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Rapid decline in lung function in coal miners: Evidence of disease in small airways
Author(s) -
Stansbury Robert C.,
BeeckmanWagner LuAnn F.,
Wang MeiLin,
Hogg Jeffery P.,
Petsonk Edward L.
Publication year - 2013
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.22211
Subject(s) - medicine , pneumoconiosis , air trapping , lung , pulmonary compliance , lung function , airway resistance , pulmonary function testing , lung volumes , cardiology , pathology
Background Coal mine dust exposure can cause both pneumoconiosis and chronic airflow limitation. The contributions of various pathophysiologic mechanisms to dust‐related lung function decrements remain unclear. Methods Clinical and physiological findings were assessed for 15 underground coal miners who had demonstrated accelerated FEV 1 losses (decliners) over 6–18 years. Decliners' findings were evaluated in comparison to a group of 11 miners who had shown relatively stable lung function (referents) during the same period. Results At follow‐up examination, the decliners showed significantly greater mean airway resistance (10.47 vs. 6.78 cmH 2 O/L/s; P = 0.05) and more air trapping (RV/TLC = 37.5 vs. 29.1%; P < 0.01) compared to the referents. Decliners also demonstrated more evidence of small airways dysfunction and tended to have more bronchospasm than the referent group. Total lung capacity, lung compliance, diffusing capacity, and chest radiography did not differ significantly between the two groups. After cessation of mine dust exposures, the decliners' mean rate of FEV 1 loss normalized. Conclusion In a series of working coal miners, accelerated lung function declines were associated with air trapping and evidence of small airways dysfunction. A preventive benefit from controlling dust exposures was suggested. Am. J. Ind. Med. 56:1107–1112, 2013. © 2013 Wiley Periodicals, Inc.