Black Lung Disease Research Articles

Characteristics of Patients With Alpha-1 Antitrypsin Deficiency From Rural Appalachia: A Retrospective Single-Center Study.

Alpha-1 antitrypsin (AAT) deficiency, an autosomal co-dominant inherited condition, significantly impacts lung and liver functions, with mutations in the SERPINA1 gene, notably the Z allele, playing a pivotal role in disease susceptibility. This retrospective descriptive study from a rural Eastern Kentucky pulmonary clinic aimed to characterize patients with AAT deficiency, focusing on demographic, clinical, and laboratory parameters extracted from electronic health records (EHR) of Appalachian Regional Healthcare (ARH). Among 100 patient encounters, 56 were analyzed, revealing notable sex-based differences in smoking rates and co-existing conditions, with males showing higher rates of black lung and chronic obstructive pulmonary disease. In comparison, females exhibited higher rates of asthma, COVID-19, pneumothorax, and obstructive sleep apnea. The study emphasizes the importance of understanding genotype-phenotype correlations and demographic factors in assessing AAT deficiency, advocating for further research to refine management strategies and elucidate causal relationships.

Pathogenetic Bases of Systemic Morphological Manifestations of Coal Worker’s Pneumoconiosis: A Review

Introduction: Miners are at increased risk of developing pneumoconiosis that poses a serious threat to their health. Progressive pneumosclerosis and bronchial mucosa atrophy are typical pathological changes in this disease. At the same time, there is evidence of systemic manifestations of pneumoconiosis. In this regard, a deeper understanding of how long-term exposure to coal dust affects pathophysiological processes not only in the target organ, but also in the whole body is required. Objective: To generalize and systematize ideas about the pathogenetic foundations of systemic morphological manifestations of black lung disease. Materials and methods: To obtain information, we have carried out a search for relevant studies published in 1995–2022 in Scopus, PubMed, and RISC databases using the following keywords: pneumoconiosis, miners, morphological changes, pathogenesis, free radical oxidation, inflammation, immune response, cytokines, growth factors, and endothelial dysfunction. We selected 59 full-text publications presenting the results of completed studies on the mechanisms of development of systemic morphological changes in coal miner’s pneumoconiosis. The systematic review was made according to PRISMA guidelines and using certain PICO(S) criteria. Results: It has been shown that long-term exposure to coal dust causes activation of macrophage-related inflammation in the respiratory system, free radical oxidation, modulation of intracellular signaling pathways, and programmed cell death. Numerous studies have demonstrated the role of inflammation as the main pathogenetic factor of pneumoconiosis, which is closely related to oxidative stress and immune response. Inflammatory mediators ensure the immune response, regeneration and sclerosis of damaged tissues. In case of high cumulative doses of coal dust, these processes begin to have a destructive and tissue-damaging effect in both the lungs and other organs due to the systemic action of the above mediators. The key role of the endothelium in the development, course and outcome of inflammation is noted.

Abstract 12571: Factors That Predict Longitudinal Transition of Symptom Cluster Profiles in Heart Failure

Background: Symptom trajectories in people with heart failure (HF) can vary over time. Few studies have explored how symptom clusters transition, essential to determine interventions. Aims: (1) Describe transitions in symptom cluster profiles in people with HF over 8 years; (2) Identify factors predicting the transitions. Methods: We conducted secondary analysis of data from the 2008, 2012, and 2016 surveys of the Health and Retirement Study (HRS), using latent transition analysis to identify cluster profiles (fatigue, dyspnea, pain, swelling, depressive symptoms, dizziness), and multinomial regression to determine the predictive factors. Results: HRS included 690 HF subjects (57% female; mean age=74.9 (SD =10.04) years). Four cluster profiles were identified: high burden, low burden, distressing, and respiratory-depressive distress. The probability staying in the same profile ranged from 0.60 to 0.89. Male sex (OR=1.39; 95% CI=0.92, 1.82), black race (OR=1.92; 95% CI=1.37, 2.73), smoking (OR=2.44; 95% CI=1.56, 3.71), having diabetes (OR=3.99; 95% CI=2.90, 6.27) and lung disease (OR=1.40; 95% CI=0.83, 1.68) were associated with an increased odds of moving from the distressing to the high burden profile. Smoking (OR=1.17; 95% CI=0.66, 1.55), having arthritis (OR=4.44; 95% CI=2.80, 6.33), lung disease (OR=1.72; 95% CI=1.17, 2.49), and diabetes (OR=3.84; 95% CI=2.87, 5.94) were associated with an increased odds of moving from the respiratory-depressive distress to the high burden profile. Black race (OR=3.58; 95% CI=2.80, 6.20), smoking (OR=1.44; 95% CI=0.91, 2.10), having arthritis (OR=1.71; 95% CI= 1.20, 2.59), lung disease (OR=1.30; 95% CI= 0.55, 1.95), and diabetes (OR=1.81; 95% CI=1.34, 2.90) were associated with an increased odds of moving from the low burden to the distressing profile. Male sex (OR=2.13; 95% CI= 1.66, 3.68), having arthritis (OR=1.51; 95% CI=1.15, 2.13) and lung disease (OR=2.28; 95% CI=1.57, 4.34) were associated with an increased odds of moving from the low burden to the respiratory-depressive distress profile. Conclusions: Although symptom cluster profiles remained stable, transitions were observed, and deterioration can occur. The identified predictive factors may enhance long-term symptom management.

Coal Production Trends and Black Lung Disease Incidence Rate in Indonesia during 2013-2021

Coal Production Trends and Black Lung Disease Incidence Rate in Indonesia during 2013-2021

The Activism of Dance Performance in Appalachia: Utilizing the Arts to Address Social and Environmental Crisis and Injustice in the Mountains

Abstract For well over a century, the human and more-than-human of Central Appalachia have endured oppression and exploitation, primarily due to natural resource extraction. In spring 2008, the author led a dark touri to a mountaintop removal coalmining site in Southern West Virginia for colleagues, which included Dance Professor Deborah McLaughlin. As a result, the two collaborated on three evening-length dance/theater works highlighting social and environmental crises and injustices in the region. The performances incorporated contemporary dance, poetry, the spoken word, and the visual arts, as well as contemporary and traditional music. The first, Eating Appalachia: Selling Out to the Hungry Ghost, focused on mountaintop removal coalmining and its environmental and cultural destruction. With Sounds of Stories Dancing, the duo paid homage to millions of mountain residents forced to leave the region to find stable employment, despite longing to remain. In the final piece, The Shadow Waltz, they honored the lives of coalminers with black lung disease, as well as their families. This essay discusses the challenges of creating art that critiques socially constructed messages portrayed as given truths, as well as the educational and social successes of daring to dance truth to power.

Digging Our Own Graves: Coal Mining & the Struggle over Black Lung Disease, by BarbaraEllen Smith. Haymarket Books, 2020, pp. 318 pages. ISBN: 978‐1‐64259‐275‐7, US $23.95

Digging Our Own Graves: Coal Mining & the Struggle over Black Lung Disease, by BarbaraEllen Smith. Haymarket Books, 2020, pp. 318 pages. ISBN: 978‐1‐64259‐275‐7, US $23.95

The effects of OMT on progressive massive fibrosis: A brief report of an adjunctive therapy to improve respiratory function in Appalachian coal miners

Recently in central Appalachia, there has been a resurgence of the more complicated form of black lung disease known as progressive massive fibrosis (PMF). This brief report was aimed at determining the effects osteopathic manipulative treatment (OMT) could have to improve the lives of these individuals. This brief report involved a former Appalachian coal miner diagnosed with PMF. Over the course of a year, the patient was seen and treated with OMT. Though the patient reported improvement in his activities of daily living compared to previous, there was no significant data according to spirometry or quality of life metrics. This study illustrates that OMT has thepotential to provide adjunctive treatment for patients with PMF. Limitations due to sample size and socioeconomic deficits of former Appalachian coal miners warrant further study.

The politics of subterranean atmospheres in China: a study of contemporary chinese mining art

Every five seconds someone dies prematurely from air pollution (UN, 2019). Environmental degradation, however, is not limited to the air above alone, but also affects the conditions of life underneath the surface. Black lung disease (pneumoconiosis), a respiratory condition, is by far the most common occupational illness in China today. Official reports suggest that over half a million people, almost exclusively rural migrants, live with the incurable disease. The real number could be 10 times as high (SCMP, 2021). The respiratory condition is a powerful reminder of the shared geological intimacy that exists between the bodies of miners and the materiality that constitutes the enveloping atmospheres of the underworld.Inspired by Hawkins’ (2020b, p. 4) idea of the “underground’s imaginative force” and the so-called “geologic turn” (Ellsworth & Kruse, 2013), this paper explores the politics of subterranean atmospheres in China by problematising the relationship between the ground above and the ground below. I analyse this “geologic politics” (Clark, 2013) through the artwork of filmmaker Zhao Liang and the painter Yang Shaobin, both contemporary artists working on subterranean lives, bodies, emotions and atmospheres. Through their art of the subterranean, its environment, lived experience, embodiment and the specificity and intimacy of its materiality, I capture a politics that challenges false binaries of a separate above and below.

Memorials and the Mine Disaster in Monongah, West Virginia: From Trauma to an Italian Global Memoryscape

Memorials and the Mine Disaster in Monongah, West Virginia: From Trauma to an Italian Global Memoryscape

Still Digging Our Own Graves: Coal Miners and the Struggle over Black Lung Disease

Barbara Ellen Smith's Digging Our Own Graves: Coal Miners and the Struggle over Black Lung Disease (Haymarket Books, 2020) charts the struggles of miners and their families from the birth of the Black Lung Movement in 1968 to the present-day resurgence of severe, lethal disease. Through extensive interviews with participants and her own experiences as an activist, the author provides a vivid portrait of communities struggling for survival against the corporate extraction of labor, mineral wealth, and the very breath of those it sends to dig their own graves. This excerpt from the newly updated edition features the photographs of Earl Dotter as well as a new introduction and conclusion from the author.

CO2 Interiors

Are there any ulterior narratives that could be mined through a close examination and interpretation of the coal mine interior spaces? CO2 Interiors is a visual essay that addresses this question. And to do so, it unpacks a meticulously curated group of archival images that expose the covert narratives of colonialism and slow violence embedded in coal mining’s (extra)ordinary interiors. This creative exercise entails integrating text into images that include a 19th Century etching of young children pushing coal-filled carriages through steep mine tunnels; and a still from an animated film produced in the 1950s by the National Coal Board Film Unit in Britain. There is an image of human tissue affected by Black Lung Disease; and a photograph of a former Australian Prime Minister enacting the mythology of the alpha male explorer, plunging into the unknown and forbidden depths of the planet. Collectively, these image/text hybrids posit an experimental narrative—an assemblage—that starkly contrasts with contemporary depictions by the mining industry, focused on the technical and quantitative aspects of the activity or greenwashing its multiscalar and devastating effects. This project engages multiple forms of visual representation (historical, spatial, political, and ideological) that have conjured a mythology of coal mining still present today. In doing so, certain refrains echo and multiply, persisting across time frames and political borders to produce a taxonomy of subterranean effects. Integrating text and images, our devices yield a performative reading that seeks to raise awareness and produce affect. As such, CO2 Interiors amplifies our understanding of coal mining beyond its economic and environmental repercussions and well into its social, political, and cultural implications—especially the spatial ones. While the 2019 Australian Federal Election results attest to the embedded mythology of coal mining that is still impossible to restrain, CO2 Interiors dismantles and reassembles it, recasting the false narrative of progress, equity, and solidarity that has been projected from within the coal mine interior space. This curated assemblage of coal stories accumulates as evidence to be critically analysed in order to truly achieve a sustainable post-carbon future.

The B Reader Program, Silicosis, and Physician Workload Management: A Niche for AI Technologies.

The National Institute for Occupational Safety and Health (NIOSH) has operated its B Reader Program for over fifty years. Originally intended as a screening program for black lung disease, it has since received a broadened mandate to cover other occupational pneumoconioses, such as silicosis. At the same time, the B Reader Program itself has witnessed a consistently declining pool of participating physicians, alongside high levels of subjectivity and possible financial conflicts of interest. This supply-demand mismatch will exacerbate the burden upon current B Readers and complicate employer compliance with federal screening requirements. This represents a particular niche for AI-enabled radiology tools, which stand to ease physician workload, enhance diagnostic accuracy, and further the public health objectives of routine screening. NIOSH should consider establishing a pilot program for these applications within its existing technology development infrastructure and utilize its rulemaking authority to facilitate scaling.

Extraction Ecology: Environment and People in the Anthropocene

The uncontrollable pursuit of growth and benefits has dominated our society. In developed part of the planet people live in energy phase of modernity but it is marked by instability of social situations and culture forms. It is often closely related to issues such as climate change, the disappearance of agro-biodiversity, or the loss of animal biodiversity. The extreme climate flux that human beings face today can be linked to the human continuous need for energy. The constant appetite to consume more and more energy has resulted in environmental degradation, like collapsed impoundment dams, floods, dead zones in forests. It has not only affected the environment but also people. It has given rise to unemployment, crippling poverty, and diseases such as black lung disease. This paper operates at the intersection of ecocriticism and extractive fiction studies to study the impact of mining by examining The Upheaval by Pundalik Naik. By applying the theory of ecocriticism, this paper will study and highlight how these places are rich in resources but are places of environmental degradation, public health issues, poverty and social conflict.

Association between Financial Conflicts of Interest and International Labor Office Classifications for Black Lung Disease.

Rationale: The U.S. Department of Labor administers the Federal Black Lung Program (FBLP), an administrative system charged with managing claims by coal miners for workers' compensation for totally disabling coal mine dust lung disease. Specific case reports have raised concern that financial conflicts of interest (COIs) may systematically bias physicians when they are classifying chest X-rays (CXRs) for the absence, presence, and severity of pneumoconiosis. Objectives: To evaluate the direction and magnitude of association between financial COIs of physicians participating in the FBLP and international standards for the classification of radiographs of pneumoconiosis. Methods: An epidemiologic assessment of black lung claims filed to the FBLP from 2000 to 2013 was conducted to determine physician classifications of radiographs. FBLP court decisions from 2002 to 2019 (n = 7,656) were used to evaluate financial COIs of each physician. The main outcome measures used were classifications of radiographs for the absence of pneumoconiosis (small opacity classifications of 0/0 or 0/1), simple pneumoconiosis (small opacity classifications of 1/0 through 3/+), and progressive massive fibrosis (PMF) (large opacities with classifications of A, B, or C). Results: Of 63,780 radiograph classifications made by 264 physicians, 31.4% were read positive for simple pneumoconiosis and 3.6% were read as having PMF. There were 52 physicians who classified CXRs as having no evidence of pneumoconiosis in 99%+ of their readings and 18 physicians who classified CXRs as positive for simple pneumoconiosis in 99%+ of their readings. The adjusted odds of a negative classification of pneumoconiosis was 1.46 (95% confidence interval [CI], 1.44-1.47) per 10% increase in the proportion of court records demonstrating that a physician was hired by the employer. Per 10% increase in court records indicating a physician was hired by the miner/claimant, the adjusted odds ratio for classifying simple pneumoconiosis was 1.51 (95% CI, 1.49-1.52), and the adjusted odds ratio for finding PMF was 1.28 (95% CI, 1.26-1.30). Conclusions: There was a strong association between source of payment and radiograph classification, suggesting the importance of eliminating financial COIs in what should be an objective determination of eligibility for Black Lung Workers' compensation benefits.

Coal Workers' Pneumoconiosis at PT. A Sawahlunto and The Influencing Factors

Background: Coal workers’s pneumoconiosis (black lung disease) is an interstitial lung disease caused by chronic inhalation of coal dust. The incidence of coal workers’s pneumoconiosis increased globally from the 1990s to the 2000s by 3.2%. Indonesia is the country which has many coal mining, but national prevalence of coal workers pneumoconiosis was not discovered. PT. A is one of mining companies in Sawahlunto. The aims of this study was to determine the incidence of coal workers’ pneumoconiosis at PT. A Sawahlunto and it’s influencing factors. Methods: This study is an analytic study with cross sectional design, conducted from November 2019 to April 2020. There were 90 coal miners participated in this study. All subjects were performed chest X-ray examination with ILO standard to asses the incidence of pneumoconiosis. Spirometr examination, dust level measurement with portable low volume air sampler, interview, and validated questionnare were performed to evaluate it’s influencing factors. Statistical analysis used Chi-square test and double logistic regression test. Results: This study found 12 workers (13.3%) had pneumoconiosis. From the statistical test results obtained age >50 years (P=0.035), duration of exposure (P=0.040), mask usage (P=0.029), restrictive lung function (P=0.004), and the mixed abnormality lung function (P=0.006) is associated with pneumoconiosis. The most dominant factor was mask usage (P=0.049) with OR=5.026 Conclusion: The most dominant factor that influence coal workers’ pneumoconiosis was mask usage. Others related factors were age, duration of exposure and abnormality lung function.

English

BACKGROUND Occupational lung diseases are diseases affecting the respiratory system, including occupational asthma, black lung disease and many more. Workers exposed to marble dust stand an increased risk of suffering from asthma symptoms, chronic bronchitis, nasal inflammation and impairment of lung functions. The recognition of occupational causes can be made difficult by years of latency between exposure in the workplace and the occurrence of disease. Through this study, authors have established the importance of early identification of symptoms of occupational lung diseases and the importance of preventive measures that can be applied to reduce incidence of such diseases. METHODS This was a cross sectional community-based study conducted on 340 marble mining or cutting workers of Rajnagar [Morwar], Rajsamand district of Rajasthan, for a duration of three months. Workers were clinically examined and asked about environmental conditions and use of preventive measures through a questionnaire designed by the investigators and with the help of pamphlets and videos, educational interventions were provided. RESULTS Almost 90 % of the workers didn’t use protective measure like mask or shield. Among the 10 % workers who were using safety measures, 60 % were using face mask and 20 % were using apron at the work place. After the educational intervention given by investigators, around 63 % had started using various safety measures. CONCLUSIONS Early interventions after development of symptoms are important as they can decrease chances of further worsening of the condition. Health education, periodic health check-ups and use of protective measures are the essence in preventing occupational lung diseases. KEYWORDS Occupational Lung Disease, Cough, Marble Workers, Silicosis

Smith, B.E. with photographs by Dotter, E. (2020, 1987). Digging Our Own Graves: Coal Miners & the Struggle over Black Lung Disease (updated edition). Haymarket Books.

Smith, B.E. with photographs by Dotter, E. (2020, 1987). Digging Our Own Graves: Coal Miners & the Struggle over Black Lung Disease (updated edition). Haymarket Books.

The future environmental and health impacts of coal

In the United States, coal consumption in the last 12 years has declined from 1,045,140 million short tons in 2007 to 539,420 million short tons in 2019, a decrease of almost 50%. During that period the number of electric power coal generators has declined from 1,470 to 738 accounting for 21% of capacity. An even more dramatic decrease in coal use has occurred in Western Europe. This significant reduction in coal use and the concomitant closure of coal mines and coal-burning power plants will result in substantially cleaner air, reductions in respiratory problems such as asthma, less heart disease, fewer hospitalizations, and other health benefits, as well as a reduction in occupational health problems such as silicosis and Coal Workers’ Pneumoconiosis (Black Lung Disease). However, in China, India, Russia and in several other Asian countries some projections indicate an increase in coal production and use. In some situations, the coal is burned in old, highly polluting power plants. In these regions the health impacts of coal use could worsen. In addition, millions of people in these regions still burn coal in their homes resulting in maximal exposure to the pollutants such as arsenic, selenium, fluorine, and mercury released from coal combustion.

Eco-media Events in China

AbstractThis article brings together recent writing on eco-media, media materialism, and racialized Otherness to rethink the place of China and Asia in debates about the Anthropocene. We begin by examining the nonwhite postapocalyptic futures imagined in Bong Joon-ho’s sci-fi film Snowpiercer and argue that the film problematizes a persistent Western-centric bias in both the environmental humanities and the literature on media materialism. Inspired by the metaphoric power of Kronon, the industrial-waste-turned-explosive in Snowpiercer, we theorize the instantaneously mediated and circulated chemical dust explosions in Kunshan and Tianjin in 2014–15 as eco-media events—that is, spectacular and ephemeral moments in which the material processes of digital production link the old forms of resource extraction with our new lives of electronic gadgetry and media tool dependency. Writing against the discourse of Yellow Eco-peril, which depicts such events (in both academic and journalistic writings) through a racialized Eco-Otherness, we offer a counter-politics to reconnect mainland China to the very systems of globalized production and consumption—the deep earth mining, the slow violence of black lung disease, the factory work, the digital consumption practices—that have propelled and intensified the country’s stupendous development as well as its ecological challenges. We find new work on eco-media and media materialism most productive, as it sheds light on three closely intertwined dimensions of eco-media events: time, body, and matter. Probing the deep entanglements between the human and the nonhuman, a critical engagement with these events presents new possibilities to think anew environmental humanities in China, across Asia, and globally.

Experimental investigation on wetting mechanism for coal dust with different metamorphic degree based on infrared spectrum and 13C‐NMR

Respirable coal dust accounts for heart and respiratory diseases of coal miners such as asthma, pneumoconiosis, and black lung disease. What is more, coal dust explosion seriously affects coal mine safety production and coal miners' life safety. Generally, dust suppressants are commonly applied in coal mines. However, current dust suppressants are not working effectively. To develop a better dust suppressant, we attempt to explore the factors affecting the wettability of coal dust under different metamorphic levels from the essence of coal dust wetting mechanism in this paper. Specifically, we use Fourier transform infrared (FTIR) spectroscopy and nuclear magnetic resonance (NMR) to reveal the microstructure of coal from two aspects of functional group and carbon skeleton structure and obtain the micro information of the surface functional group types, quantity, and carbon structure of coal with different degrees of metamorphism, as well as the change rule of functional group of coal sample with coal rank and the law of carbon increase and deoxidization of coal metamorphism. After that, we acquired the structural parameters of coal by the NMR experiments and fitted the quantitative mathematical relationship between the microstructure parameters and wettability of coal through SPSS and ORIGIN software. Finally, this paper constructs an evaluation model for the influencing factors of coal dust wettability, explains the influence degree of different coal dust structure on coal dust wettability, improves the coal dust wettability mechanism, and provides more quantitative research ideas and methods for the control of coal dust.