Coalworkers' pneumoconiosis. The clinical features.
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Biomedical subjects
Publications and source records attributed to W K Morgan.
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A 17-year-old previously well ice hockey player experienced acute shortness of breath and cough productive of clear frothy sputum about 1.5 hours following an ice hockey match. Noncardiogenic pulmonary edema was found to develop as a result of the inhalation of the oxides of nitrogen. The latter was produced by a Zamboni machine that is used to resurface the ice on a rink. Several other players were affected but less severely.
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.
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The issue of carcinogenicity among mine workers and among workers in selected nonmining industries is examined. In the late 19th century, a high frequency of lung cancers was noted among metal miners in Bohemia, which probably related to their exposure to radon. Subsequently, other substances, including arsenic, asbestos, chromates, nickel, and chloroethers, have been linked causally to lung cancer. The IARC classification of substances as carcinogens is summarized, and the epidemiologic studies of humans employed in occupations with high rates of lung cancer due to carcinogen exposures are reviewed.