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Target Concepts:
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Query: UMLS:C0034067 (
emphysema
)
11,506
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
General mortality in approximately 25 000 British coalminers over 22 year periods ending in 1980 was 13% lower on average than in English and Welsh men in the same regions of Britain. There were significant within region variations between collieries, and standardised mortality ratios increased during the later years of the follow up, approaching or slightly exceeding 100 in most of the 20 coalmines studied. Age specific comparisons of 22 year survival rates were made in subgroups. Relative risks of death from all non-violent causes for men with the earliest stage of progressive massive fibrosis (
PMF
category A), compared with risks in miners with no pneumoconiosis (category O), ranged from 1.2 in those aged 55-64 initially to 3.5 for those aged 25-34. Mortality in miners with higher categories of
PMF
(B or C) was even more severe. Survival rates in men with category 1 simple pneumoconiosis were about 2% to 3% lower than in miners with radiographs classified as category O, but there was no consistent evidence of an increase in mortality with increasing category of simple pneumoconiosis. Mortality from all non-violent causes increased systematically with increases in estimates of exposure to dust before the start of the follow up. That gradient was attributable primarily to deaths certified as due to pneumoconiosis and those recorded as due to bronchitis and
emphysema
(p less than 0.001). There was some evidence of a dust related increase in deaths from cancers of the digestive system (p approximately equal to 0.05), but none of an association between exposure to coalmine dust and lung cancer. Lung cancer mortality, assessed over 17 year periods, was about 5.5 times higher in smokers than in life long non-smokers. Smokers with no pneumoconiosis had slightly higher lung cancer death rates than smokers with pneumoconiosis. We conclude that miners exposed to excessive amounts of respirable coalmine dust are at increased risk of premature death, either from progressive massive fibrosis or from chronic bronchitis or
emphysema
.
...
PMID:Dust exposure, pneumoconiosis, and mortality of coalminers. 406 15
The lungs of 450 coal miners who had been studied previously in a long-term epidemiologic project at 24 British mines have been examined post-mortem for signs of dust-related fibrosis and
emphysema
. Reliable estimates of cumulative (working-life) exposures to respirable mine dust were available for 342 of the men. The relative frequency of
emphysema
increased with age at death, and both panacinar and centriacinar
emphysema
occurred more frequently in smokers than in nonsmokers. The proportion of subjects with any
emphysema
was 47% in 92 men with no palpable dust lesions, 65% in 183 with small, simple pneumoconiotic lesions, and 83% in 175 miners with massive fibrosis (
PMF
). The chance of finding centriacinar
emphysema
in those with
PMF
increased significantly with increasing exposure to coal dust in life (p less than 0.025). A similar but less convincing relationship was found in those with simple pneumoconiosis (p less than 0.11), but in both groups, increasing amounts of ash with a given exposure to coal reduced the probability of finding centriacinar
emphysema
. The occurrence of centriacinar
emphysema
was associated also with increasing amounts of dust retained in the lungs. A preliminary exploration of this association did not support the hypothesis that emphysematous lungs clear dust less efficiently. We conclude that the association observed between exposure to respirable coal dust and
emphysema
in coal miners indicates a causal relationship. However, because it can be demonstrated only for men whose lungs show some dust-related fibrosis, it is suggested that the extent and nature of such fibrosis may be a crucial factor in determining the presence of centriacinar
emphysema
.
...
PMID:Emphysema and dust exposure in a group of coal workers. 671 95