Percutaneous renal biopsy was performed in a surface coal miner with radiographic and histopathologic pulmonary changes consistent with acute silicolipoproteinosis who developed proteinuria and hematuria. Electron microscopic evaluation of the renal tissue specimen revealed a diffusely thickened glomerular basement membrane, foot process effacement, and dense lamellar inclusions in swollen glomerular epithelial cells, similar to those seen in Fabry's disease. However, normal levels of plasma alpha-galactosidase A, normal urinary sediment glycosphingolipids and the absence of the clinical characteristics of Fabry's disease excluded this diagnosis. This case illustrates that electron-dense lamellar inclusions, similar to those seen in Fabry's disease, may be seen in other entities such as nephropathy associated with silicosis.

Adult↗

PubMedDate not supplied

Cardio-respiratory function in United States coal workers.

Over the past five years the cardio-respiratory function of selected groups of U.S. coal workers has been intensively studied. The subjects studied included approximately 10,000 working miners at mines selected as part of an epidemiological study of the prevalence and progression of coal workers' pneumoconiosis (CWP) as well as selected groups of non-working symptomatic miners. The occupation of coal mining per se is sometimes associated with a mild reduction in ventilatory capacity which is not closely related to radiographic category of simple CWP. Slight abnormalities in gas exchange and lung mechanics appear to be associated with the higher categories of simple CWP which do not appear to affect longevity. Subjects with complicated CWP (massive fibrosis) demonstrate moderate to severe degrees of obstruction, abnormalities of gas exchange and lung mechanics that generally relate to the extent of the massive fibrosis and result in premature disability and death.

Adult↗

PubMedDate not supplied

Small airways disease in coal miners. A longitudinal study.

Seventeen of an original cohort of 25 non-smoking working coal miners and 6 age-matched controls studied in 1969 were re-examined in 1973. Measurements included lung volumes, maximal expiratory flow-volume curves, and closing volumes. Miners, when compared with controls, showed a marked decline in maximal expiratory flow at mid-vital capacity (V 50%) over the 4-year period which took place without significant change in the 1-second forced expiratory volume (FEV1). Frequency dependence of dynamic compliance (Cdyn) in association with an increased upstream airways resistance (Rus), and also loss of lung elastic recoil (PL(St)) which were present at the time of the original study led to similar declines in V 50%. An abnormally elevated closing capacity expressed as a percentage of total lung capacity (CC/TLC)% was found in 9 miners (53%) and none of the controls. Closing volume as a percentage of vital capacity (CV/VC)% was abnormal in 4 miners (23.5)% and no controls. Measurement of closing volume did not relate well to the variety of mechanical abnormality present on the original study; namely, loss of recoil or small airways obstruction. The presence of an elevated (CC/TLC)% and (CV/VC)% correlated mainly with the presence of hyperinflation as indicated by an elevated residual volume.

Follow-Up Studies↗