Comparative 6+studies of environmentally persistent free radicals on nano-sized coal dusts.

Coal dust is the major hazardous pollutant in the coal mining environment. Recently environmentally persistent free radicals (EPFRs) were identified as one of the key characteristics which could impart toxicity to the particulates released into the environment. The present study used Electron Paramagnetic Resonance (EPR) spectroscopy to analyze the characteristics of EPFRs present in different types of nano-size coal dust. Further, it analyzed the stability of the free radicals in the respirable nano-size coal dust and compared their characteristics in terms of EPR parameters (spin counts and g-values). It was found that free radicals in coal are remarkably stable (can remain intact for several months). Also, Most of the EPFRs in the coal dust particles are either oxygenated carbon centered or a mixture of carbon and oxygen-centered free radicals. EPFRs concentration in the coal dust was found to be proportional to the carbon content of coal. The characteristic g-values were found to be inversely related to the carbon content of coal dust. The spin concentrations in the lignite coal dust were between 3.819 and 7.089 µmol/g, whereas the g-values ranged from 2.00352 to 2.00363. The spin concentrations in the bituminous coal dust were between 11.614 and 25.562 µmol/g, whereas the g-values ranged from 2.00295 to 2.00319. The characteristics of EPFRs present in coal dust identified by this study are similar to the EPFRs, which were found in other environmental pollutants such as combustion-generated particulates, PM2.5, indoor dust, wildfires, biochar, haze etc., in some of the previous studies. Considering the toxicity analysis of environmental particulates containing EPFRs similar to those identified in the present study, it can be confidently hypothesized that the EPFRs in the coal dust might play a major role in modulating the coal dust toxicity. Hence, it is recommended that future studies should analyze the role of EPFR-loaded coal dust in mediating the inhalation toxicity of coal dust.

Chronic Pulmonary Aspergillosis Infection in Coal Workers Pneumoconiosis With Progressive Massive Fibrosis.

Pneumoconiosis is associated with coal dust particles depositing within the lung causing nodules coalesce to form progressive massive fibrosis (PMF). Cavitary lesions can develop in these PMF areas for concerns of tuberculosis and aspergillosis. We present a 59-year-old patient who had coal workers pneumoconiosis and PMF presenting with chronic dyspnea and hemoptysis with an upper cavitary lesion noted on chest imaging. He notes dyspnea with walking very short distances with associated productive cough. He admits to occasional wheezing, paroxysmal dyspnea, hemoptysis, and orthopnea but denies chest pain. He is an everyday smoker. His physical examination was only remarkable for bronchial breath sounds. On review of his prior imaging, he had a right upper lobe infiltrate as far back as 2012. As the years progressed, a new cavitary lesion developed in the PMF area which progressively got larger with a thick wall and no eccentric region noted inside the cavity. Tuberculosis test was negative. He underwent a transbronchial biopsy with methenamine silver stain which showed acute angle branching and septation suggestive of Aspergillus species. He was diagnosed with pulmonary aspergillosis and treated with voriconazole for 1 year. With pneumoconiosis and evidence confirming aspergillosis, the presence of a new lung infiltration with progression into a cavitary lesion leads to a diagnosis of chronic cavitary pulmonary aspergillosis (CCPA). With follow-up imaging showing extensive lung fibrosis, he had chronic fibrosing pulmonary aspergillosis (CFPA), a late-stage manifestation of CCPA.

Prevalence of coal worker's pneumoconiosis: a systematic review and meta-analysis.

Global prevalence trend and regional differences of coal worker's pneumoconiosis (CWP) remain unclear. This study aimed to provide systematic and comprehensive evidence for the global prevalence of CWP. Literature research for studies that reported prevalence of CWP was conducted in PubMed, CNKI, and Web of Science. The identified studies were strictly screened according to predetermined inclusion and exclusion criteria. The pooled prevalence of CWP in different periods and regions was calculated. A total of 37 studies were included after screening, and data from the Coal Workers' Health Surveillance Program was additionally included in the meta-analysis. The global pooled prevalence of CWP decreased from 23.33% (95% confidence interval [CI]: 18.03%, 28.62%) before 1970 to 6.00% (95% CI: 4.11%, 7.90%) in 1981-1990, but indicated a rebound (10.35%, 95% CI: 8.08%, 12.62%) in 1991-2000 and finally dropped to 2.29% (95% CI: 2.06%, 2.51%) in 2011-2020. In the recent 30 years, the top three pooled prevalence of CWP was found in Europe, China, and the USA, respectively. Few articles have reported the prevalence in developing regions, but available evidence indicated that the prevalence in developing regions was much higher than that in developed regions. Higher pooled prevalence was observed in studies which reported larger number of miners in collieries, older average age of miners, underground collieries, and longer dust exposure time. The global prevalence of CWP indicates a rebound in 1990s, but the overall trend is downward in the recent 60 years. The prevention and treatment of CWP should be currently emphasized in developing countries.

Computer-Aided Diagnosis of Coal Workers' Pneumoconiosis in Chest X-ray Radiographs Using Machine Learning: A Systematic Literature Review.

Computer-aided diagnostic (CAD) systems can assist radiologists in detecting coal workers' pneumoconiosis (CWP) in their chest X-rays. Early diagnosis of the CWP can significantly improve workers' survival rate. The development of the CAD systems will reduce risk in the workplace and improve the quality of chest screening for CWP diseases. This systematic literature review (SLR) amis to categorise and summarise the feature extraction and detection approaches of computer-based analysis in CWP using chest X-ray radiographs (CXR). We conducted the SLR method through 11 databases that focus on science, engineering, medicine, health, and clinical studies. The proposed SLR identified and compared 40 articles from the last 5 decades, covering three main categories of computer-based CWP detection: classical handcrafted features-based image analysis, traditional machine learning, and deep learning-based methods. Limitations of this review and future improvement of the review are also discussed.

Updating "Characteristics of respirable dust in eight Appalachian coal mines: A dataset including particle size and mineralogy distributions, and metal and trace element mass concentrations" with expanded data to cover a total of 25 US mines.

A total of 171 sets respirable dust samples were collected from 25 underground coal mines in several regions of the United States. One sample from each set was analyzed by scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) to determine particle size and mineralogy distributions. Results from the first eight mines were presented in the original dataset (Sarver et al., 2019). Here, the dataset is updated to include results from all 25 mines and to further subclassify particle mineralogy using improved SEM-EDX routines. The current article presents particle mineralogy binned by size between about 100-10,000 nm on a per sample basis, and data is also available on a per particle basis. Discussion of the SEM-EDX data is included in a parallel research article "Particle size and mineralogy distributions in respirable dust samples from 25 US underground coal mines" (Sarver et al., 2021). Moreover, sequential digestions and analysis of the digestates by inductively coupled plasma-mass spectroscopy (ICP-MS) were used to estimate mass concentrations of potentially bioaccessible and total-acid soluble metals and trace elements in the respirable dust samples. Results are included here for a total of 76 samples representing 15 mines; results from first eight mines were presented in the original dataset (Sarver et al., 2019) and discussed in an earlier research article (Sarver et al., 2019).

Association between Financial Conflicts of Interest and International Labor Office Classifications for Black Lung Disease.

Rationale: The U.S. Department of Labor administers the Federal Black Lung Program (FBLP), an administrative system charged with managing claims by coal miners for workers' compensation for totally disabling coal mine dust lung disease. Specific case reports have raised concern that financial conflicts of interest (COIs) may systematically bias physicians when they are classifying chest X-rays (CXRs) for the absence, presence, and severity of pneumoconiosis. Objectives: To evaluate the direction and magnitude of association between financial COIs of physicians participating in the FBLP and international standards for the classification of radiographs of pneumoconiosis. Methods: An epidemiologic assessment of black lung claims filed to the FBLP from 2000 to 2013 was conducted to determine physician classifications of radiographs. FBLP court decisions from 2002 to 2019 (n = 7,656) were used to evaluate financial COIs of each physician. The main outcome measures used were classifications of radiographs for the absence of pneumoconiosis (small opacity classifications of 0/0 or 0/1), simple pneumoconiosis (small opacity classifications of 1/0 through 3/+), and progressive massive fibrosis (PMF) (large opacities with classifications of A, B, or C). Results: Of 63,780 radiograph classifications made by 264 physicians, 31.4% were read positive for simple pneumoconiosis and 3.6% were read as having PMF. There were 52 physicians who classified CXRs as having no evidence of pneumoconiosis in 99%+ of their readings and 18 physicians who classified CXRs as positive for simple pneumoconiosis in 99%+ of their readings. The adjusted odds of a negative classification of pneumoconiosis was 1.46 (95% confidence interval [CI], 1.44-1.47) per 10% increase in the proportion of court records demonstrating that a physician was hired by the employer. Per 10% increase in court records indicating a physician was hired by the miner/claimant, the adjusted odds ratio for classifying simple pneumoconiosis was 1.51 (95% CI, 1.49-1.52), and the adjusted odds ratio for finding PMF was 1.28 (95% CI, 1.26-1.30). Conclusions: There was a strong association between source of payment and radiograph classification, suggesting the importance of eliminating financial COIs in what should be an objective determination of eligibility for Black Lung Workers' compensation benefits.

Automated detection of pneumoconiosis with multilevel deep features learned from chest X-Ray radiographs.

Early detection of pneumoconiosis in X-Rays has been a challenging task that leads to high inter- and intra-reader variability. Motivated by the success of deep learning in general and medical image classification, this paper proposes an approach to automatically detect pneumoconiosis using a deep feature based binary classifier. The features are extracted from X-rays using deep transfer learning, comprising both low and high-level feature sets. For this, a CNN model pre-trained with a transfer learning from a CheXNet model was initially used to extract deep features from the X-Ray images, then the deep features were mapped to higher-dimensional feature spaces for classification using Support Vector Machine (SVM) and CNN based feature aggregation methods. In order to cross validate the proposed method, the training and testing images were randomly split into three folds before each experiment. Nine evaluation metrics were employed to compare the performance of the proposed method and state-of-the-art methods from the literature that used the same datasets. The experimental results show that the proposed framework outperformed others, achieving an accuracy of 92.68% in the automated detection of pneumoconiosis.

Progression of coal workers' pneumoconiosis absent further exposure.

OBJECTIVES: The natural history of coal workers' pneumoconiosis (CWP) after cessation of exposure remains poorly understood. METHODS: We characterised the development of and progression to radiographic progressive massive fibrosis (PMF) among former US coal miners who applied for US federal benefits at least two times between 1 January 2000 and 31 December 2013. International Labour Office classifications of chest radiographs (CXRs) were used to determine initial and subsequent disease severity. Multivariable logistic regression models were used to identify major predictors of disease progression. RESULTS: A total of 3351 former miners applying for benefits without evidence of PMF at the time of their initial evaluation had subsequent CXRs. On average, these miners were 59.7 years of age and had 22 years of coal mine employment. At the time of their first CXR, 46.7% of miners had evidence of simple CWP. At the time of their last CXR, 111 miners (3.3%) had radiographic evidence of PMF. Nearly half of all miners who progressed to PMF did so in 5 years or less. Main predictors of progression included younger age and severity of simple CWP at the time of initial CXR. CONCLUSIONS: This study provides further evidence that radiographic CWP may develop and/or progress absent further exposure, even among miners with no evidence of radiographic pneumoconiosis after leaving the industry. Former miners should undergo regular medical surveillance because of the risk for disease progression.

A virtual community-of-practice approach by rural stakeholders in managing pneumoconiosis in the USA: a cross-sectional analysis.

INTRODUCTION: The re-emergence of pneumoconiosis, particularly among coal miners (ie black lung), in the USA is a challenge for rural communities because more miners require specialized care while expertise is scarce. The Miners' Wellness TeleECHO (Extension for Community Health Outcomes) Clinic, jointly held by the University of New Mexico and a community hospital in New Mexico, provides structured telementoring to professionals caring for miners, including clinicians, respiratory therapists, home health professionals, benefits counselors, lawyers/attorneys and others, forming a virtual 'community of practice'. This approach has not been utilized and evaluated previously. METHODS: The study's bimonthly program uses the ECHO telementoring model, which uses technology to leverage scarce mentoring resources; uses a disease-management model that is proven to improve outcomes in other disease states, by reducing variation in processes of care and sharing best practices; uses the principle of case-based learning with highly contextualized discussions, which fulfils key learning theory principles; creates a virtual community of practice; and uses an internet-based database to monitor outcomes. This 1-year cross-sectional study from September 2018 to September 2019 used geographical mapping of all attendee locations, web-based continuing medical education surveys completed by attendees using iECHO software, and a Research Electronic Data Capture-based survey of a convenience sample of participants, which obtained detailed information on demographics, knowledge, self-efficacy and collective efficacy. Knowledge sharing among participants was examined using insights and methods from social network analysis. Subgroup analysis involved comparisons between clinical and non-clinical professional groups, and between new and existing participants. Groups were compared using Fisher's exact test for categorical variables, and non-parametric Wilcoxon ranked sum test or student's t-test for continuous variables. RESULTS: Participants were largely located in pneumoconiosis mortality hotspots of the USA. In a convenience sample of 70 participants, clinical professional groups such as clinicians (29%), home health professionals (20%) and respiratory therapists (17%) constituted the majority of the stakeholders. Participants demonstrated the lowest knowledge score on 'legal pneumoconiosis' among the knowledge areas questioned; reported low self-efficacy with respect to managing miners' conditions and interpreting test results; and rated the learning community highly in terms of trust (86%), willingness to help each other (93%) and being closely knit (87%). Analysis of knowledge sources indicated that participants receive substantial proportions of knowledge from individuals outside of their stakeholder and professional groups, but proportions differ among clinical and non-clinical professional groups, as well as among 'fresh' and existing participants. CONCLUSION: The present study demonstrates the successful creation of a virtual multidisciplinary community of practice in pneumoconiosis mortality hotspot rural regions of the USA, with participants reporting multidisciplinary knowledge transfer. The community is regarded highly by participants in relation to trust, willingness to help and being closely knit. This innovative educational approach may help ensure the delivery of high-quality interdisciplinary care to rural miners in pneumoconiosis mortality hotspots in the USA.

Estimating the prevalence and spatial clusters of coal workers' pneumoconiosis cases using medicare claims data, 2011-2014.

BACKGROUND: Workers employed in the coal mining sector are at increased risk of respiratory diseases, including coal workers' pneumoconiosis (CWP). We investigated the prevalence of CWP and its association with sociodemographic factors among Medicare beneficiaries. METHODS: We used 5% Medicare Limited Data Set claims data from 2011 to 2014 to select Medicare beneficiaries with a diagnosis of ICD-9-CM 500 (CWP). We aggregated the data by county and limited our analysis to seven contiguous states: Illinois, Indiana, Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia. We estimated county-level prevalence rates using total Medicare beneficiaries and miners as denominators and performed spatial hotspot analysis. We used negative binomial regression analysis to determine the association of county-wise sociodemographic factors with CWP. RESULTS: There was significant spatial clustering of CWP cases in Kentucky, Virginia, and West Virginia. Spatial clusters of 210 and 605 CWP cases representing an estimated 4200 to 12 100 cases of Medicare beneficiaries with CWP were identified in the three states. Counties with higher poverty levels had a significantly elevated rate of CWP (adjusted rate ratios [RR]: 1.15; 95% CI, 1.12-1.18). There was a small but significant association of CWP with the county-wise catchment area. Rurality was associated with a more than three-fold elevated rate of CWP in the unadjusted analysis (RR: 3.28, 95% CI, 2.22-4.84). However, the rate declined to 1.45 (95% CI, 1.04-2.01) after adjusting for other factors in the analysis. CONCLUSIONS: We found evidence of significant spatial clustering of CWP among Medicare beneficiaries living in the seven states of the USA.

A thermogravimetric analysis application to determine coal, carbonate, and non-carbonate minerals mass fractions in respirable mine dust.

Occupational lung diseases such as coal worker's pneumoconiosis, often called black lung, are caused by exposures to respirable coal mine dust. Dust composition is increasingly understood as an important disease factor, and it can vary significantly depending on dust source materials and generation processes. For regulatory compliance purposes, the mass concentration and quartz percentage of respirable dust are monitored in U.S. coal mines, but the whole composition is not typically determined. Previous work has indicated that thermogravimetric analysis (TGA) can be used to apportion the respirable dust mass to three important component fractions (i.e., coal, non-carbonate minerals, and carbonate), which should generally correlate with three different dust sources (i.e., coal strata, rock strata, and limestone rock dusting products being applied in the mine). However, a primary shortcoming of that previous work was use of fibrous sampling filters, which limited dust recovery and thus analytical accuracy. Here, an improved TGA application is presented using smooth polycarbonate filters. Based on experiments with laboratory-generated dust samples (masses ranging between 95-1,319 µg), the TGA-derived mass fractions (reported as percentage values) for all three components were found to generally be within ±10% of expected values.

Characteristics of respirable dust in eight appalachian coal mines: A dataset including particle size and mineralogy distributions, and metal and trace element mass concentrations.

Respirable dust samples were collected in several key locations of eight underground coal mines in central and northern Appalachia. In total, there were 76 unique sampling events (i.e., specific location in a specific mine). Here, we present data from each event describing particle size and mineralogy class distributions across the ∼100-10,000nm size range, which were determined using SEM-EDX; and estimated mass concentrations of potentially bioaccessible and total acid-soluble metals and trace elements, which were determined using sequential digestions with digestate analysis by ICP-MS. Discussion of this dataset is included in a companion research article "Beyond conventional metrics: Comprehensive characterization of respirable coal mine dust" Sarver et al., 2019.

Progressive Massive Fibrosis Resurgence Identified in U.S. Coal Miners Filing for Black Lung Benefits, 1970-2016.

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. RESULTS: There were 4,679 unique PMF cases among claimants for federal black lung benefits between 1970 and 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, and 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% annual percent change [APC]; 95% confidence interval [CI], 0.05-0.07%; P < 0.0001), and began increasing at a significantly increased rate after 1996 (0.26% APC; 95% CI, 0.25-0.28%; P < 0.0001). 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, more than 17% of claimants received a PMF determination. The proportion of PMF determinations for the rest of the United States has 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.

The enduring legacy of black lung: environmental health and contested illness in Appalachia.

Over the past twenty years there has been a deadly resurgence of coal workers' pneumoconiosis (CWP), commonly known as black lung disease. While increased prevalence of the disease is alarming, these data only capture cases where CWP has been officially recognised. We argue that many more cases of the disease are going unreported. Drawing from contested environmental illness literature, we examine issues surrounding diagnostic uncertainty and medical surveillance. We draw from qualitative data on black lung that includes in-depth interviews, observation and document analysis. Findings indicate ongoing ambiguity and contestation over diagnosis of the disease, ranging from clinical and legal debates to concerted efforts to limit official recognition. While health screenings are currently available to miners, our results indicate low participation rates based on disincentives for early detection, logistical problems, and economic fears. Miners fear workplace discrimination and retaliation for participation in black lung screening programmes. Implications for public health policy and future research are discussed.

DUALIDAD, LA LOCOMOTORA MINERA Vs. EL PULMÓN NEGRO / DUALIDADE, LOCOMOTIVA MINERA Vs. PULMÃO PRETO / Duality, mining locomotive vs. black lung

La neumoconiosis es caracterizada por el depósito nodular difuso de polvo en los pulmones como resultado de la exposición prolongada a polvo bituminoso o de antracita en los trabajadores de las minas de carbón. La neumoconiosis de los mineros del carbón también se denomina enfermedad del pulmón negro o antracosis. Un minero del carbón que padece o desarrolla una Antracosis puede presentar numerosos nódulos redondeados pulmonares en poco tiempo. Dichos nódulos aparecen en ocasiones en ausencia de una antracosis simple. A nivel histológico pueden parecerse a los nódulos reumatoides, pero tienen una zona periférica de inflamación aguda. Estos nódulos representan la respuesta inmunológica a la diátesis reumatoide asociada. En Colombia la minería es un factor estratégico a nivel económico para su desarrollo. Sin embargo, existen factores negativos derivados de ésta que giran en una carrera sin control ni reglas claras; esta actividad hace trámite en el territorio, arrastrando una estela de problemas sobre la sociedad, el ambiente, el bienestar y la salud de las personas.

Pneumoconiosis is characterized by diffuse nodular dust in the lungs as a result of prolonged exposure of workers in coal mines to bituminous dust or anthracite. Pneumoconiosis presented in coal miners is also called black lung disease lung. A coal miner who develops Anthracosis can present numerous pulmonary rounded nodules in a short time. These nodules appear sometimes in the absence of a simple anthracosis. Histologically they may look like resemble rheumatoid nodules, with the difference; they have a peripheral area of acute inflammation. These nodes represent the immune response associated to rheumatoid diathesis. In Colombia, mining is a strategy for economical development. However, there are negative factors arising rotating it in a race without control or clear rules; This activity is pending in the territory, dragging a trail of problems on society, the environment, welfare and People's health

A pneumoconiose é caracterizada por poeira nodular difusa nos pulmões como resultado da exposição prolongada a poeiras betuminosas ou antracite nas minas de carvão. Pneumoconiose de mineiros de carvão também chamado preto ou preto doença pulmonar pulmão. Um mineiro de carvão que sofre ou desenvolve uma antracose pode apresentar numerosos nódulos pulmonares arredondados em um curto espaço de tempo. Estes nódulos aparecem às vezes na ausência de uma antracose simples. Histologicamente podem assemelhar-se a nódulos reumatóides, mas têm uma área periférica de inflamação aguda. Esses nódulos representam a resposta imune associada à diátese reumatóide. A mineração na Colômbia é um fator estratégico economicamente para o desenvolvimento. No entanto, existem fatores negativos decorrent surgindo girando-o em uma corrida sem controle ou regras claras. Esta atividade está pendente no território, arrastando um rastro de problemas na sociedade, o meio ambiente, bem-estar e da saúde das pessoas.

The "Pneumoconiosis event" and China's diagnosis and verification system for occupational diseases / 中华医院管理杂志

Ongoing improvement of the laws, rules and regulations are putting the diagnosis and verification of occupational diseases in China onto a legal and standard track. A case study of the "Pneumouconiosis event" of migrant worker Z in 2009 analyzed the challenges and causes of such system.In addition, the authors probed into the fundamental principles to follow in the diagnosis and verification,and raised recommendations for a better diagnosis and verification system in China.