Get access

Rapid decline in lung function in coal miners: Evidence of disease in small airways

Authors

  • Robert C. Stansbury MD,

    Corresponding author
    • Section of Pulmonary and Critical Care Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia
    Search for more papers by this author
  • Lu-Ann F. Beeckman-Wagner PhD,

    1. Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, National Institute for Occupational Safety and Health, Morgantown, West Virginia
    Search for more papers by this author
  • Mei-Lin Wang MD,

    1. Division of Respiratory Disease Studies, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, National Institute for Occupational Safety and Health, Morgantown, West Virginia
    Search for more papers by this author
  • Jeffery P. Hogg MD,

    1. Department of Radiology, School of Medicine, West Virginia University, Morgantown, West Virginia
    Search for more papers by this author
  • Edward L. Petsonk MD

    1. Section of Pulmonary and Critical Care Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia
    Search for more papers by this author

  • Disclosure Statement: I certify that I do not have personal or financial support nor involvement with organization(s) with financial interest in the subject matter.
  • The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health. This article has an online data supplement, which is accessible from this issue's table of content online at (designated by Journal).

Correspondence to: Robert C. Stansbury, MD, Section of Pulmonary and Critical Care Medicine, School of Medicine, West Virginia University, 4075A Health Sciences Center North, Morgantown, WV 26505-9166.

E-mail: rstansbury@hsc.wvu.edu

Abstract

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 FEV1 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 cmH2O/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 FEV1 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.

Ancillary