Disc lo sure o f F ina nc ia l I nte re st F unde d b y the - PDF document

L ung Dise a se , Mine rs, a nd Mining Communitie s, a Globa l Popula tion a t Risk Unive rsity of California, San F ranc isc o – Division of OE M Marc h 14, 2019 Robe rt Cohe n, MD, F CCP Clinic a l Pro fe sso r - E OHS, Unive rsity o f Illino is Sc ho o l o f Pub lic He a lth Chic a g o , Illino is Pro fe sso r o f Me dic ine No rthwe ste rn Unive rsity F e inb e rg Sc ho o l o f Me dic ine Ae ria l vie w o f Bruma dinho , Bra zil 1/ 25/ 19 Disc lo sure o f F ina nc ia l I nte re st  F unde d b y the Alpha F o unda tio n fo r the I mpro ve me nt o f Mine Sa fe ty a nd He a lth  F unde d b y HHS/ HRSA/ ORHP/ BL CP & BL CE  E mplo ye e o f NI OSH/ RHD  F unde d b y USDOL / OWCP & MSHA  F unde d b y Que e nsla nd Go ve rnme nt, Austra lia  Pro vide I ME ’ s fo r Oc c upa tio na l L ung Dise a se Go a ls fo r T o da y’ s T a lk  Disc uss e xa mple s o f mining re la te d lung dise a se in g lo b a l po pula tio ns  De sc rib e risks to c o mmunitie s fro m mining re la te d a c tivitie s  Surfa c e Mining  Unde rg ro und Mining  Mine Ma te ria ls Pro c e ssing  Give e xa mple s o f mining re la te d disa ste rs tha t a ffe c t wo rke rs, the ir fa milie s, a nd the ir c o mmunitie s

Co a l’ s De a dly Dust – F ro ntline / PBS/ NPR 1/ 22/ 19 Ra pidly Pro g re ssive CWP b y Co unty 0% 4.5 - 20.0% 22.2 - 40.0% 41.7 - 60% 61.5 - 80% * Results from NIOSH Coal Workers’ Health Surveillance Program, 1996-2002 Not shown are counties with fewer than 5 miners evaluated PA OH WV VA KY

Re sults  Risk fa c to rs  Sma lle r mine > la rg e r mine  L o ng e r te nure in jo b s a t fa c e  Yo ung e r > o lde r  I mplic a ting re c e nt mining c o nd itio ns  Othe r fa c to rs  Mining te c hniq ue  Appro a c he s to dust c o ntro l  E nfo rc e me nt o f PE L NIOSH CWHSP – Surveillance of Active Miners  Pa rtic ipa ting me d ic a l fa c ilitie s  NIOSH mo b ile o utre a c h  Sc re e ning c he st ra d io g ra phs re c e ive d in F Y-2017  7423 ra d io g ra phs re c e ive d  3110 und e rg ro und mine rs  2383 fro m surfa c e mine rs  1930 fro m c o ntra c to rs  2812/ 7423 fro m mo b ile o utre a c h unit  Sc re e ning lung func tio n with spiro me try c urre ntly b e ing imple me nte d a s pa rt o f te sting o ffe re d b y CWHSP Radiographic Findings of Pneumoconiosis in CWHSP Participants (5‐year moving average) 40 Mining Tenure 35 25+ 20-24 30 15-19 10-14 0-9 25 Prevalence (%) 20 15 10 5 0 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 Year

Radiographic Findings of Pneumoconiosis in CWHSP Participants from KY, VA, and WV (5‐year moving average) 40 Mining Tenure 35 25+ 20-24 30 15-19 10-14 0-9 25 Prevalence (%) 20 15 10 5 0 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 Year Radiographic Findings of Pneumoconiosis in CWHSP Participants Other Than From KY, VA, WV (5‐year moving average) 40 Mining Tenure 35 25+ 20-24 30 15-19 10-14 0-9 25 Prevalence (%) 20 15 10 5 0 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 Year Bla c kle y DJ, Ha lldin CN, L a ne y AS. R e sur ge nce of a de bilitating and e ntir e ly pr e ve ntable r e spir ator y dise ase among wor king coal mine r s. Am J Re spirCrit Care Me d . 2014;190(6):708-709. do i:10.1164/ rc c m.20 1407-1286L E . Pre vale nc e of progre ssive massive fibrosis (PMF ) among working unde rground c oal mine rs with at le ast 25 ye ars of unde rground mining te nure in KY, VA, and WV

 1/ 1/ 15–8/ 17/ 16, a to ta l o f 60 pa tie nts with PMF  49 ha d the ir ra dio g ra ph ta ke n during 2016.  Hig h pro po rtio n o f mine rs with ve ry a dva nc e d dise a se :  52% c a te g o ry A  38% c a te g o ry B  10% c a te g o ry C  Surve illa nc e da ta ha ve indic a te d a re surg e nc e o f PMF in re c e nt ye a rs, b ut the c a se s de sc rib e d in this re po rt re pre se nt a la rg e c luste r no t disc o ve re d thro ug h ro utine surve illa nc e . Che st ra dio g ra ph ima g e ta ke n in 2016 o f a 56-ye a r-o ld ma le e a ste rn K e ntuc ky re side nt with 29 ye a rs o f to ta l mining te nure (inc luding 11 ye a rs a s a ro o f b o lte r). Ca te g o ry C PMF , Pro fusio n q / q 3/ 2

416 Ca se of PMF from 3 Clinic s in VA Blackley et. al. JAMA 319:5 p. 500-501  T he pre va le nc e o f PMF a mo ng fo rme r mine rs is le ss we ll unde rsto o d .  Da ta ta ke n fro m the U.S. De pa rtme nt o f L a b o r Offic e o f Wo rke rs Co mpe nsa tio n Administra tive Da ta Se t  Use d DOL de te rmina tio n c la ssific a tio n o f PMF a nd to ta l disa b ility  T his study is the first to re po rt tre nds in the pro po rtio n o f Bla c k L ung c la ima nts with PMF using da ta fro m the F e de ra l Bla c k L ung Pro g ra m.  T he se da ta a re inde pe nde nt o f na tio na l surve illa nc e da ta a nd he lp us furthe r unde rsta nd the b urde n o f PMF a mo ng fo rme r U.S. c o a l mine rs.

Re sults  E va lua te d 341,176 c la ims b e twe e n 1970–2016  PMF % o f c la ims inc re a se d fro m 1970–2016  PMF % o f c la ims a c c e le ra te d sinc e 1996.  2,474 c a se s o f PMF ide ntifie d fro m 1996–2016  T his is mo re tha n 10 time s the numb e r ide ntifie d CWHSP (n=225).  Inc re a se in PMF o c c urre d a s wo rkfo rc e d e c line d a nd c la im ra te re ma ine d sta b le .  PMF c a se s g re a te st fro m K e ntuc ky, Virg inia , a nd We st Virg inia . 450 250,000 Average Number of Coal Mine Employees 400 Number of Claimants with PMF 200,000 350 300 150,000 250 200 100,000 150 100 50,000 50 0 0 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 Year F ig ure 1. Numb e r o f mine rs with PMF c o mp a re d to a ve ra g e a nnua l c o a l mine e mplo yme nt, 1970– 2016. T he numb e ro f c la ima nts with PMF fro m 1970–1972 a re c o mb ine d d ue to sma ll numb e rs. Offic e wo rke rs a re inc lud e d in e mplo yme nt to ta ls fro m 1973–1977. Da ta so urc e s: U .S. DOL , OWCP, DCMWC; U .S. DOL , MSHA; a nd the E I A. Ge o g ra phic Distrib utio n o f PMF Ca se s

PMF c a se s fo und in re tire d mine rs who ne ve r pa rtic ipa te d in NIOSH CWHSP.  Why do n’ t mine rs pa rtic ipa te ?  Ho le s in the so c ia l sa fe ty ne t:  1985 – 2005, e mplo yme nt in the Appa la c hia c o a l mining industry de c line d b y 56% due to  Co st o f c o a l re la tive to o il a nd na tura l g a s  Inc re a se d me c ha niza tio n  Shift to c o ntra c t la b o r  F e a r o f jo b lo ss  F e a r o f dise a se a nd a sso c ia te d disa b ility  Mistrust o f g o ve rnme nt Re yno ld s L , Ha lldin CN, L a ne y AS, Bla c kle y DJ. Co a l mine r pa rtic ipa tio n in a jo b tra nsfe r pro g ra m de sig ne d to p re ve nt p ro g re ssio n o f p ne umo c o nio sis, U nite d Sta te s, 1986–2016. Ar c h E nvir on Oc c up He alth . No ve mb e r 2017 Pa rt 90 Optio n Miner notified Miner can Miner of radiographic exercise Part 90 findings participates option through consistent with in CWHSP MSHA CWP

Pa rt 90 Optio n Pro g ra m Da ta NIOSH MSHA  CWHSP  Mine rs who  E e xe rc ise d the ir Pa rt lig ible Pa r t 90 90 option option mine rs E xe rc ising the Pa rt 90 Optio n  14% o f e lig ib le mine rs e xe rc ise d the ir Pa rt 90 rig ht in the la st 30 ye a rs  Me dia n da ys to e xe rc ise Pa rt 90 o ptio n wa s 63 da ys (ra ng e 0 – 10831 da ys)  Mine rs who e xe rc ise d the ir o ptio n mo re q uic kly we re o ld e r a nd ha d lo ng e r mining te nure s E xe rc ising the Pa rt 90 Optio n  Mine rs wo rking in c e ntra l Appa la c hia we re le ss like ly to e xe rc ise Pa rt 90 c o mpa re d to tho se in o the r sta te s  Mine rs fro m Virg inia a nd K e ntuc ky we re le a st like ly to e xe rc ise the ir o ptio n, a t 8.9 % a nd 9.8%  Mine rs fro m Uta h a nd Co lo ra do we re mo st like ly to e xe rc ise the ir o ptio n, a t 32.8% a nd 30.2%

Mining Disasters Mining Re la te d Disa ste rs  E xplo sio ns  I nunda tio ns  Ro o f F a lls – Mine Co lla pse  F ire s

I nunda tio ns – Que c re e k, So me rse t, PA July 24-28, 2002  9 Mine rs tra ppe d fo r 77 ho urs  Re sc ue ho le wa s d rille d  Ca psule lo we re d a nd a ll we re sa ve d SAGO MINE E XPL OSION DRIFT JANUARY 2, 2006 OPENI NG INT E RNAT IONAL COAL GROUP SAGO MINE MSHA I.D. No. 46- 08791 Sa g o Mine E xplo sio n a nd F ire  12 Mine rs die d a nd one se ve re ly injure d in the e xplosion oc c urre d a t a pproxima te ly 6:26 AM on Ja nua ry 2, 2006.

5/22/2006 5/22/2006 Darby Mine, Darby Mine, Kentucky Kentucky 5 Miners died 5 Miners died in methane in methane mine explosion mine explosion Aracoma Alma Mine # 1 Conveyer Belt Fire – 2 Deaths Logan County, WVA Cra nda ll Ca nyo n Mine Uta h Aug ust 6, 2007 a nd Aug ust 16, 2007 Ro o f F a ll During Re tre a t Mining 3 Re sc ue rs die d in sub se q ue nt b ump e ve nt