Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Rose CS[original query] |
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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. |
Consensus statements on deployment-related respiratory disease, inclusive of constrictive bronchiolitis: A modified Delphi study
Falvo MJ , Sotolongo AM , Osterholzer JJ , Robertson MW , Kazerooni EA , Amorosa JK , Garshick E , Jones KD , Galvin JR , Kreiss K , Hines SE , Franks TJ , Miller RF , Rose CS , Arjomandi M , Krefft SD , Morris MJ , Polosukhin VV , Blanc PD , D'Armiento JM . Chest 2022 163 (3) 599-609 BACKGROUND: The diagnosis of constrictive bronchiolitis (CB) in previously deployed individuals, and evaluation of respiratory symptoms more broadly, presents considerable challenges, including utilizing consistent histopathologic criteria and clinical assessments. RESEARCH QUESTION: What is the recommended diagnostic workup, and associated terminology, of respiratory symptoms in previously deployed individuals STUDY DESIGN AND METHODS: Nineteen experts participated in a three-round modified Delphi study, ranking their level of agreement for each statement with a priori definition of consensus. Additionally, rank-order voting on the recommended diagnostic approach and terminology was performed. RESULTS: 25 of 28 statements reached consensus, including the definition of CB as a histological pattern of lung injury that occurs in some previously deployed individuals while recognizing the importance of considering alternative diagnoses. Consensus statements also identified a diagnostic approach for the previously deployed individual with respiratory symptoms distinguishing assessments best performed at a local or specialty referral center. Also, 'deployment-related respiratory disease' (DRRD) was proposed as a broad term to subsume a wide range of potential syndromes and conditions identified through non-invasive evaluation, or when surgical lung biopsy reveals evidence of multi-compartmental lung injury which may include CB. INTERPRETATION: Using a modified Delphi technique, consensus statements provide a clinical approach to possible CB in previously deployed individuals. Use of DRRD provides a broad descriptor encompassing a range of post-deployment respiratory findings. Additional follow-up of individuals with DRRD is needed to assess disease progression and define other features of its natural history, which could better inform and lead to evolution in this nosology. |
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. |
Associations between radiographic findings and spirometry in a community exposed to Libby amphibole
Larson TC , Lewin M , Gottschall EB , Antao VC , Kapil V , Rose CS . Occup Environ Med 2012 69 (5) 361-6 BACKGROUND: Among asbestos-exposed individuals, abnormal spirometry is usually associated with parenchymal abnormalities or diffuse pleural thickening. Localised pleural thickening (LPT), the most common abnormality associated with asbestos exposure, is typically thought to be a marker of exposure with little clinical consequence. Our objective was to determine if abnormal spirometry is associated with LPT independent of other abnormalities, using data from community-based screening conducted in Libby, Montana. METHODS: Subjects were a subset of screening participants comprising persons with interpretable spirometry and chest radiograph results (n=6475). Chest radiographs were independently evaluated by two or three B readers, and participants were classified by mutually exclusive categories of spirometry outcome: normal, restriction, obstruction or mixed defect. RESULTS: Restrictive spirometry was strongly associated with parenchymal abnormalities (OR 2.9; 95% CI 1.4 to 6.0) and diffuse pleural thickening (OR 4.1; 95% CI 2.1 to 7.8). Controlling for the presence of these abnormalities as well as age, smoking status and other covariates, restrictive spirometry was also associated with LPT (OR 1.4; 95% CI 1.1 to 1.8). The risk of restrictive spirometric findings correlated with the severity of LPT. CONCLUSIONS: In this large community-based screening cohort, restrictive spirometry is significantly associated with LPT, indicating that this abnormality may result in lung function impairment. Physicians treating patients exposed to Libby amphibole should be aware that LPT may have functional consequences. |
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