Histocompatibility antigens in coal miners with pneumoconiosis

Twenty-five histocompatibility antigens have been measured in 100 coal miners with pneumoconiosis attending a pneumoconiosis medical panel and the results compared with a panel of 200 normal volunteers not exposed to dust. Chest radiographs were read independently by three readers according to the ILO U/C classification. On a combined score, 40 men were thought to have simple pneumoconiosis and 60 men complicated pneumoconiosis. The number of antigens tested and associations between antigens caused difficulties in assessing the statistical significance of differences in prevalence of antigens between groups of men. Using stringent criteria for statistical significance, no significant differences were found in antigen prevalences between miners and controls, or miners with simple or complicated pneumoconiosis. When a less stringent statistical approach was applied, three antigens appeared to have abnormal prevalences in these 100 miners by comparison with the normal volunteers. More detailed examination of these antigen prevalences in relation to radiographic category of pneumoconiosis did not provide any supportive evidence that these slight associations were of statistical or clinical significance. Reports on histocompatibility antigens in miners with pneumoconiosis are reviewed briefly and the results compared. There is no good evidence that any of the histocompatibility antigens so far tested are associated with a clinically important altered risk of simple or complicated pneumoconiosis when dust is inhaled.     

824名煤矿脱尘工人尘肺病现状调查

调查显示,824名煤矿脱尘工人的尘肺患病率较高,占尘肺总数的37.40%;按不同接尘年代分组,晚发尘肺患病数及尘肺晋期人数比较,50年代接尘组高于60年代及70年代以后接尘组(P<0.01);不同作业工龄及工种的煤矿脱尘工人晚发性尘肺发病率及尘肺晋期率无明显差异(P>0.05)。     

静脉滴注免疫球蛋白治疗煤工尘肺并发重度支气管哮喘23例

煤工尘肺患者中并发支气管哮喘者可达 2 5 % [1] 。我们自 2 0 0 0年 6月至 2 0 0 2年 8月对煤工尘肺并发重度支气管哮喘经抗生素、激素及氨茶碱等治疗效果不佳的 2 3例患者 ,给予静脉滴注免疫球蛋白治疗 ,取得了较好的临床效果。报告如下。一、对象与方法1 病例选择 :选择自 2 0 0 0年 6月至 2 0 0 2年 8月经抗生素、大剂量激素、氨茶碱及吸氧等综合治疗后呼吸困难仍不缓解的煤工尘肺并发重度支气管哮喘男性患者 2 3例作为治疗对象 ,年龄 5 8～ 79岁 (平均 6 5 .3岁 ) ,其中煤工尘肺Ⅰ期13例、Ⅱ期 8例、Ⅲ期 2例。以 1998年 6月至 2 0 0 0…     

梅州市248名煤尘肺工人体质监护结果分析

目的 分析梅州市国营煤矿煤尘肺工人体质状况集体监护结果。方法 病史采集，内外科常规检查，采用高千伏X射线拍胸片，使用肺功能仪进行肺功能测定，采用生化分析仪检测肝功能、尿糖等项目。结果 检查煤尘肺工人248名。年龄分布：最小40岁，最大81岁。接尘工龄：最短3．5a，最长49．6a，平均19．5a。工种分布：掘进工最多，其次为采煤工，再次为混合工。尘肺期别：Ⅰ期、Ⅰ^ 期、Ⅱ(Ⅱ^ )期，分别占68．5％、8．9％、22．6％。晋期情况：无变化占75．0％，发现晋期62例，占25．0％。X线表现复杂多样，以小阴影表现为主，占79．8％。有肺功能损害101人，占40．7％。轻度损害最多，占20．2％。并发症主要为高血压42．3％，心电图异常17．7％，肺气肿7．3％，胸膜粘连8．9％，肺结核1．6％，肺癌0．4％。结论 梅州市煤尘肺患者具有如下特征：年龄大、病程长、确诊尘肺年龄早。呼吸系统症状明显，肺通气功能损害不严重，并发症尤其肺结核发病率低。表明梅州市在及早诊断尘肺新发病例，预防新发病例发生，延长尘肺病人寿命，以及控制尘肺并发症方面是有成效的。     

An investigation into the relationship between coal workers' pneumoconiosis and dust exposure in U.S. coal miners.

The National Study of Coal Workers' Pneumoconiosis (NSCWP) is a large, continuing epidemiologic study of the respiratory health of U.S. coal miners. By using information from the study, prevalence of coal workers' pneumoconiosis (CWP) was related to indexes of dust exposure obtained from research and compliance sampling data. Clear relationships between prevalences of both simple CWP and progressive massive fibrosis (PMF) and estimated dust exposure were seen. Additional effects independently associated with coal rank (% carbon) and age were also seen. Logistic model fitting indicated that between 2% and 12% of miners exposed to a 2-mg/m3 dust environment in bituminous coal mines would be expected to have Category 2 or greater CWP after a 40-yr working life; PMF would be expected for between 1.3% and 6.7%. The risks for anthracite miners appeared to be greater. There was a suggestion of a background level of abnormality, not associated with dust exposure, but increasing with age. Although there are certain weaknesses in the data used to derive these exposure estimates, the results are in general agreement with, but somewhat greater than, some recent findings for British coal miners.     

煤矿矿工尘肺与肺癌死亡Poisson回归分析

目的 探讨尘肺与肺癌的关系。方法 对涟邵矿务局3140例尘肺矿工进行回顾性队列分析,计算主要死因的标化死亡比（SMR）,对尘肺与肺癌的关系进行Poisson回归分析。结果 尘肺矿工全死因与肺癌均高于对照人数,其中肺癌高于湖南省人群5倍;Poisson回归分析表明尘肺矿工肺癌与对照组的差别主要在25－44岁组。结论 支持尘肺与肺癌的相关关系。     

Long-term mortality in miners with coal workers' pneumoconiosis in The Netherlands: a pilot study

In order to investigate whether the prolonged exposure to coal mine dust increases the cancer risk for coal miners, a pilot study in a selected cohort of 334 Dutch miners with coal workers' pneumoconiosis (CWP), followed from 1956 until 1983, was conducted. In total, 165 miners had died (49.4%); for 162 (98.2%) the cause of death was traced. In comparison to the general Dutch male population, total mortality in the cohort was statistically significantly increased (SMR: 153). This was in general due to the significantly higher than expected cancer mortality (SMR: 163), cancer of stomach and small intestine (SMR: 401) and nonmalignant respiratory disease (SMR: 426). The lung cancer mortality was within the expected range.     

福莫特罗与特布他林吸入对煤工尘肺患者的支气管扩张作用

目前临床上对煤工尘肺 (CWP)主要以对症治疗为主。β2 受体激动剂用于治疗哮喘与慢性阻塞性肺病 (COPD) ,取得了较好的疗效[1,2 ] ,但用于治疗CWP尚未见报道。本研究观察了长效 β2 受体激动剂———福莫特罗与短效 β2 受体激动剂———特布他林吸入对煤工尘肺患者的支气管扩张作用。一、对象与方法1 病例选择 :从淮北矿业集团公司 3410例煤工尘肺患者中随机抽取 6 0人 ,均为男性 ,年龄 4 7～ 79岁 ,平均 (6 2 .1±7.4 )岁。所有受试者符合下列条件 :过去 2周内无并发呼吸道感染 ,无严重心、肝、肾脏、内分泌疾病及肌肉神经疾病 ,除…     

Functional variables associated with the clinical grade of dyspnoea in coal miners with pneumoconiosis and mild bronchial obstruction

OBJECTIVES—Dyspnoea is a common symptom in coal miners with pneumoconiosis. Among others, gas exchange disturbances due to airway obstruction or mismatch between ventilation and perfusion may be underlying mechanisms. The validation of dyspnoea by the degree of airway obstruction is controversial, because the extent of airway obstruction often does not correlate with the clinical grade of breathlessness.
METHODS—The association was investigated between breathlessness (self reported, on a six point scale) and indices of submaximal spiroergometry in 66 coal workers with radiographically confirmed pneumoconiosis (International Labour Organisation (ILO) grade of profusion 1/0, mean (SD) age 64 (5.5) years, mean (SD) forced expired volume in 1 second (FEV₁) 77.5 (22.9) % predicted).
RESULTS—The clinical degree of breathlessness was independently associated with minute ventilation/oxygen consumption (E/O₂) ratio (β 0.423, 95% confidence interval (95% CI) 0.18 to 0.67, p=0.001) and smoking (β 0.318, 95% CI 0.21 to 1.79, p=0.014) in a multiple linear regression analysis. The E/O₂ ratio (β 0.556, 95% CI 0.20 to 0.90, p=0.003) was also the best predictor of breathlessness when only coal miners with airway obstruction (FEV₁ < 80% predicted) were analyzed.
CONCLUSION—The E/O₂ ratio as a measurement of mismatch between ventilation and perfusion predicted the clinical grade of breathlessness better than measurements of bronchial obstruction at rest in coal workers with pneumoconiosis.


Keywords: coal workers' pneumoconiosis; bronchial obstruction; ventilation     

Contrasting geographical distribution of mortality from pneumoconiosis and chronic bronchitis and emphysema in British coal miners.

To explore whether the characteristics of coal mine dust that predispose to chronic airways obstruction are the same as those associated with pneumoconiosis, mortality from the two disease was compared in coal miners in 22 counties of England and Wales during 1979-80 and 1982-90. The proportional mortality ratios (PMRs) for coal workers' pneumoconiosis varied from 135 (95% confidence interval (95% CI) 16-488) in Leicestershire to 3825 (95% CI 1538-7881) in South Glamorgan. The PMRs for chronic bronchitis and emphysema were consistently higher than those in other occupations, but showed much less geographical variation and did not correlate geographically with those for pneumoconiosis. These findings indicate that the pathogenetic mechanisms by which coal mine dust causes chronic bronchitis and emphysema depend on different features of the dust from those producing pneumoconiosis. Also, they suggest that current social security regulations in Britain, which require evidence of pneumoconiosis as a condition of compensation for chronic bronchitis and emphysema in coal miners, may discriminate unfairly against claimants from some regions.     

煤工尘肺并发肺癌患者C-erbB-2基因表达的研究

目的　检测C erbB 2癌基因在煤工尘肺并发肺癌患者的表达与单纯肺癌患者的差异及与临床病理的关系。方法　采用免疫组织化学方法分别检测 32例煤工尘肺并发肺癌者及 30例单纯肺癌者的C erbB 2表达。结果　煤工尘肺肺癌组患者C erbB 2阳性表达率为 5 3.13% ,单纯肺癌组患者C erbB 2阳性表达率为 2 6 .6 7% ,差异有显著性 (P <0 .0 5 ) ;两组中有淋巴结转移者C erbB 2阳性表达率 (尘肺组 70 .5 9%、单纯肺癌组 5 0 .0 0 % )与无淋巴结转移者 (尘肺组 33.33%、单纯肺癌组 11.11% )的差异有显著性 (P <0 .0 5 ) ;C erbB 2阳性表达者预后差 ,与病理组织学类型无关。结论　C erbB 2是煤工尘肺并发肺癌的重要的调控基因之一 ,可作为判断有无淋巴结转移及预后的参考指标。     

Decreased glutathione content and glutathione S-transferase activity in red blood cells of coal miners with early stages of pneumoconiosis.

Blood samples of miners heavily exposed to coal dust were examined for changes in glutathione S-transferase (GST) activity. Decreased GST activity was found in red blood cells of subjects with early stages of coal workers' pneumoconiosis (International Labour Office classification 0/1-1/2) when compared with control miners. At further progression of coal workers' pneumoconiosis (> or = 2/1), the activity of GST was not different from controls. In the same group with moderate coal workers' pneumoconiosis a decrease in GSH in red blood cells occurred. Decreases in GST activity in early stages of coal workers' pneumoconiosis, as well as the decreases in glutathione peroxidase (GPx) activity and in GSH concentrations reported earlier, may originate from damage caused by reactive oxygen species. These changes might imply an impairment of the detoxification capacity for electrophilic and oxidative compounds during this stage of the disease.     

Legionella pneumophila in coal miners.

Legionnaires' disease was diagnosed in three mineworkers at a colliery. Investigation of water samples from various sites at the colliery did not discover a source of the infection. Results of serological surveys undertaken on the workmates of the patients and other miners showed only one additional positive Legionella indirect fluorescent antibody test. There was, therefore, no justification for any alteration in the water supply or the ventilation at the colliery.     

广西不同煤质煤矿尘肺流行病学比较分析

目的探讨不同煤质煤尘对尘肺患病的影响。方法用回顾性流行病学方法对广西3种不同煤质的12个煤矿进行尘肺患病率、历年粉尘浓度、粉尘游离二氧化硅含量情况进行调查分析。结果褐煤、烟煤、无烟煤作业场所历年平均粉尘浓度（mg／m^3）分别为68．75、24．01、17．18,游离二氧化硅含量（％）分别为11,07、59．77和13,78。褐煤、烟煤、无烟煤煤矿工人尘肺患病率（％）分别为0．15、6．70、1．58。褐煤矿接尘工人尘肺患病率明显低于烟煤、无烟煤矿工人（P〈0．001）。结论广西煤工尘肺患病率以烟煤矿最高,无烟煤矿次之,褐煤矿最低。不同煤质煤矿尘肺患病率差异除了与粉尘浓度和游离二氧化硅含量有关外,还可能有其它影响因素。研究结果提示,在今后修订煤尘卫生标准时,可能需要根据不同的煤质制订相应的卫生标准。     

煤矿工尘肺发病分布与动态变化趋势

目的　分析和探讨我国1960～1996年煤矿工尘肺发病的分布特点与动态变化趋势。 方法　采用Cox回归、寿命表和Gehan比分检验等分析方法,分析煤矿工尘肺发病的影响因素,探讨不同控制危险因素条件下煤矿工工龄别尘肺累积患病率的分布与差异。结果　入矿年代和工种是影响煤矿工尘肺发病的重要危险因素(P<0.01),纯掘工种尘肺患者和纯采工种尘肺患者的入矿年代分别主要分布于1960～1969年(85.5%)和1965～1974年(69.8%);纯掘工种1969年以前入矿矿工的各工龄段工龄别尘肺累积患病率为0.00%～95.53%,明显高于该工种1970年以后入矿的矿工(0.00%～5.77%)和纯采工种1969年以前入矿的矿工(0.00%～62.10%),差异有显著性(P<0.05、P<0.01);纯采工种1965～1974年入矿矿工的各工龄段工龄别尘肺累积患病率为0.00%～14.95%,明显高于1975年以后入矿矿工的0.00%～3.86%,差异有显著性(P<0.05);纯掘工种与纯采工种各工龄段的工龄别尘肺患病率之间,自1970年入矿年代以后差异无显著性(P>0.05)。结论　煤矿纯掘与纯采工种尘肺累积患病率随入矿年代的后移呈逐渐下降趋势,纯采工种的逐期下降幅度较纯掘低。煤矿工尘肺新发病例数近期内仍将处于较高阶段。     

The incidence and progression of pneumoconiosis over nine years in U.S. coal miners: I. Principal findings

Chest radiographs, taken at a 9-year interval for 1,261 U.S. coal miners, were read for pneumoconiosis side-by-side by six readers in a controlled trial. Incidence and progression of small, rounded opacities were consistent with levels predicted from dose-response curves developed by the British Pneumoconiosis Field Research interpolated at a concentration derived from U.S. compliance levels mandated over the last 9 years. The results imply that the level of pneumoconiosis in U.S. miners is being reduced through application of the current 2 mg/m3 standard. The long developmental period for pneumoconiosis necessitates that further study be undertaken to verify this finding and to determine whether 2 mg/m3 is an appropriate regulatory dust level for the prevention of category 2 or greater simple pneumoconiosis over a 35-year period.