or Coal Criteria Document (CCD). This led to the following principal conclusions concerning health effects associated with coal mining: 1. Exposure to coal mine dust causes various pulmonary diseases, including coal workers' pneumoconiosis (CWP) and chronic obstructive pulmonary disease (COPD). 2. Coal miners are also exposed to crystalline silica dust, which causes silicosis, COPD, and other diseases. 3. These lung diseases can bring about impairment, disability and premature death. This Current Intelligence Bulletin updates the previously published review with respect to findings relevant to the health of U.S. coal miners published since 1995. The main conclusions are: 1. After a long period of declining CWP prevalence, recent surveillance data indicate that the prevalence is rising. 2. Coal miners are developing severe CWP at relatively young ages (less than 50 years). 3. There is some indication that early development of CWP is being manifested as premature mortality. 4. The above individuals would have been employed all of their working lives in environmental conditions mandated by the 1969 Coal Mine Health and Safety Act. 5. The increase in CWP occurrence appears to be concentrated in hot spots of disease mostly concentrated in the central Appalachian region of southern West Virginia, eastern Kentucky, and western Virginia. 6. The cause of this resurgence in disease is likely multifactorial. Possible explanations include excessive exposure due to increases in coal mine dust levels and duration of exposure (longer working hours), and increases in crystalline silica exposure. As indicated by data on disease prevalence and severity, workers in smaller mines may be at special risk. 7. Given that the more productive seams of coal are being mined out, a transition by the industry to mining thinner coal seams and those with more rock v intrusions is taking place and will likely accelerate in the future. Concomitant with this is the likelihood of increased potential for exposure to crystalline silica, and associated increased risk of silicosis, in coal mining. The main conclusions drawn from review of the new information are: 1. While findings published since 1995 refine or add further to the understanding of the respiratory health effects of coal mine dust described in the NIOSH CCD, they do not contradict or critically modify the primary conclusions and associated recommendations given there. Rather, the new findings strengthen those conclusions and recommendations. 2. Overall, the evidence and logical basis for recommendations concerning prevention of occupational respiratory disease among coal miners remains essentially unaffected by the newer findings that have emerged since publication of the CCD. In summary, as recommended by the CCD, every effort needs to be made to reduce exposure to both coal mine dust and to crystalline silica dust. As also recommended in the CCD, the latter task requires establishing a separate compliance standard in order to provide an effective limit to exposure to crystalline silica dust."--NIOSHTIC-2.

This authoritative text on occupational lung disorders builds upon the fundamentals, including clinical, epidemiological, and predictive approaches. It discusses interstitial and malignant diseases, airways diseases, and other respiratory issues, such as diving, working at high altitudes, and abnormal sleep conditions. It also covers related long-term conditions, such as asthma and COPD. This edition has been completely revised and brought up to date for all physicians dealing with pulmonary disorders caused by the environment or the workplace. Print Versions of this book also include access to the ebook version.