Occupational respiratory disease in mining

Our plain-English summary of Occupational respiratory disease in mining, by M.H. Ross, J. Murray (Occupational Medicine, 2004).

The study

• Authors: M.H. Ross, J. Murray
• Journal: Occupational Medicine
• Published: 2004;54(5):304-10
• Type of article: Review
• Cited by: 90 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This review is based on research-based literature on occupational lung disease in the mining and related industries, focusing on conditions of public health importance arising from asbestos, coal and silica exposure. Both 'traditional' and 'new' concerns about occupational respiratory disease in miners are addressed, with the inclusion of practical evidence-based findings relevant to practitioners working in developed and developing countries. Mining is not a homogeneous industry since current miners work in formal and informal operations with numerous, and often multiple, air-borne exposures. A further occupational health challenge facing primary care practitioners are ex-miners presenting with disease only after long latency. The sequelae of silica exposure remain an occupational health priority, particularly for practitioners who serve populations with concomitant HIV and tuberculosis infection and even when exposure is apparently below the statutory occupational exposure level. Coal workers' pneumoconiosis, asbestos related diseases, lung cancer and other occupational respiratory diseases remain of considerable importance even after mining operations cease. While mining exposures contribute significantly to lung disease, smoking is a major factor in the development of lung cancer and chronic obstructive airways disease necessitating a comprehensive approach for prevention and control of mining-related occupational lung disease.

In plain English

This article was a review, not a new study. The authors summarized published research on lung disease in miners, focusing on asbestos, coal and silica. They drew on earlier reviews, their own research and literature from the previous 10 years. Citing other studies, the review reported that pleural plaques made up 28–35% of occupational respiratory disease cases reported in the UK in 1992–1999. It also reported that a Swedish study linked plaques to an increased risk of mesothelioma, that asbestosis deaths in the USA rose more than 10-fold from 1968 to 1999, and that mesotheliomas among UK males rose almost 3-fold over 20 years, with 6475 cases in 1996–2000. It described debate over whether asbestos raises lung cancer risk by itself or through asbestosis. For silica, it cited a study of black South African gold mineworkers in which HIV and silicosis together increased tuberculosis incidence fifteen-fold. The authors concluded that these diseases remain important after mining ends. They also concluded that smoking, a major factor in lung cancer and chronic obstructive airways disease, calls for a comprehensive approach to prevention.

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: Narrative review of published literature (no new data collected)
• Who was studied: No study population of its own; the review covered published research on current and former miners and related workers exposed to asbestos, coal and silica, in developed and developing countries
• Exposure: Asbestos (chrysotile, the amphiboles amosite and crocidolite, and chrysotile contaminated by tremolite), coal mine dust, and silica dust, with smoking as a co-factor
• Main results:
  • Citing UK surveillance data, the review reported that pleural plaques (benign pleural disease) made up 28–35% of occupational respiratory disease cases reported in the UK in 1992–1999
  • Citing a Swedish study, the review reported that pleural plaques on chest X-ray indicated significant asbestos exposure and an increased risk of mesothelioma (and possibly lung cancer)
  • Citing US data, the review reported that asbestosis deaths in the USA increased more than 10-fold from 1968 to 1999
  • Citing other work, the review stated that asbestosis is not a risk factor for tuberculosis
  • Citing UK statistics, the review reported that mesotheliomas among UK males increased almost 3-fold over 20 years, with 6475 cases in 1996–2000
  • Citing other work, the review reported a high incidence of mesothelioma in women who live or lived in the Quebec chrysotile mining area, and noted that tremolite contamination of chrysotile there increases its toxicity
  • The review stated that there is no effective therapy for malignant mesothelioma and that untreated median survival is 9 months
  • The review described smoking as greatly enhancing lung cancer risk in asbestos-exposed people, and noted that the multiplicative model of this combined effect had recently been challenged
  • Citing NIOSH surveillance, the review reported that coal workers' pneumoconiosis rates in active US underground miners fell from more than 10% in the early 1970s to less than 2% in the late 1990s
  • Citing a study of black South African gold mineworkers, the review reported that HIV infection increased tuberculosis incidence five times, silicosis three times, and both together fifteen times
• The authors' conclusion: The authors concluded that coal workers' pneumoconiosis, asbestos-related diseases, lung cancer and other occupational respiratory diseases remain of considerable importance even after mining ends. They also concluded that, because smoking is a major factor in lung cancer and chronic obstructive airways disease, a comprehensive approach to prevention and control is needed.
• Limitations the authors state:
  • The authors stated that the review was limited in scope because the relevant diseases and exposures are too many to cover fully in a short review

Topics

Medical terms in this study, explained in our Lexicon: Occupational Lung Disease, Latency, Occupational Exposure, Pneumoconiosis, Lung Cancer.

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