ArticleOccupational and environmental medicine2023
Historical shift in pathological type of progressive massive fibrosis among coal miners in the USA.
Article in Occupational and environmental medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Silicosis and silica dust sampling in mineral mining across 30 countries: a systematic review and meta-analysis.BMC public health · 2026Pooled it
- Evaluating the efficacy of prednisolone for silicosis with progressive massive fibrosis in Australia: an observational pilot study.Annals of occupational and environmental medicine · 2026Article
- The disease burden of pneumoconiosis in China from 1990 to 2021 and projection to 2050 based on GBD 2021: a cross-sectional study.Frontiers in public health · 2025Article
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Authors and funding
19 authors at 10 institutions in 3 countries.
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Abstract
backgroundPneumoconiosis among coal miners in the USA has been resurgent over the past two decades, despite modern dust controls and regulatory standards. Previously published studies have suggested that respirable crystalline silica (RCS) is a contributor to this disease resurgence. However, evidence has been primarily indirect, in the form of radiographic features.
methodsWe obtained lung tissue specimens and data from the National Coal Workers' Autopsy Study. We evaluated specimens for the presence of progressive massive fibrosis (PMF) and used histopathological classifications to type these specimens into coal-type, mixed-type and silica-type PMF. Rates of each were compared by birth cohort. Logistic regression was used to assess demographic and mining characteristics associated with silica-type PMF.
resultsOf 322 cases found to have PMF, study pathologists characterised 138 (43%) as coal-type, 129 (40%) as mixed-type and 55 (17%) as silica-type PMF. Among earlier birth cohorts, coal-type and mixed-type PMF were more common than silica-type PMF, but their rates declined in later birth cohorts. In contrast, the rate of silica-type PMF did not decline in cases from more recent birth cohorts. More recent year of birth was significantly associated with silica-type PMF.
conclusionsOur findings demonstrate a shift in PMF types among US coal miners, from a predominance of coal- and mixed-type PMF to a more commonly encountered silica-type PMF. These results are further evidence of the prominent role of RCS in the pathogenesis of pneumoconiosis among contemporary US coal miners.
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