Shriver Thomas E, Bodenhamer Aysha
Department of Sociology and Anthropology, North Carolina State University, North Carolina, USA.
Department of Sociology, Radford University, Radford, Virginia, USA.
Sociol Health Illn. 2018 Nov;40(8):1361-1375. doi: 10.1111/1467-9566.12777. Epub 2018 Jun 28.
Over the past twenty years there has been a deadly resurgence of coal workers' pneumoconiosis (CWP), commonly known as black lung disease. While increased prevalence of the disease is alarming, these data only capture cases where CWP has been officially recognised. We argue that many more cases of the disease are going unreported. Drawing from contested environmental illness literature, we examine issues surrounding diagnostic uncertainty and medical surveillance. We draw from qualitative data on black lung that includes in-depth interviews, observation and document analysis. Findings indicate ongoing ambiguity and contestation over diagnosis of the disease, ranging from clinical and legal debates to concerted efforts to limit official recognition. While health screenings are currently available to miners, our results indicate low participation rates based on disincentives for early detection, logistical problems, and economic fears. Miners fear workplace discrimination and retaliation for participation in black lung screening programmes. Implications for public health policy and future research are discussed.
在过去二十年里，煤工尘肺（CWP）——俗称黑肺病——出现了致命的死灰复燃。虽然该疾病患病率的上升令人担忧，但这些数据仅涵盖了煤工尘肺已得到官方认可的病例。我们认为，还有更多该疾病的病例未被报告。借鉴有争议的环境疾病文献，我们研究了围绕诊断不确定性和医学监测的问题。我们借鉴了关于黑肺病的定性数据，包括深入访谈、观察和文件分析。研究结果表明，在该疾病的诊断方面存在持续的模糊性和争议，从临床和法律辩论到限制官方认可的协同努力。虽然目前矿工可接受健康筛查，但我们的结果表明，由于早期检测的不利因素、后勤问题和经济担忧，参与率较低。矿工担心参与黑肺病筛查计划会受到工作场所的歧视和报复。文中还讨论了对公共卫生政策和未来研究的影响。
