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首页> 外文期刊>Occupational and environmental medicine >Coal workers' pneumoconiosis in the United States: regional differences 40 years after implementation of the 1969 Federal Coal Mine Health and Safety Act.
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Coal workers' pneumoconiosis in the United States: regional differences 40 years after implementation of the 1969 Federal Coal Mine Health and Safety Act.

机译：美国的煤矿工人尘肺病：1969年《联邦煤矿健康与安全法》实施40年后的地区差异。

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OBJECTIVE: To assess whether the recent increases in the prevalence of coal workers' pneumoconiosis (CWP) in the USA reflect increased measured exposures over recent decades, and to identify other potential causative factors. METHODS: The observed CWP prevalence was calculated for 12,408 underground coal miner participants in the Coal Workers' Health Surveillance Program for the period 2005-2009, stratified by the Mine Safety and Health Administration (MSHA) geographical districts. The predicted prevalence was estimated using a published exposure-response model from a large epidemiological study among U.S. coal miners using dust exposure, tenure, miner's age and coal rank as predictors. chi2 Testing was performed to compare the observed versus predicted CWP prevalence. RESULTS: Observed prevalence was significantly higher than predicted prevalence in MSHA districts 4-7 (central Appalachian region) (10.1% vs. 4.2%; prevalence ratio (PR) 2.4; p<0.001) and significantly lower than predicted in other regions (1.6% vs. 3.6%; PR 0.4; p<0.001). The central Appalachian region had a significantly older workforce with greater mining tenure, a lower proportion of mines with 200 or more employees, and lower seam heights. Significant lower average compliance dust concentrations were reported for this region. CONCLUSION: The observed CWP prevalence substantially exceeded predicted levels in central Appalachia. However, the increased prevalence was not explained by the measured levels of dust exposures. Likely contributing factors include mine size and low seam mining, which may be associated with higher exposure to silica. Further study is needed to characterise the responsible factors for the elevated CWP rates in central Appalachia.
机译：目的：评估近期美国煤矿工人尘肺病（CWP）患病率的增加是否反映了近几十年来测得的暴露量增加，并确定了其他潜在的致病因素。方法：根据矿山安全与健康管理局（MSHA）地理区域分层，对2005-2009年期间煤矿工人健康监视计划中12,408名地下煤矿工人的CWP患病率进行了计算。预测的患病率是使用来自美国煤矿工人的一项大型流行病学研究的已发布的暴露响应模型估算的，该模型使用粉尘暴露量，任期，矿工年龄和煤炭等级作为预测指标。进行了chi2测试以比较观察到的CWP发生率与预测的CWP发生率。结果：在MSHA 4-7区（阿巴拉契亚中部地区），观察到的患病率显着高于预期患病率（10.1％vs. 4.2％;患病率（PR）为2.4; p <0.001），并且显着低于其他地区的预测患病率（1.6） ％对3.6％; PR 0.4; p <0.001）。阿巴拉契亚中部地区的劳动力年龄大得多，采矿权更长，拥有200名或更多员工的矿山比例较低，煤层高度较低。据报该地区的平均合规粉尘浓度较低。结论：观察到的CWP患病率大大超过了阿巴拉契亚中部的预测水平。但是，测得的粉尘暴露水平并不能解释患病率上升的原因。可能的影响因素包括矿山规模和低煤层开采，这可能与较高的二氧化硅暴露量有关。需要进一步研究来表征阿巴拉契亚中部CWP率升高的原因。

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