肺部疾病与煤矿开采：肺科医生需要了解的内容。
Lung disease and coal mining: what pulmonologists need to know.
作者信息
Go Leonard H T, Krefft Silpa D, Cohen Robert A, Rose Cecile S
机构信息
aEnvironmental and Occupational Health Sciences Division, University of Illinois at Chicago School of Public Health, Chicago, Illinois bColorado School of Public Health, Aurora cDivision of Pulmonary Sciences and Critical Care Medicine, University of Colorado dDivision of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado, USA.
出版信息
Curr Opin Pulm Med. 2016 Mar;22(2):170-8. doi: 10.1097/MCP.0000000000000251.
PURPOSE OF REVIEW
Coal mine workers are at risk for a range of chronic respiratory diseases including coal workers' pneumoconiosis, diffuse dust-related fibrosis, and chronic obstructive pulmonary disease. The purpose of this review is to describe coal mining processes and associated exposures to inform the diagnostic evaluation of miners with respiratory symptoms.
RECENT FINDINGS
Although rates of coal workers' pneumoconiosis declined after regulations were enacted in the 1970s, more recent data shows a reversal in this downward trend. Rapidly progressive pneumoconiosis with progressive massive fibrosis (complicated coal workers' pneumoconiosis) is being observed with increased frequency in United States coal miners, with histologic findings of silicosis and mixed-dust pneumoconiosis. There is increasing evidence of decline in lung function in individuals with pneumoconiosis. Multiple recent cohort studies suggest increased risk of lung cancer in coal miners.
SUMMARY
A detailed understanding of coal mining methods and processes allows clinicians to better evaluate and confirm chronic lung diseases caused by inhalational hazards in the mine atmosphere.
综述目的
煤矿工人面临一系列慢性呼吸道疾病的风险，包括煤工尘肺、弥漫性粉尘相关纤维化和慢性阻塞性肺疾病。本综述的目的是描述煤矿开采过程及相关暴露因素，为有呼吸道症状的矿工的诊断评估提供依据。
最新发现
尽管在20世纪70年代颁布相关规定后，煤工尘肺的发病率有所下降，但最近的数据显示这一下降趋势出现了逆转。在美国煤矿工人中，快速进展性尘肺伴进行性大块纤维化（复杂性煤工尘肺）的观察频率增加，其组织学表现为矽肺和混合性粉尘尘肺。越来越多的证据表明尘肺患者的肺功能下降。最近的多项队列研究表明煤矿工人患肺癌的风险增加。
总结
对煤矿开采方法和过程的详细了解使临床医生能够更好地评估和确诊由矿井空气中吸入性危害导致的慢性肺部疾病。
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