Progression of coal workers’ pneumoconiosis absent further exposure

2020 ◽  
Vol 77 (11) ◽  
pp. 748-751
Author(s):  
Kirsten S Almberg ◽  
Lee S Friedman ◽  
Cecile S Rose ◽  
Leonard H T Go ◽  
Robert A Cohen

ObjectivesThe natural history of coal workers’ pneumoconiosis (CWP) after cessation of exposure remains poorly understood.MethodsWe 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.ResultsA 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.ConclusionsThis 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.

2020 ◽  
Vol 119 (1) ◽  
pp. 65-92
Author(s):  
Beris Penrose

Some reporters, politicians, and doctors have described current cases as a “re-emergence” of these diseases, based on the notion that they had been eliminated. However, silicosis persisted in centuries-old industries like sandblasting and stonemasonry and coal workers pneumoconiosis (CWP) continued in coal mining. Until recently, their presence was obscured by a combination of factors such as misdiagnosis, especially if there was a history of smoking; the failure to follow up workers thought to have silicosis or CWP; the long latency period between dust exposure and disease onset that can conceal the link between the two; and the lack of data collection that may have revealed their presence. As the recent Queensland government inquiry into CWP noted, current cases are more accurately a reidentification.


2016 ◽  
Vol 31 (3) ◽  
pp. 402-415 ◽  
Author(s):  
Rémi Boivin ◽  
Chloé Leclerc

This article analyzes reported incidents of domestic violence according to the source of the complaint and whether the victim initially supported judicial action against the offender. Almost three quarters of incidents studied were reported by the victim (72%), and a little more than half of victims initially wanted to press charges (55%). Using multinomial logistic regression models, situational and individual factors are used to distinguish 4 incident profiles. Incidents in which the victim made the initial report to the police and wished to press charges are the most distinct and involve partners who were already separated at the time of the incident or had a history of domestic violence. The other profiles also show important differences.


2021 ◽  
Vol 12 ◽  
Author(s):  
Rui Zhong ◽  
Qingling Chen ◽  
Xinyue Zhang ◽  
Weihong Lin

Purpose: This retrospective observational study aimed to investigate the self-reported prevalence of seizure clusters (SCs) in patients with epilepsy (PWE) and its relationship with clinical characteristics.Methods: We retrospectively analyzed data from consecutive PWE from our hospital in northeastern China. Data were collected from the databank of a tertiary epilepsy center. Logistic regression models were employed to investigate the relationships between the individual patient demographic/clinical variables and the occurrence of SC.Results: In total, 606 consecutive PWE were included in the final analysis, and 268 (44.2%) patients experienced at least one seizure cluster. In multivariate logistic regression models, age (OR: 1.014; 95% CI: 1.002–1.027; p = 0.02), seizure frequency (OR: 2.08; 95% CI: 1.555–2.783; p < 0.001), multiple seizure types (OR: 5.111; 95% CI: 1.737–15.043; p = 0.003), number of current anti-seizure medications (ASM) (OR: 1.533; 95% CI: 1.15–2.042; p = 0.004), drug-resistant epilepsy (OR: 1.987; 95% CI: 1.159–3.407; p = 0.013), and a history of status epilepticus (OR: 1.903; 95% CI: 1.24–2.922; p = 0.003) were independent variables associated with a history of SC in PWE.Conclusion: Seizure clusters (SCs) are common occurrences at our study center. The occurrence of SC in individuals with epilepsy, to some extent, is determined by the epilepsy severity.


2019 ◽  
Vol 76 (7) ◽  
pp. 479-481 ◽  
Author(s):  
Noemi B Hall ◽  
David J Blackley ◽  
Cara N Halldin ◽  
A Scott Laney

IntroductionRespirable crystalline silica exposure has been implicated in the resurgence of coal workers’ pneumoconiosis (CWP) in the USA. A 2010 report found an increasing prevalence of r-type opacities, which are associated with silicosis lung pathology, on the radiographs of working underground coal miners in central Appalachia. This analysis updates that report by assessing the prevalence of r-type opacities during 2010–2018 compared with earlier decades.MethodsData from the Coal Workers’ Health Surveillance Program were used to calculate the prevalence of r-type opacities on radiographs of working underground coal miners. The data were restricted to radiographs taken during 1 January 1980 to 15 September 2018. The presence of r-type opacities was defined as an r-type classification for either the primary or secondary shape/size of small opacities. Prevalence ratios for r-type opacities were calculated using log binomial regression.ResultsRadiograph classifications for 106 506 miners were included in analysis. For the USA overall, the prevalence of r-type opacities among miners with radiographs taken during 2010–2018 compared with 1980–1989 has increased (PR 2.4; 95% CI 1.9 to 3.0). For central Appalachia, the proportion of r-type opacities observed increased when comparing 1980–1989 to 2010–2018 (PR 6.0; 95% CI 4.6 to 7.9).ConclusionsThe prevalence of r-type opacities on the radiographs of Appalachian underground coal miners continues to increase, implicating exposure to crystalline silica in respirable coal mine dust. The current findings underscore the importance of monitoring and controlling exposure to silica in coal mines.


2019 ◽  
Vol 5 (2) ◽  
pp. 00197-2018 ◽  
Author(s):  
Ina Kreyberg ◽  
Karen E.S. Bains ◽  
Kai-H. Carlsen ◽  
Berit Granum ◽  
Hrefna K. Gudmundsdóttir ◽  
...  

In young women, the use of snus increases in parallel with decreasing smoking rates but the  use in pregnancy is unclear. Our aims were to determine the prevalence of snus use, smoking and other nicotine-containing product use during pregnancy, and to identify predictors for snus use in pregnancy.Prevalence was determined for 2528 women in Norway and Sweden based on the Preventing Atopic Dermatitis and ALLergies (PreventADALL) study, a population-based, mother–child birth cohort. Electronic questionnaires were completed in pregnancy week 18 and/or week 34, and potential predictors of snus use were analysed using logistic regression models.Ever use of any snus, tobacco or nicotine-containing products was reported by 35.7% of women, with similar rates of snus use (22.5%) and smoking (22.6%). Overall, 11.3% of women reported any use of nicotine-containing products in pregnancy up to 34 weeks, most often snus alone (6.5%). Most women (87.2%) stopped using snus by week 6 of pregnancy.Snus use in pregnancy was inversely associated with age and positively associated with urban living and personal or maternal history of smoking. While 11.3% of women used snus or other nicotine-containing products at some time, most stopped when recognising their pregnancy. Younger, urban living, previously smoking women were more likely to use snus in pregnancy.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Adam Knowlden ◽  
Michael A Grandner

Background: Epidemiological evidence of short sleep’s (<6 hours) association with negative cardiometabolic health outcomes continues to mount; yet, the complex relationship between sleep and health is still not well-understood. Sleep problems, such as short sleep (SS) and insomnia (IN), are often analyzed as a singular construct at the population level; however, it has been proposed that, although these two sleep problems likely overlap, they are separate phenomena. The purpose of this study was to: (1) determine if SS and IN were independent constructs; and to (2) evaluate whether SS and IN predicted obesity, hypertension, and diabetes. Methods: Analyses were based on the 2015-2016 National Health and Nutrition Examination Survey (NHANES). NHANES employs a complex, multistage, probability sampling design to survey a representative sample of non-institutionalized U.S. adults (≥18 years). Data related to short (<6), normal (7-8), and long (9+) sleep duration, insomnia (present: mild, moderate, severe), hypertension (present: previous hypertension/hypertension medications/blood pressure in the hypertensive range), and diabetes (present: history of diabetes/fasting blood sugar of 130+) were extracted for analysis. Age, sex, and obesity (body mass index, 30.0+) were entered as covariates into the models. Results: Among the subjects, 0.08% were normal sleepers with IN; 0.21% were SS with insomnia; and, 0.59% had IN with SS. Table 1 summarizes the multivariate and stratified logistic regression models of SS and IN predicting obesity, hypertension, and diabetes. Conclusions: Findings from this study suggested SS and IN are independent constructs, uniquely predicting obesity, hypertension, and diabetes. SS and IN neither mediated nor moderated one another, implying these two sleep outcomes are not additive in nature, but are instead separate health problems. The distinction between SS and IN may have important epidemiological and clinical implications.


2021 ◽  
pp. 145507252110212
Author(s):  
Jonna Levola ◽  
Arno Aranko ◽  
Tuuli Pitkänen

Aims: Treatment retention is associated with addiction treatment outcomes. Research regarding predictors of retention at inpatient detoxification treatment is limited. The aim of this study was to investigate whether psychosocial difficulties (PSDs) are associated with treatment retention among Finnish inpatients undergoing detoxification treatment. Design: This register-based study included real-life data on detoxification treatment episodes ( n = 2,752) between February of 2016 and May of 2019 from several inpatient treatment units in Finland. The PARADISE24fin instrument was used to assess PSDs. Socio-demographic and substance use related variables, as well as PSDs, were analysed with regard to treatment retention. Multiple logistic regression models were used to identify predictors of treatment incompletion. Results: Of the 2,752 detoxification treatment episodes, 80.3% ( n = 2,209) were completed. Men and women differed with regard to the variables associated with treatment retention. After adjusting for confounders, younger age (≤ 35 years), being less educated (≤ 9 years), being unemployed, using opioids, polysubstance use and more severe dependence were associated with treatment incompletion. Overall severity of PSDs (PARADISE24fin mean score) became non-significant after adjusting for confounders. However, having more severe cognitive difficulties was significantly associated with treatment incompletion, while more severe difficulties in daily activities was associated with treatment completion. Conclusions: Special attention should be paid to younger individuals with opioid and/or polysubstance use, as well as those with cognitive difficulties, in order to retain people in treatment.


Sign in / Sign up

Export Citation Format

Share Document