NIOSH's Respiratory Health Division: 50 years of science and service

Our plain-English summary of NIOSH's Respiratory Health Division: 50 years of science and service, by K.J. Cummings, D.O. Johns, J.M. Mazurek, et al (Archives of Environmental & Occupational Health, 2019).

The study

• Authors: K.J. Cummings, D.O. Johns, J.M. Mazurek, F.J. Hearl, D.N. Weissman
• Journal: Archives of Environmental & Occupational Health
• Published: 2019;74(1-2):15-29
• Type of article: Historical article
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The year 2017 marked the 50th anniversary of NIOSH's Respiratory Health Division (RHD). RHD began in 1967 as the Appalachian Laboratory for Occupational Respiratory Diseases (ALFORD), with a focus on coal workers' pneumoconiosis. ALFORD became part of NIOSH in 1971 and added activities to address work-related respiratory disease more generally. Health hazard evaluations played an important role in understanding novel respiratory hazards such as nylon flock, diacetyl, and indium-tin oxide. Epidemiologic and laboratory studies addressed many respiratory hazards, including coal mine dust, silica, asbestos, cotton dust, beryllium, diesel exhaust, and dampness and mold. Surveillance activities tracked the burden of diseases and enhanced the quality of spirometry and chest radiography used to screen workers. RHD's efforts to improve scientific understanding, inform strategies for prevention, and disseminate knowledge remain important now and for the future.

In plain English

This article is a historical overview, not a new study. It described 50 years of the Respiratory Health Division of the US National Institute for Occupational Safety and Health (NIOSH). The division began in 1967 in Morgantown, West Virginia, focused on coal workers' pneumoconiosis, and later took on many other workplace lung hazards. On asbestos, the review described earlier reports by other researchers. A 1987 report found a dose–response relationship between lung cancer deaths and workers' exposure to asbestos fibers found in vermiculite mined and processed near Libby, Montana. A 2007 follow-up confirmed increased risk of lung cancer death and showed increased risk of cancer of the pleura in these workers. The review said these studies also documented increased deaths from nonmalignant respiratory disease and asbestosis, respectively. It also mentioned laboratory work on the pathology of asbestos-associated diseases of the lungs and pleura, and surveillance reports covering asbestosis and malignant mesothelioma. It described a program certifying physicians (B Readers) who classify chest X-rays for dust diseases, including those from asbestos. The authors concluded that the division had been impactful and was well poised to keep working to prevent work-related respiratory disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Historical review/overview of a NIOSH research division's activities; no new data collected
• Who was studied: NIOSH's Respiratory Health Division (formerly ALFORD, then DRDS), Morgantown, West Virginia, from 1967 to about 2017, and the studies and programs it carried out
• Exposure: A broad range of workplace respiratory hazards, including coal mine dust, silica, asbestos (fibers in vermiculite from Libby, Montana), cotton dust, beryllium, diesel exhaust, flavorings, indium-tin oxide, nylon flock, and dampness and mold
• Main results:
  • The review described a 1987 report of a dose–response relationship for lung cancer mortality associated with workers' exposure to asbestos fibers found in vermiculite mined and processed near Libby, Montana
  • The review described a 2007 follow-up report that confirmed increased risk of lung cancer mortality and showed increased risk of cancer of the pleura in these Libby vermiculite workers
  • According to the review, the 1987 and 2007 studies also documented increased mortality from nonmalignant respiratory disease and from asbestosis, respectively
  • The review listed laboratory contributions describing the pathology of coal workers' pneumoconiosis and of asbestos-associated diseases of the lungs and pleura
  • The division's surveillance reports covered asbestosis: the first Work-Related Lung Disease report (1991) presented data for 1968 to 1987. The later web platform eWoRLD presents data on malignant mesothelioma among other conditions
  • The review said chest X-ray surveillance is used for pneumoconioses caused by agents including asbestos. Certified B Readers rose to about 750 by the mid-1990s and have since declined to fewer than 200
• The authors' conclusion: The authors concluded that the division had been impactful and was well poised to continue improving scientific understanding, informing prevention strategies, and disseminating information to prevent work-related respiratory disease

Topics

Medical terms in this study, explained in our Lexicon: NIOSH, Pneumoconiosis, Spirometry.

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