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首页> 外文期刊>Occupational and environmental medicine >Pneumoconiosis among underground bituminous coal miners in the United States: is silicosis becoming more frequent?
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Pneumoconiosis among underground bituminous coal miners in the United States: is silicosis becoming more frequent?

机译：美国地下沥青煤矿工人的尘肺病：矽肺病是否变得更加频繁？

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OBJECTIVES: Epidemiological reports since 2000 have documented increased prevalence and rapid progression of pneumoconiosis among underground coal miners in the United States. To investigate a possible role of silica exposure in the increase, we examined chest x-rays (CXRs) for specific abnormalities (r-type small opacities) known to be associated with silicosis lung pathology. METHODS: Underground coal miners are offered CXRs every 5 years. Abnormalities consistent with pneumoconiosis are recorded by National Institute for Occupational Safety and Health (NIOSH) B Readers using the International Labour Organization Classification of Radiographs of Pneumoconioses. CXRs from 1980 to 2008 of 90 973 participating miners were studied, focussing on reporting of r-type opacities (small rounded opacities 3-10 mm in diameter). Log binomial regression was used to calculate prevalence ratios adjusted for miner age and profusion category. RESULTS: Among miners from Kentucky, Virginia and West Virginia, the proportion of radiographs showing r-type opacities increased during the 1990s (prevalence ratio (PR) 2.5; 95% CI 1.7 to 3.7) and after 1999 (PR 4.1; 95% CI 3.0 to 5.6), compared to the 1980s (adjusted for profusion category and miner age). The prevalence of progressive massive fibrosis in 2000-2008 was also elevated compared to the 1980s (PR 4.4; 95% CI 3.1 to 6.3) and 1990s (PR 3.8; 95% CI 2.1 to 6.8) in miners from Kentucky, Virginia and West Virginia. CONCLUSIONS: The increasing prevalence of pneumoconiosis over the past decade and the change in the epidemiology and disease profile documented in this and other recent studies imply that US coal miners are being exposed to excessive amounts of respirable crystalline silica.
机译：目的：自2000年以来的流行病学报告表明，美国地下煤矿工人尘肺病的患病率上升且进展迅速。为了调查二氧化硅暴露在增加中的可能作用，我们检查了胸部X射线（CXR）是否存在与矽肺病病理相关的特定异常（r型小混浊）。方法：每5年向地下煤矿工人提供CXR。美国职业安全与健康研究院（NIOSH）B读者使用国际劳工组织《肺尘埃沉着病X线片分类》记录了与尘肺病相符的异常情况。从1980年到2008年，研究了90973名参与该计划的矿工的CXR，重点是报告r型不透明物体（直径为3-10毫米的小圆形不透明物体）。使用对数二项式回归来计算针对矿工年龄和丰富类别调整的患病率。结果：在肯塔基州，弗吉尼亚州和西弗吉尼亚州的矿工中，显示R型浑浊的X射线照片比例在1990年代（患病率（PR）2.5; 95％CI 1.7至3.7）和1999年之后（PR 4.1; 95％CI）有所增加3.0至5.6），与1980年代相比（针对大量类别和矿工年龄进行了调整）。与肯塔基州，弗吉尼亚州和西维吉尼亚州的矿工相比，2000-2008年进行性大规模纤维化的患病率与1980年代（PR 4.4; 95％CI 3.1至6.3）和1990年代（PR 3.8; 95％CI 2.1至6.8）相比也有所提高。结论：在过去的十年中，尘肺病的患病率不断上升，在这项研究和其他近期研究中记录的流行病学和疾病状况的变化表明，美国煤矿工人正暴露于过量的可吸入结晶硅中。

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