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Original research
Increased odds of mortality from non-malignant respiratory disease and lung cancer are highest among US coal miners born after 1939
  1. Kirsten S Almberg1,
  2. Cara N Halldin2,
  3. Lee S Friedman1,
  4. Leonard H T Go1,
  5. Cecile S Rose3,
  6. Noemi B Hall4,
  7. Robert A Cohen1
  1. 1School of Public Health, Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
  2. 2National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Spokane, Washington, USA
  3. 3Medicine, National Jewish Health, Denver, Colorado, USA
  4. 4National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
  1. Correspondence to Dr Kirsten S Almberg, School of Public Health, Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA; almberg{at}uic.edu

Abstract

Objectives Coal miners suffer increased mortality from non-malignant respiratory diseases (NMRD), including pneumoconioses and chronic obstructive pulmonary disease, compared with the US population. We characterised mortality trends from NMRD, lung cancer and ischaemic heart disease (IHD) using data from the Federal Black Lung Program, National Coal Workers’ Health Surveillance Program and the National Death Index.

Methods We compared mortality ORs (MORs) for NMRD, lung cancer and IHD in former US coal miners to US white males. MORs were computed for the study period 1979–2017 by birth cohort (<1920, 1920–1929, 1930–1939, ≥1940), with a subanalysis restricted to Central Appalachia.

Results The study population totalled 235 550 deceased miners, aged >45 years. Odds of death from NMRD and lung cancer across all miner birth cohorts averaged twice those of US males. In Central Appalachia, MORs significantly increased across birth cohorts. There was an eightfold increase in odds of death from NMRD among miners born after 1940 (MORBC≥1940 8.25; 95% CI 7.67 to 8.87). Miners with progressive massive fibrosis (PMF) were younger at death than those without PMF (74 vs 78 years; p<0.0001). We observed a pattern of reduced MORs from IHD in coal miners compared with national and regional counterparts.

Conclusion US coal miners have excess mortality from NMRD and lung cancer compared with total US and Appalachian populations. Mortality is highest in the most recent birth cohorts, perhaps reflecting increased rates of severe pneumoconiosis.

  • Mortality
  • Occupational Health
  • Coal Mining
  • Lung Diseases, Interstitial

Data availability statement

All data used in this study are owned and maintained by the US National Institute for Occupational Safety and Health and is not publicly available at this time.

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Data availability statement

All data used in this study are owned and maintained by the US National Institute for Occupational Safety and Health and is not publicly available at this time.

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Footnotes

  • Contributors KSA contributed to the conceptual design, methods development, and data acquisition for this manuscript. She performed all data management, cleaning and analyses; as well as drafted and revised the manuscript. She is guarantor of this manuscript. CNH was instrumental in the project conceptualisation and data acquisition for this work. She also aided in manuscript revisions. LSF helped develop the analytic approach to these data and aided in manuscript preparation and revisions. CSR, NBH and LHTG contributed to data interpretation, manuscript preparation and revision. RAC contributed to all aspects of project conceptualisation, methods development, data acquisition, data interpretation, and manuscript preparation and revision.

  • Funding This research was supported in part by National Occupational Research Agenda intramural funding from the National Institute for Occupational Safety and Health and a grant from the Alpha Foundation for the Improvement of Mining Safety and Health (#AFCTG20-102).

  • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. The views, opinions and recommendations addressed here are solely those of the authors and do not imply any endorsement by the Alpha Foundation, its Directors and staff.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.