Resting diffusing capacity and severity of radiographic disease predict gas exchange abnormalities with exercise in former US coal miners.

BACKGROUND: The US Department of Labor (DOL) does not fund diffusing capacity (DLCO) or metabolic measurements from cardiopulmonary exercise testing (CPET) for coal miners' disability evaluations. Although exercise arterial blood gas testing is covered, many miners are unable to perform maximal tests, and sampling at peak exercise can be challenging. We explored the relationship between resting DLCO, radiographic disease severity, and CPET abnormalities in former US coal miners. METHODS: We analyzed data from miners evaluated between 2005 and 2015. Multivariable linear and logistic regression analyses were used to examine relationships between percent predicted (pp) forced expiratory volume in 1 s (FEV1pp), DLCOpp, VO2maxpp, A-a oxygen gradient (A-a)pp, dead space fraction (Vd/Vt), disabling oxygen tension (PO2), and radiographic findings of pneumoconiosis. RESULTS: Data from 2015 male coal miners was analyzed. Mean tenure was 28 years (SD 8.6). Thirty-twopercent had an abnormal A-a gradient (>150 pp), 20% had elevated Vd/Vt (>0.33), and 34% a VO2max < 60 pp. DLCOpp strongly predicted a disabling PO2, with an odds ratio (OR) of 2.33 [2.09-2.60], compared to 1.18 [1.08-1.29] for FEV1. Each increase in subcategory of small opacity (simple) pneumoconiosis increased the odds of a disabling PO2 by 42% [1.29-1.57], controlling for age, body mass index, pack-years of tobacco smoke exposure, and years of coal mine employment. CONCLUSIONS: DLCO is the best resting pulmonary function test predictor of CPET abnormalities. Radiographic severity of pneumoconiosis was also associated with CPET abnormalities. These findings support funding DLCO testing for impairment and suggest the term "small opacity" should replace "simple" pneumoconiosis to reflect significant associations with impairment.

Deep Learning Models of Multi-Scale Lesion Perception Attention Networks for Diagnosis and Staging of Pneumoconiosis: A Comparative Study with Radiologists.

Accurate prediction of pneumoconiosis is essential for individualized early prevention and treatment. However, the different manifestations and high heterogeneity among radiologists make it difficult to diagnose and stage pneumoconiosis accurately. Here, based on DR images collected from two centers, a novel deep learning model, namely Multi-scale Lesion-aware Attention Networks (MLANet), is proposed for diagnosis of pneumoconiosis, staging of pneumoconiosis, and screening of stage I pneumoconiosis. A series of indicators including area under the receiver operating characteristic curve, accuracy, recall, precision, and F1 score were used to comprehensively evaluate the performance of the model. The results show that the MLANet model can effectively improve the consistency and efficiency of pneumoconiosis diagnosis. The accuracy of the MLANet model for pneumoconiosis diagnosis on the internal test set, external validation set, and prospective test set reached 97.87%, 98.03%, and 95.40%, respectively, which was close to the level of qualified radiologists. Moreover, the model can effectively screen stage I pneumoconiosis with an accuracy of 97.16%, a recall of 98.25, a precision of 93.42%, and an F1 score of 95.59%, respectively. The built model performs better than the other four classification models. It is expected to be applied in clinical work to realize the automated diagnosis of pneumoconiosis digital chest radiographs, which is of great significance for individualized early prevention and treatment.

AMFP-net: Adaptive multi-scale feature pyramid network for diagnosis of pneumoconiosis from chest X-ray images.

Early detection of pneumoconiosis by routine health screening of workers in the mining industry is critical for preventing the progression of this incurable disease. Automated pneumoconiosis classification in chest X-ray images is challenging due to the low contrast of opacities, inter-class similarity, intra-class variation and the existence of artifacts. Compared to traditional methods, convolutional neural networks have shown significant improvement in pneumoconiosis classification tasks, however, accurate classification remains challenging due to mainly the inability to focus on semantically meaningful lesion opacities. Most existing networks focus on high level abstract information and ignore low level detailed object information. Different from natural images where an object occupies large space, the classification of pneumoconiosis depends on the density of small opacities inside the lung. To address this issue, we propose a novel two-stage adaptive multi-scale feature pyramid network called AMFP-Net for the diagnosis of pneumoconiosis from chest X-rays. The proposed model consists of 1) an adaptive multi-scale context block to extract rich contextual and discriminative information and 2) a weighted feature fusion module to effectively combine low level detailed and high level global semantic information. This two-stage network first segments the lungs to focus more on relevant regions by excluding irrelevant parts of the image, and then utilises the segmented lungs to classify pneumoconiosis into different categories. Extensive experiments on public and private datasets demonstrate that the proposed approach can outperform state-of-the-art methods for both segmentation and classification.

Women in Coal Mining-Radiographic Findings of Women Participants in the Coal Workers' Health Surveillance Program 1970-2022.

Objective: To describe the work experience and respiratory health of women coal miners in the United States using Coal Workers' Health Surveillance Program (CWHSP) data. Methods: Analysis included CWHSP participants with self-reported sex of female between January 1, 1970, and December 31, 2022, and examined radiographic surveillance, demographics, and job history. National Institute for Occupational Safety and Health-certified physicians classified chest radiographs. Results: Among 8,182 women participants, most worked <10 years and a majority reported working in non-dusty jobs. Among 3,392 with ≥1 year of coal mining tenure, 18 (0.5%) had evidence of pneumoconiosis, with no cases of progressive massive fibrosis. Conclusion: Women coal miners participating in the CWSHP had short mining careers and low pneumoconiosis prevalence. Few worked in the most dusty jobs, indicating limited exposure to coal mine dust. This underscores the need to explore women's roles in mining, and for improved gender-specific employment reporting. Such changes can enhance health and work conditions for women in male-dominated industries.

[Analysis of disease burden of welder's pneumoconiosis in Jiangsu Province].

Objective: To investigate the current status of disease burden and its influencing factors among welder's pneumoconiosis patients, and provide scientific basis for taking targeted intervention measures. Methods: From June 2022 to June 2023, the patients with welder's pneumoconiosis in Jiangsu Province were selected from 1956 to 2020 as the research objects, and disability adjusted life years (DALY) were used as the comprehensive index to study the disease burden. The direct and indirect economic losses caused by the diseases were calculated, and the factors affecting the disease burden were discussed by multiple linear regression method. Results: A total of 974 cases of welder's pneumoconiosis were reported in Jiangsu Province, the cumulative loss of DALY was 6300.73 person-years, and the per capita loss was 6.47 person-years. Among them, the healthy life years lost due to disability (YLD) was 6156.50 person-years (97.71%) , and the healthy life years lost due to premature death (YLL) was 144.23 person-years (2.29%) . Multiple linear regression analysis showed that the main factors affecting DALY were disability grade, diagnostic age, pneumoconiosis grade and length of dust exposure (P<0.05) . The total economic loss caused by 974 welder's pneumoconiosis patients was 1831838160.18 yuan, and the per capita loss was 1880737.33 yuan. Among them, the direct economic loss was 970917563.75 yuan (53.00%) , and the indirect economic loss was 860920596.43 yuan (47.00%) . Conclusion: Welder's pneumoconiosis causes serious disease burden to patients, and at the same time causes huge economic losses to individuals and society, which seriously hinders the development of society. Taking effective control measures to prevent the incidence of welder's pneumoconiosis is the key to reduce the disease burden.

[The relationship between the comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infections].

Objective: To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease. Methods: In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed. Results: There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) (P<0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased (P<0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased (P<0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group (P<0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis (P<0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI: 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection (P<0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95%CI: 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion: The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

[Research progress on pneumoconiosis markers based on multi-omics analysis].

The etiology of pneumoconiosis is relatively clear, but the pathogenic mechanism is not fully understood, and there is no effective cure for pneumoconiosis. Clarifying the pathogenesis of pneumoconiosis and exploring relevant markers can help screen high-risk groups of dust exposure, and relevant markers can also be used as targets to intervene in the process of pulmonary fibrosis. The in-depth development of genomics, transcriptomics and proteomics has provided a new way to discover more potential markers of pneumoconiosis. In the future, the combination of multi-omics and multi-stage interactive analysis can systematically and comprehensively identify key genes (proteins) , metabolites and metabolic pathways in the occurrence and development of pneumoconiosis, build a core regulatory network, and then screen out sensitive markers related to early diagnosis and treatment of pneumoconiosis. This article summarizes the research progress of pneumoconiosis markers from the perspective of multi-omics, hoping to provide more basic data for the early prevention and diagnosis of pneumoconiosis, pathogenesis research, and therapeutic intervention.

[Study on evaluation method of circular small shadow profusion in chest CT reconstruction images of pneumoconiosis].

Objective: To select chest CT image patterns for the diagnosis of pneumoconiosis and establish a method for determining the profusion of circular small shadows in chest CT. Methods: In April 2021, 66 cases of occupational pneumoconiosis patients with digital radiography (DR) chest radiographs and chest CT imaging data with circular small shadow as the main manifestations were selected as the study objects. 1.5 mm and 5 mm chest CT axial images, 1 mm and 5 mm chest CT coronal multi-plane recombination (MPR) images, and 5 mm chest CT coronal maximum intensity projection (MIP) images were used to observe the different characteristics of pneumoconiosis patients, and were compared and analyzed with DR chest radiographs to establish the experimental chest CT standards. The consistency of the profusion results between the experimental chest CT standards and GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis was verified. Results: All the 66 objects were male, including 33 cases of stage Ⅰ pneumoconiosis, 17 cases of stage Ⅱ pneumoconiosis and 16 cases of stage Ⅲ pneumoconiosis. By observing five chest CT images of 66 objects, we found that chest CT images of different modes could clearly display and identify abnormal images such as small circular shadow, large shadow, small shadow aggregation, honeycomb glass shadow, flake glass shadow, uniform low-profusion glass shadow, mesh glass shadow, cable shadow, linear shadow, subpleural spinous shadow, subpleural nodules, various kinds of emphysema and lung texture distortion and fracture. Small shadow aggregation was usually accompanied by the appearance of large shadow. The vascular shadows in 5 mm CT images had good ductility, and small nodules were easy to distinguish. The coronal MIP image of 5 mm chest CT used edge enhancement technology, which was prone to small shadow fusion and fibrotic shadow fusion. The coronal MPR image of 5 mm chest CT was highly consistent with the DR chest radiographs in terms of the integrity of film reading. GBZ 70-2015 standard was used to compare the profusion of DR chest radiographs and 5 mm chest CT coronal MPR images of 66 objects, and the consistency test Kappa=0.64. GBZ 70-2015 standard and experimental chest CT standard were used to compare the profusion results of DR chest radiographs and 5 mm chest CT coronal MPR images of 66 objects, respectively, and the consistency test Kappa=0.80, with high consistency. Conclusion: 5 mm coronal MPR image is suitable for chest CT imaging in the diagnosis of pneumoconiosis. Following the selection path and method of GBZ 70-2015 profusion criterion, the established experimental chest CT standard in determining the profusion of small circular shadows in 5 mm coronal MPR images of chest CT with pneumoconiosis has a high consistency with GBZ 70-2015 standard.

Survival and disease burden analyses of occupational pneumoconiosis during 1958-2021 in Huangshi city, China: a retrospective cohort study.

BACKGROUND: Pneumoconiosis, a chronic disease stemming from prolonged inhalation of dust particles, stands as a significant global burden of occupational diseases. This study aims to investigate the survival outcomes of pneumoconiosis patients in Huangshi city, China, while also evaluating the disease burden on afflicted patients. METHODS: Data for this study were sourced from the Huangshi Center for Disease Control and Prevention. Survival analyses of pneumoconiosis patients were conducted employing life tables and the Kaplan-Meier method. The Cox proportional hazards models were deployed to identify factors influencing pneumoconiosis patients' survival duration. Competing risks models were employed to confirm the validity of the model outcomes. Additionally, in the disease burden assessment, disability-adjusted life years (DALYs) were computed for various demographic groups and time frames. RESULTS: A total of 5,641 pneumoconiosis cases, diagnosed in Huangshi City, Hubei Province between 1958 and 2021, were incorporated into the cohort analysis. The probability of mortality and the risk ratio increased with advancing age. Notably, the median survival time of stage III pneumoconiosis patients was significantly shorter compared with those in stages I and II. The Cox proportional hazards model and competing risks analyses underscored several significant factors influencing survival time, including dust exposure duration (HR = 1.197, 95% CI: 1.104-1.298), age at first diagnosis (HR = 3.149, 95% CI: 2.961-3.349), presence of silicosis (HR = 1.378, 95% CI: 1.254-1.515), and stage II-III pneumoconiosis (HR = 1.456, 95% CI: 1.148-1.848). Cumulatively, DALYs amounted to 7,974.35 person-years, with an average of 1.41 person-years. The period between 2000 and 2019 witnessed the highest disease burden. CONCLUSION: Our findings highlight the urgent need for improved prevention, earlier detection, and more effective management strategies for the occupational pneumoconiosis population. This study not only underscores the persistent issue of pneumoconiosis in industrial environments but also serves as a crucial call to action for policymakers and healthcare providers.

Alloyed Airways: Chromium, Beryllium, and Titanium in the Lungs of an Aerospace Veteran.

Pneumoconiosis is a form of interstitial lung disease (ILD) that commonly occurs secondary to occupational or environmental exposures. This is an emerging disease as there are many potential forms of pathologic insults. Further adding to the complication is that clinical symptomatology secondary to pneumoconiosis can have long latent periods, as repetitive exposure over years leads to long-standing inflammation and subsequent irreversible damage. Exposure to asbestos, coal, silica, aluminum, talc, hay, and many more agents has the potential to cause pneumoconiosis. This case highlights a veteran, who made his career working with heavy metals such as chromium, beryllium, and titanium in the aerospace defense industry. This case discusses high-risk occupations, a workup for suspected pneumoconiosis, management, and the mechanism of lung injury underlying the three aforementioned pathologic agents. In each case of pneumoconiosis, a thorough history is essential, and diagnoses are made via the incorporation of the patient's historical risk factors, pulmonary function test (PFT) findings, and high-resolution chest computed tomography (HRCT).

The First Case Report of Inactive Nontuberculous Mycobacterial Pulmonary Disease (NTM-PD) in a Pneumoconiosis Patient Caused by Mycobacterium europaeum in China.

We reported a 51-year-old male electric welder with stage I pneumoconiosis, who had no significant cough, sputum, fever, chest pain, or other discomfort. However, regular physical examination at our hospital revealed bilateral pulmonary nodules with cavity formation. Blood routine, liver or kidney function, and infection-related biomarkers, including interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and procalcitonin (PCT), were normal. Sputum and alveolar lavage fluid (BALF) acid-fast bacilli (AFB) smears, BALF Mycobacterium tuberculosis (TB) PCR, and T-SPOT.TB were negative. The nucleic acid sequence of Mycobacterium europaeum was detected by BALF metagenomic next-generation sequencing (mNGS), which was confirmed by the subsequent positive culture for NTM. Considering stable conditions, no significant discomfort, and no significant changes in the lung lesion, the patient was diagnosed with inactive nontuberculous mycobacterial pulmonary disease (NTM-PD).

[Asbestos: detection and characterization in tissue]. / Asbest: Nachweis und Charakterisierung im Gewebe.

BACKGROUND: When asbestos fibers are inhaled, asbestos bodies can form in the lungs with the involvement of macrophages. It can take decades from the last exposure to the onset of an asbestos-related disease. OBJECTIVES: The aim of this review is to present methods to detect asbestos bodies in lung tissue, the development of diagnostic criteria and to discuss pros and cons of different methods. MATERIALS AND METHODS: Observations and evaluations from the German Mesothelioma Register, along with relevant literature review and expert recommendations in guidelines are presented. RESULTS: Assessing asbestos-related diseases requires recognition of the person's occupational history, the asbestos fiber burden in the lungs, and determining fiber types. Various methods have been developed and validated, including light microscopy techniques such as bright-field microscopy, phase-contrast microscopy, polarization microscopy, and differential interference microscopy, as well as electron microscopy techniques like field-emission-scanning electron microscopy (e.g., FE-SEM) and transmission electron microscopy (TEM). CONCLUSION: The use of asbestos has been heavily restricted worldwide, even completely banned in Europe. Thus, patients' exposure to asbestos is decreasing. However, asbestos exposure during renovations, demolitions, or through unconscious handling of asbestos-containing materials remains a concern.

[A survey on the application of convolutional neural networks in the diagnosis of occupational pneumoconiosis].

Pneumoconiosis ranks first among the newly-emerged occupational diseases reported annually in China, and imaging diagnosis is still one of the main clinical diagnostic methods. However, manual reading of films requires high level of doctors, and it is difficult to discriminate the staged diagnosis of pneumoconiosis imaging, and due to the influence of uneven distribution of medical resources and other factors, it is easy to lead to misdiagnosis and omission of diagnosis in primary healthcare institutions. Computer-aided diagnosis system can realize rapid screening of pneumoconiosis in order to assist clinicians in identification and diagnosis, and improve diagnostic efficacy. As an important branch of deep learning, convolutional neural network (CNN) is good at dealing with various visual tasks such as image segmentation, image classification, target detection and so on because of its characteristics of local association and weight sharing, and has been widely used in the field of computer-aided diagnosis of pneumoconiosis in recent years. This paper was categorized into three parts according to the main applications of CNNs (VGG, U-Net, ResNet, DenseNet, CheXNet, Inception-V3, and ShuffleNet) in the imaging diagnosis of pneumoconiosis, including CNNs in pneumoconiosis screening diagnosis, CNNs in staging diagnosis of pneumoconiosis, and CNNs in segmentation of pneumoconiosis foci to conduct a literature review. It aims to summarize the methods, advantages and disadvantages, and optimization ideas of CNN applied to the images of pneumoconiosis, and to provide a reference for the research direction of further development of computer-aided diagnosis of pneumoconiosis.

Time-/dose- series transcriptome data analysis and traditional Chinese medicine treatment of pneumoconiosis.

Pneumoconiosis' pathogenesis is still unclear and specific drugs for its treatment are lacking. Analysis of series transcriptome data often uses a single comparison method, and there are few reports on using such data to predict the treatment of pneumoconiosis with traditional Chinese medicine (TCM). Here, we proposed a new method for analyzing series transcriptomic data, series difference analysis (SDA), and applied it to pneumoconiosis. By comparison with 5 gene sets including existing pneumoconiosis-related genes and gene set functional enrichment analysis, we demonstrated that the new method was not inferior to two existing traditional analysis methods. Furthermore, based on the TCM-drug target interaction network, we predicted the TCM corresponding to the common pneumoconiosis-related genes obtained by multiple methods, and combined them with the high-frequency TCM for its treatment obtained through literature mining to form a new TCM formula for it. After feeding it to pneumoconiosis modeling mice for two months, compared with the untreated group, the coat color, mental state and tissue sections of the mice in the treated group were markedly improved, indicating that the new TCM formula has a certain efficacy. Our study provides new insights into method development for series transcriptomic data analysis and treatment of pneumoconiosis.

Risk of sleep disorders in patients with pneumoconiosis: a retrospective cohort study.

BACKGROUND: Pneumoconiosis is associated with pulmonary and cardiovascular diseases; however, the link between pneumoconiosis and sleep disorders is not well understood. This study aimed to investigate the connection between pneumoconiosis and subsequent risk of sleep disorders. METHODS: This population-based retrospective cohort study used data from the National Health Insurance database in Taiwan. The pneumoconiosis cohort consisted of 13,329 patients newly diagnosed between 2000 and 2015. The comparison group included 53,316 age-, sex-, and diagnosis date-matched individuals without pneumoconiosis. The development of sleep disorders was monitored until the end of 2018. Cox proportional hazard regression models were used for risk assessment. RESULTS: The incidence of sleep disorders was 1.31 times higher in the pneumoconiosis cohort than in the comparison cohort (22.8 vs. 16.2 per 1000 person-years). After controlling for age, sex, comorbidity, and medication, the adjusted hazard ratio (aHR) was 1.24 (95% confidence interval [CI] = 1.17-1.32). Stratified analyses by age group, sex, and comorbidity status showed significant associations between pneumoconiosis and sleep disorders (aHRs, 1.19-1.64). In addition, patients with pneumoconiosis had a significantly increased risk of developing sleep apnea (aHR = 1.71, 95% CI = 1.31-2.22). CONCLUSION: This study demonstrates that patients with pneumoconiosis are at a higher risk of developing sleep disorders and sleep apnea. Healthcare professionals should pay close attention to sleep quality and disturbances in patients with pneumoconiosis.

Evaluating silicosis risk: Assessing dust constitution and influence of water as a primary prevention measure in cutting and polishing of silica agglomerates, granite and marble.

An increasing number of silicosis cases have been reported related to the use of silica agglomerates. Many studies agree on the severity of this disease, which often presents with severe clinical forms in young workers and after a short latency period. Are there differences in the composition of dust generated by cutting and polishing with silica agglomerates versus granite and marble? Does the use of water injection reduce the risk associated with the use of these materials? We carried out a comparative observational-analytical study, measuring the concentration of dust generated during different machining operations on three different materials: granite, marble, and silica agglomerates. The effect of water injection on dust generation was evaluated. Personal sampling pumps were used, connected to a cyclone with polyvinyl chloride filters. The flow rate of the pumps was adjusted using a piston flowmeter. Measurements with a cascade impactor were made to assess the size distribution of respirable crystalline silica particles within the respirable fraction. In addition, environmental measurements with a spectrometer were made. 10 tests were carried out on granite and silica agglomerates for each procedure. In the case of marble, with very low silica content, only 2 tests of each type were carried out. Duration of each measurement was between 6 and 25 min. Cleaning times were set for each of the operations. The amount of dust collected in the respirable fraction was 70.85, 32.50 and 35.78 mg/m3 for dry cutting; 6.50, 3.75 and 3.95 mg/m3 for wet cutting; and 21.35, 13.68 and 17.50 mg/m3 for dry polishing, for granite, marble, and silica agglomerates respectively. Dry procedures in marble, silica agglomerates and granite showed higher dust concentration of particles smaller than 0.5 µm. Silica agglomerates showed higher concentrations of respirable crystalline silica particles than granite and marble, mainly with dry procedures. The greater production of small particles in dry and wet procedures with silica agglomerates shows that water injection is an insufficient preventive measure.

Distribution and characteristics of malignant tumours by lung lobe.

BACKGROUND: The main focus on the characteristics of malignant lung tumours has been the size, position within the lobe, and infiltration into neighbouring structures. The aim of this study was to investigate the distribution and characteristics of malignant tumours between the lung lobes and whether the diagnosis, treatment, and outcome differed based on location. METHODS: This study is based on 10,849 lung cancer patients diagnosed in 2018-2022 with complete data on the location and characteristics of the tumours. The proportions of tumours in each lobe divided by its volume were termed the relative proportion. RESULTS: The right upper lobe comprised 31.2% of the tumours and 17.6% of the lung volume. The relative proportion of 1.77 was higher than in the other lobes (p < 0.001). The right middle lobe had a relative proportion of 0.64 but the highest proportion of neuroendocrine tumours (26.1% vs. 15.3 on average). Surgical resection was more often performed in patients with tumours in the lower lobes, and curative radiotherapy was more often performed in the upper lobes. After adjusting for age, sex, stage, and histology, the location of the tumour was found to be a significant independent predictor for resection but not for survival. CONCLUSION: The main finding of the right upper lobe as a site of predilection for lung cancer is similar to tuberculosis and pneumoconiosis. This may be explained that most of the inhaled air, containing bacilli, inorganic particles or tobacco smoke goes to the upper and right parts of the lung.

Neurofibromatosis type 1 and pneumoconiosis: A case report on a coincidence.

Neurofibromatosis (NF) is a neurocutaneous syndrome characterized by the development of central or peripheral nervous system tumors. The most common form, known as NF1 or Von Recklinghausen's disease, presents with distinct clinical features, including cutaneous and ocular manifestations, along with various other organ and systemic symptoms. While the lung findings associated with neurofibromatosis lack specificity, they can include parenchymal cysts and bullae formation, primarily in the upper-apical regions. Additionally, progressive fibrotic changes, such as ground-glass areas, consolidations, and paving stone patterns, may manifest in the basal parts of the lungs. In this case report, a case of NF1 diagnosed in adulthood and accompanying pneumoconiosis was discussed as a coincidence.

Aluminosis pneumoconiosis presenting as hyperdense lung nodules.

We present the case of a 66-year-old man who presented with new incidentally found hyperdense pulmonary nodules. Further workup with a PET/CT revealed that the nodules were FDG-avid and that there was associated hypermetabolic lymphadenopathy. Due to his history of aluminum toxicity from welding, aluminosis pneumoconiosis was suspected. Biopsy of one of the nodules was done which reinforced this diagnosis. Aluminosis pneumoconiosis is a rare occupational lung disease mostly associated with industrial workers with prolonged unprotected exposure to fine aluminum dust. Prognosis depends on the duration and intensity of exposure, and there is no definitive treatment other than eliminating further exposure.

[The history of compensation system for workers with pneumoconiosis-related lung cancer].

OBJECTIVE: To review the historical aspects of compensation system for workers with pneumoconiosis who developed lung cancer. METHODS: Materials and papers published on the compensation system as discussed in administrative meetings were utilized. RESULTS: Legal claims for compensation for lung cancer among individuals with pneumoconiosis increased during the period of rapid economic growth in Japan. A possible causal relationship between pneumoconiosis and lung cancer in workers has been discussed by committees of specialists. The Expert Committee on Pneumoconiosis and Lung Cancer in 1978 did not find a causal relationship between them. However, a survey of physicians specializing in pneumoconiosis revealed medical disadvantages among individuals diagnosed with pneumoconiosis who developed lung cancer. The Ministry of Labour announced the risk of work-related lung cancer in patients with advanced pneumoconiosis (class IV or equivalent severity). Since then, numerous lung cancer patients with pneumoconiosis have been adjudicated. In 1997, the International Agency for Research on Cancer (IARC) re-evaluated the carcinogenicity of silica and declared it to be a Group I carcinogen in humans. The Expert Committee on Compensation of Lung Cancer Cases Developing from Pneumoconiosis discussed the IARC evaluation but did not accept this classification. However, the Committee of Occupational Exposure Limits in the Japan Society of Occupational Health upheld the IARC evaluation of silica as a Group I carcinogen. Because the Expert Committee of Medical Disadvantage of Lung Cancer Patients with Pneumoconiosis accepted the increased risk of lung cancer in patients with class III or equivalent severity pneumoconiosis, the Ministry of Labour announced worker compensation for such patients. The Expert Committee of Health Control of Pneumoconiosis Complicated with Lung Cancer reported in 2002 that a meta-analysis revealed no increased risk of lung cancer among workers exposed to crystalline silica; however, there was an increased risk of lung cancer in patients with pneumoconiosis. The Ministry of Labour has added lung cancer to the list of complications from pneumoconiosis and, if necessary, regular medical checkups for lung cancer. After Leaving dust work, the Health Care System provides for workers who are diagnosed With class II or higher pneumoconiosis. Therefore, if an individual with pneumoconiosis develops class II or higher lung cancer, that individual becomes eligible for workers' compensation. CONCLUSIONS: The conclusion of the Expert Committee in 2002 and the decision of the Ministry of Labour to add lung cancer to its list of complications of pneumoconiosis are evaluated to be appropriate.