Silicosis prevalence and incidence among Medicare beneficiaries.

INTRODUCTION: Existing epidemiologic information on silicosis relies on mortality data. METHODS: We analyzed health insurance claims and enrollment information from 49 923 987 fee-for-service (FFS) Medicare beneficiaries aged ≥65 from 1999 to 2014. Three different definitions were developed to identify silicosis cases and results are presented as ranges of values for the three definitions. RESULTS: Among FFS beneficiaries, 10 026-19 696 fit the silicosis case definitions (16-year prevalence: 20.1-39.5 per 100 000) with the highest prevalence among North American Natives (87.2-213.6 per 100 000) and those in New Mexico (83.9-203.4 per 100 000). The annual average prevalence had a significant (P < 0.05) 2-5% annual decline from 2005 to 2014. The average annual number of incident cases had a significant 3-16% annual decline from 2007 to 2014. CONCLUSIONS: Silicosis is a prevalent disease among Medicare beneficiaries aged ≥65, with variation across the country. Morbidity data from health insurance claims can provide a more complete picture of silicosis burden.

A Novel Variant of Desmoplakin Is Potentially Associated with Silicosis Risk.

Two genome-wide association studies and one sequencing study have coincidently reported significant associations of single nucleotide polymorphisms (SNPs) in the desmoplakin (DSP) gene with the risk of pulmonary fibrosis (mainly idiopathic pulmonary fibrosis). However, these findings have not been well generalized to occupational pulmonary fibrosis (e.g., silica-related silicosis). We systematically genotyped 8 potentially functional SNPs and the previously reported rs2076295 and rs2744371 in DSP gene region and evaluated the associations between these 10 SNPs and silicosis risk in a case-control study that included 177 silicosis cases and 204 controls with similar numbers of silica dust exposure years as the cases from a Chinese population. Genotyping was performed using the improved multiligase detection reaction multiplex SNP genotyping system. The variant A allele of rs2076304 exhibited significant association with the risk of silicosis (odds ratio = 1.53, 95% confidence interval = 1.03-2.29, p = 0.036). Moreover, significant association was observed between different genotypes of rs2076304 and DSP expression (p = 1.1 × 10-7) in 383 normal lung tissues. Further functional annotation indicated that the rs2076304 might influence the binding of RHOXF1. The rs2076304 in DSP gene is associated with a significantly increased risk of silicosis in a Han Chinese population. Further studies are warranted to validate and extend our findings, especially the biological mechanisms of rs2076304 in silicosis susceptibility.

The social costs of uranium mining in the US Colorado Plateau cohort, 1960-2005.

OBJECTIVES: Long-term social costs associated with underground uranium mining are largely unknown. This study estimated health costs of Native American and white (Hispanic and non-Hispanic origin) uranium miners in the US Public Health Service Colorado Plateau cohort study. METHODS: Elevated uranium miner person-years of life lost (PYLL) were calculated from the most recent study of the Colorado Plateau cohort over 1960-2005. Nine causes of death categories were included. Costs to society of miner PYLL were monetized using the value of a statistical life-year approach. RESULTS: Costs over 1960-2005 totaled $2 billion USD [95% CI: $1.8, $2.2], or $2.9 million per elevated miner death. This corresponds to $43.1 million [95%: $38.7, $48.7] in annual costs. Lung cancer was the most costly cause of death at $1.4 billion [95%: $1.3, $1.5]. Absolute health costs were largest for white miners, but Native Americans had larger costs per elevated death. Annual excess mortality over 1960-2005 averaged 366.4 per 100,000 miners; 404.6 (white) and 201.5 per 100,000 (Native American). CONCLUSIONS: This research advances our understanding of uranium extraction legacy impacts, particularly among indigenous populations.

Occupational health disparities: a state public health-based approach.

BACKGROUND: This report used employment and public health surveillance data in Michigan to characterize work-related race/ethnic health disparities. METHODS: U.S. Census data were used to calculate the percent by race/Hispanic ethnicity in occupational groups ranked by three measures for potential work-related health risks. Disparities by race/ethnicity were generated from occupational health surveillance data. RESULTS: Blacks and Hispanics were over-represented in lower wage-higher manual-labor occupations and in highest risk occupations. Blacks were at greater risk of silicosis, work-related asthma, and work-related burns than whites, and Hispanics had higher rates of work-related acute fatal injuries and pesticide injury than non-Hispanics. CONCLUSIONS: Michigan employment data indicated that blacks and Hispanics were overly represented in lower paid and more hazardous jobs. Occupational health surveillance data confirmed disparate risks for some illnesses and injuries. This approach can be used in other states to bring awareness to policy makers and direct interventions.

[The characteristics of the development and course of pneumoconiosis under the conditions of a mountain climate]. / Osobennosti razvitiia i techeniia pnevmokoniozov v usloviiakh gornogo klimata.

Analysis of pneumoconiosis course in workers exposed to dust in the mines of different altitudes showed, that the increased altitude augmented mountainous hypobaric hypoxia hasten the development of pneumoconiotic process and increase the number of nodular pneumoconiosis growing progressively worse. Pneumoconiosis develops considerably earlier and nodular forms predominate in the newcomers than in native workers. The frequency of such complications, as chronic bronchitis, asthmatic syndrome decreases in accordance with increasing of altitude which can be explained by the features of inhabitants' immunologic status and peculiarity of the mountainous climate.