Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Almberg KS [original query] |
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Progressive massive fibrosis identified at federally funded black lung clinics in the US
Harris DA , Almberg KS , Blackley DJ , Cohen RA , Edwards C , Johnson B , Hall NB . JAMA 2024 This study of US Black Lung Clinics (established to treat coal miners) reports the prevalence of progressive massive fibrosis identified through June 2023. | eng |
Historical shift in pathological type of progressive massive fibrosis among coal miners in the USA
Go LHT , Rose CS , Zell-Baran LM , Almberg KS , Iwaniuk C , Clingerman S , Richardson DL , Abraham JL , Cool CD , Franko AD , Green FHY , Hubbs AF , Murray J , Orandle MS , Sanyal S , Vorajee NI , Sarver EA , Petsonk EL , Cohen RA . Occup Environ Med 2023 80 (8) 425-430 BACKGROUND: Pneumoconiosis among coal miners in the USA has been resurgent over the past two decades, despite modern dust controls and regulatory standards. Previously published studies have suggested that respirable crystalline silica (RCS) is a contributor to this disease resurgence. However, evidence has been primarily indirect, in the form of radiographic features. METHODS: We obtained lung tissue specimens and data from the National Coal Workers' Autopsy Study. We evaluated specimens for the presence of progressive massive fibrosis (PMF) and used histopathological classifications to type these specimens into coal-type, mixed-type and silica-type PMF. Rates of each were compared by birth cohort. Logistic regression was used to assess demographic and mining characteristics associated with silica-type PMF. RESULTS: Of 322 cases found to have PMF, study pathologists characterised 138 (43%) as coal-type, 129 (40%) as mixed-type and 55 (17%) as silica-type PMF. Among earlier birth cohorts, coal-type and mixed-type PMF were more common than silica-type PMF, but their rates declined in later birth cohorts. In contrast, the rate of silica-type PMF did not decline in cases from more recent birth cohorts. More recent year of birth was significantly associated with silica-type PMF. CONCLUSIONS: Our findings demonstrate a shift in PMF types among US coal miners, from a predominance of coal- and mixed-type PMF to a more commonly encountered silica-type PMF. These results are further evidence of the prominent role of RCS in the pathogenesis of pneumoconiosis among contemporary US coal miners. |
Mining tenure and job duties differ among contemporary and historic underground coal miners with progressive massive fibrosis
Zell-Baran L , Go LHT , Sarver E , Almberg KS , Iwaniuk C , Green FHY , Abraham JL , Cool C , Franko A , Hubbs AF , Murray J , Orandle MS , Sanyal S , Vorajee N , Cohen RA , Rose CS . J Occup Environ Med 2022 65 (4) 315-320 OBJECTIVE: To characterize differences in mining jobs and tenure between contemporary (born 1930+, working primarily with modern mining technologies) and historic coal miners with progressive massive fibrosis (PMF). METHODS: We classified jobs as designated occupations (DOs) and non-DOs based on regulatory sampling requirements. Demographic, occupational characteristics, and histopathological PMF type were compared between groups. RESULTS: Contemporary miners (n = 33) had significantly shorter mean total (30.4 years vs. 37.1 years, p = 0.0006) and underground (28.8 years vs. 35.8 years, p = 0.001) mining tenure compared to historic miners (n = 289). Silica-type PMF was significantly more common among miners in non-DOs (30.1% vs. 15.8%, p = 0.03) and contemporary miners (58.1% vs. 15.2%, p < 0.0001). CONCLUSIONS: Primary jobs changed over time with the introduction of modern mining technologies and likely changed exposures for workers. Elevated crystalline silica exposures are likely in non-DOs and require attention. |
Increased odds of mortality from non-malignant respiratory disease and lung cancer are highest among US coal miners born after 1939
Almberg KS , Halldin CN , Friedman LS , Go LHT , Rose CS , Hall NB , Cohen RA . Occup Environ Med 2023 80 (3) 121-128 OBJECTIVES: Coal miners suffer increased mortality from non-malignant respiratory diseases (NMRD), including pneumoconioses and chronic obstructive pulmonary disease, compared with the US population. We characterised mortality trends from NMRD, lung cancer and ischaemic heart disease (IHD) using data from the Federal Black Lung Program, National Coal Workers' Health Surveillance Program and the National Death Index. METHODS: We compared mortality ORs (MORs) for NMRD, lung cancer and IHD in former US coal miners to US white males. MORs were computed for the study period 1979-2017 by birth cohort (<1920, 1920-1929, 1930-1939, ≥1940), with a subanalysis restricted to Central Appalachia. RESULTS: The study population totalled 235 550 deceased miners, aged >45 years. Odds of death from NMRD and lung cancer across all miner birth cohorts averaged twice those of US males. In Central Appalachia, MORs significantly increased across birth cohorts. There was an eightfold increase in odds of death from NMRD among miners born after 1940 (MOR(BC≥1940) 8.25; 95% CI 7.67 to 8.87). Miners with progressive massive fibrosis (PMF) were younger at death than those without PMF (74 vs 78 years; p<0.0001). We observed a pattern of reduced MORs from IHD in coal miners compared with national and regional counterparts. CONCLUSION: US coal miners have excess mortality from NMRD and lung cancer compared with total US and Appalachian populations. Mortality is highest in the most recent birth cohorts, perhaps reflecting increased rates of severe pneumoconiosis. |
Pathology and mineralogy demonstrate respirable crystalline silica is a major cause of severe pneumoconiosis in US coal miners
Cohen RA , Rose CS , Go LHT , Zell-Baran LM , Almberg KS , Sarver EA , Lowers HA , Iwaniuk C , Clingerman SM , Richardson DL , Abraham JL , Cool CD , Franko AD , Hubbs AF , Murray J , Orandle MS , Sanyal S , Vorajee NI , Petsonk EL , Zulfikar R , Green FHY . Ann Am Thorac Soc 2022 19 (9) 1469-1478 RATIONALE: The reasons for resurgent coal workers' pneumoconiosis and its most severe forms, rapidly progressive pneumoconiosis and progressive massive fibrosis (PMF), in the United States (US) are not yet fully understood. OBJECTIVE: To compare the pathologic and mineralogic features of contemporary coal miners suffering severe pneumoconiosis to their historical counterparts. METHODS: Lung pathology specimens from 85 coal miners with PMF were included for evaluation and analysis. We compared the proportion of cases with pathologic and mineralogic findings in miners born between 1910 and 1930 (historical) to those born in or after 1930 (contemporary). RESULTS: We found a significantly higher proportion of silica-type PMF (57% vs. 18%, p<0.001) among contemporary miners compared to their historical counterparts. Mineral dust alveolar proteinosis (MDAP) was also more common in contemporary miners compared to their historical counterparts (70% vs. 37%, p<0.01). In situ mineralogic analysis showed the percentage (26.1% vs. 17.8%, p<0.01) and concentration (47.3 x 108 vs. 25.8 X 108 particles/cm3, p=0.036) of silica particles was significantly greater in specimens from contemporary miners compared to their historical counterparts. The concentration of silica particles was significantly greater when silica-type PMF, MDAP, silicotic nodules, or immature silicotic nodules were present (p<0.05). CONCLUSIONS: Exposure to respirable crystalline silica appears causal in the unexpected surge in severe disease in contemporary miners. Our findings underscore the importance of controlling workplace silica exposure in order to prevent the disabling and untreatable adverse health effects afflicting US coal miners. Primary Source of Funding: Alpha Foundation for the Improvement of Mine Safety and Health, Inc. |
Progressive massive fibrosis resurgence identified in U.S. coal miners filing for black lung benefits, 1970-2016
Almberg KS , Halldin CN , Blackley DJ , Laney AS , Storey E , Rose CS , Go LHT , Cohen RA . Ann Am Thorac Soc 2018 15 (12) 1420-1426 RATIONALE: There has been a resurgence of progressive massive fibrosis (PMF) in the United States, particularly among central Appalachian miners. OBJECTIVES: We characterized the proportion of PMF among former U.S. coal miners applying for Federal Black Lung Program benefits, 1970-2016. METHODS: Data from the U.S. Department of Labor were used to characterize trends in proportion of PMF cases, defined as an approved black lung claim with a determination of PMF, among all miners who filed for federal benefits between January 1, 1970 and December 31, 2016. Joinpoint, logistic, and linear regression models were used to identify changes in the proportion of claimants with PMF over time. MEASUREMENTS AND MAIN RESULTS: There were 4,679 unique PMF cases among claimants for federal black lung benefits between 1970 - 2016, with 2,474 miners determined to have PMF since 1996. The number of PMF cases among Federal Black Lung Program claimants fell from 404 (0.5% of claimants) in 1978 to a low of 18 cases (0.6%) in 1988, then increased to 353 cases (8.3%) in 2014. The proportion of federal black lung benefits claimants with PMF has been increasing since 1978 (0.06% APC; 95%CI 0.05%, 0.07%; p < .0001), and began increasing at a significantly increased rate after 1996 (0.26% APC; 95% CI 0.25%, 0.28%; p < .0001). Most miners with PMF (84%) last mined in West Virginia, Kentucky, Pennsylvania, or Virginia. Since 1970, the proportion of claimants with PMF has increased significantly among miners who last worked in Kentucky (16.6% APC; 95%CI 16.5%, 16.7%), Pennsylvania (4.7% APC; 95%CI 4.6%, 4.8%), Tennessee (16.1% APC; 95%CI 15.7%, 16.4%), West Virginia (16.8% APC; 95%CI 16.6%, 16.9%), and most sharply among miners last working in Virginia (31.5% APC; 95%CI 31.2%, 31.7%), where in 2009, over 17% of claimants received a PMF determination. The proportion of PMF determinations for the rest of the U.S. have not exceeded 4%. CONCLUSIONS: There has been a resurgence of PMF, particularly in central Appalachian miners. The resurgence of this preventable disease points to the need for improved primary and secondary prevention of dust-related lung disease in U.S. coal miners. |
Linking compensation and health surveillance data sets to improve knowledge of US coal miners' health
Almberg KS , Cohen RA , Blackley DJ , Laney AS , Storey E , Halldin CN . J Occup Environ Med 2017 59 (10) 930-934 OBJECTIVE: Increase knowledge of US coal miners' respiratory health by linking data from the black lung benefits program (BLBP) and the coal workers' health surveillance program (CWHSP). METHODS: BLBP claims data from 2000 through 2013 was linked to CWHSP data from 1970 through 2016. RESULTS: Overall, 273,644 miners participated in CWHSP, 37,548 in BLBP, and 22,903 in both programs. Median age of miners at their time of first/only participation in CWHSP was 28 and 32 years, respectively. BLBP claimants were older (median age 59). Thirty-nine percent of BLBP claimants had not participated in CWHSP. The relative contributions of states to participation differed between CWHSP and BLBP. For example, Kentucky miners accounted for 18% of CWHSP participants, but 36% of BLPB participants. CONCLUSIONS: Many BLBP claimants never appeared in CWHSP, indicating missed opportunities for secondary prevention. |
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