Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
Occup Environ Med. 2020 Jun;77(6):402-406. doi: 10.1136/oemed-2019-106307. Epub 2020 Mar 13.
Pneumoconiosis prevalence and severity among US coal miners has been increasing for the past 20 years. An examination of the current approaches to primary and secondary prevention efforts is warranted. One method of secondary prevention is the Mine Safety and Health Administration-administered part 90 option programme where US coal miners with radiographic evidence of pneumoconiosis can exercise their right to be placed in a less dusty area of the mine. This study focuses on characterising the progression of disease among US coal miners who participated in the National Institute for Occupational Safety and Health-administered Coal Workers' Health Surveillance Programme (CWHSP) and exercised their part 90 job transfer option.
Chest radiograph classifications of working underground coal miners who exercised their part 90 job transfer option during 1 January 1986 to 21 November 2016 and participated in the CWHSP during 1 January 1981 to 19 March 2019 were analysed.
513 miners exercised their part 90 option and participated in the CWHSP at least once during this time period. Of the 149 miners with ≥2 radiographs available, 48 (32%) showed progression after exercising part 90 and had more severe disease prior to exercising, compared with miners who did not progress (severity score of 2.8 vs 1.7, p=0.0002).
The part 90 job transfer option programme is not routinely used as intended to prevent progression of pneumoconiosis among US coal miners. The one-third of miners who participated in part 90 and continued to progress, exercised their part 90 option at a later stage of disease compared with non-progressors.
在过去的 20 年中，美国煤矿工人的尘肺病患病率和严重程度一直在上升。有必要审查当前初级和二级预防措施的方法。二级预防的一种方法是矿山安全与健康管理局管理的第 90 部分选项计划，根据该计划，有 X 光片证据表明患有尘肺病的美国煤矿工人可以行使其权利，被安置在煤矿中尘埃较少的区域。本研究重点描述了参加美国国家职业安全与健康研究所管理的煤矿工人健康监测计划（CWHSP）并行使第 90 部分工作调动选择的美国煤矿工人中疾病的进展情况。
分析了 1986 年 1 月 1 日至 2016 年 11 月 21 日期间行使第 90 部分工作调动选择权并参加 CWHSP 的在地下煤矿工作的矿工的胸部 X 射线分类，并在 1981 年 1 月至 2019 年 3 月 19 日期间至少参加过一次 CWHSP。在有≥2 张 X 光片的 149 名矿工中，有 48 名（32%）在行使第 90 部分选择权后病情进展，且在行使前病情更严重（严重程度评分为 2.8 与 1.7，p=0.0002）。
第 90 部分工作调动选择计划并未按预期常规用于预防美国煤矿工人尘肺病的进展。在参加第 90 部分且继续进展的矿工中，有三分之一的矿工在疾病的后期阶段行使了第 90 部分选择权。
