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Oral Session 9 – Mortality studies and lung disease

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R. N. Naidoo1, T. Robins2, J. Murray3.1University of Natal; Durban, South Africa; 2University of Michigan; Ann Arbor, MI, USA; 3National Institute for Occupational Health, Johannesburg, South Africa

Introduction: The objectives of the study were to describe the prevalence of autopsy diagnosed respiratory outcomes, particularly emphysema, among South African coalminers, and to determine whether dose–response relationships existed between these outcomes and measures of exposure (years worked in coalmining), using data from the Pathology Automation System (PATHAUT) database of South African miners, one of the largest autopsy databases in the world.

Methods: All autopsies (n = 7760) conducted on coalworkers and recorded on PATHAUT from 1975 to 1997 were evaluated for prevalence of emphysema, coal workers’ pneumoconiosis (CWP), silicosis and tuberculosis. Analyses were restricted to those with exclusive coalmining exposure and information on years of exposure (n = 3167). Logistic regression was conducted to determine relationships between exposure and outcomes, controlling for covariates such as race, smoking, and age.

Results: The average number of years of coalmining exposure was 11.0 years, and mean age of the workers was 41.1 years. There were 66.1% black miners and 33.6% white in the cases, and 31% of the cases had information on smoking. Among those with exclusive coal exposure, the prevalences of silicosis, tuberculosis (TB), CWP, and moderate to marked emphysema were 10.2%, 5.5%, 7.0% and 5.2% respectively. With the exception of TB, all respiratory outcomes were associated with years worked (p<0.0001). A significant relationship was found between smoking and all autopsy outcomes, except CWP. Black miners had a 6.59-fold and a 1.35-fold greater risk for TB and CWP respectively compared with white miners, while white miners had an increased risk of 1.28 times and 5.26 times for silicosis and emphysema respectively. Moderate to marked emphysema was strongly associated …

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