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Historical shift in pathological type of progressive massive fibrosis among coal miners in the USA
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  • Published on:
    Coal and quartz
    • Anthony Seaton, Emeritus Professor of Environmental and Occupational Medicine Univ of Aberdeen

    The paper by Go et al (Occup Environ Med 2023;80425-30) is an important reminder of the problem of quartz in coal mine dusts and of its association with early development of pneumoconiosis, often associated with unusual radiological patterns. The UK work which they kindly cite brought to light a problem for regulation of the quartz in coal mine dust – that in many cases quartz concentrations greater than 0.1mg/m3 in mine environments seemed not to be associated with development of silicosis. Experimentally, the toxicity of quartz is reduced when it is associated, as is usual in coal mines, with a high concentration of other silicates, which occlude the crystal surface. This led to the pragmatic solution of ignoring quartz if it constituted less than 10% of the total mine dust concentration (which then was regulated as less than 5mg/m3).
    These difficulties in setting and monitoring compliance with a quartz standard in coal mines are obsolete in UK as long as mines remain closed. However, while mining continues elsewhere it is important to recognise that miners know when they are cutting rock and so do their employers. When this is happening it should be recognised that they are at risk of silicosis and, as the authors show, the implications are far more serious for their health than those from coal alone; any early radiological evidence is usually too late for the miners and extra action to increase their safety needs to be required of the employer in these circumstan...

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    Conflict of Interest:
    None declared.