Am. J. Respir. Crit. Care Med.,
Volume 163, Number 3, March 2001, 633-639
Rapid Declines in FEV1 and Subsequent Respiratory
Symptoms, Illnesses, and Mortality in Coal Miners
in the United States
LU-ANN F.
BEECKMAN,
MEI-LIN
WANG,
EDWARD L.
PETSONK,
and
GREGORY R.
WAGNER
Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention,
U.S. Department of Health and Human Services, Morgantown, West Virginia
Coal mine dust exposure is associated with accelerated loss of lung
function. We assessed long-term health outcomes in two groups
of underground coal miners who during previous mine surveys had
shown either high rates of FEV1 decline (cases, n = 310) or relatively stable lung function (referents, n = 324). Cases and referents were matched initially for age, height, smoking status, and
FEV1. We determined vital status for 561 miners, and obtained a
follow-up questionnaire for 121 cases and 143 referents. Responses on the follow-up questionnaire were compared with those
on the last previous mine health survey questionnaire. Cases showed
a greater incidence of symptoms than did referents for cough,
phlegm production, Grades II and III dyspnea, and wheezing, and
greater incidences than referents of chronic bronchitis and self-
reported asthma and emphysema. More cases than referents
(15% versus 4%) left mining before retirement because of chest
illnesses. After controls were applied for age and smoking, cases
had twice the risk of dying of cardiovascular and nonmalignant
respiratory diseases and a 3.2-fold greater risk of dying of chronic
obstructive pulmonary disease than did referents. Rapid declines
in FEV1 experienced by some coal miners are associated with subsequent increases in respiratory symptoms, illnesses, and mortality
from cardiovascular and nonmalignant respiratory diseases.
