Factors associated with patterns of psychological distress, alcohol use and social network among Australian mineworkers.

OBJECTIVE: To investigate the convergence of individual findings relating to psychological distress, alcohol use and social network (SN) to identify their associated clusters within Australian mineworkers. METHODS: This study used cross-sectional survey data from 3,056 participants across 12 Australian mines. Latent class analysis used the scores of Kessler Psychological Distress Scale, Alcohol Use Disorders Identification Test (AUDIT) and Social Network Index. RESULTS: Class 1 (moderate to very high psychological distress, low SN score and low to moderate AUDIT) included 39% (n=1,178) participants and class 2 (low to moderate psychological distress and AUDIT and very high SN) composed of 61% (n=1,873) participants. Class 1 was associated with younger age (OR=0.65, 95%CI=0.53-0.81), being a current smoker (OR=1.45, 95%CI=1.18-1.79), and reporting a history of anxiety (OR=3.00, 95%CI=2.23-4.05) and/or depression (OR=2.18, 95%CI=1.65-2.90). CONCLUSIONS: These findings highlight the challenges the mining sector faces regarding the welfare of its employees. Implications for public health: Modifiable work factors associated with lower social networks and higher psychological distress need addressing at an individual and industry level through targeted and specifically tailored multi-component interventions.

Assessment of pneumoconiosis in surface coal miners after implementation of a national radiographic surveillance program, United States, 2014-2019.

BACKGROUND: Pneumoconiosis can occur in surface coal miners. The Coal Workers' Health Surveillance Program (CWHSP) has only included surface coal miners as part of its regular disease surveillance since 2014. This analysis identifies the prevalence of pneumoconiosis among working surface coal miners participating in the CWHSP since their initial inclusion, through 2019. METHODS: Working surface coal miners who had chest radiographs through the CWHSP from January 1, 2014 through December 31, 2019 were included in this analysis. Demographic information, mining tenure and occupation, and radiographic classifications according to the International Labour Office system were included from each miner's most recent encounter with the CWHSP. Prevalence ratios were calculated comparing the prevalence of the disease by region and occupation by log-binomial regression. RESULTS: Pneumoconiosis was present in 109 (1.6%) surface coal miners, including 12 miners with progressive massive fibrosis, the most severe form of the disease. After taking surface mining tenure into account, surface miners in Central Appalachia (prevalence ratio [PR], 3.2; 95% confidence interval [CI], 2.2-4.7) and surface miners who worked as a driller or blaster (PR, 2.1; 95% CI, 1.3-3.5) were at increased risk of pneumoconiosis. CONCLUSION: The occurrence of pneumoconiosis in surface coal miners supports including them within a systematic respiratory health surveillance program. The current surveillance findings are consistent with past findings of pneumoconiosis, particularly silicosis, in surface mining occupations such as drilling and blasting.

Progression of coal workers' pneumoconiosis absent further exposure.

OBJECTIVES: The natural history of coal workers' pneumoconiosis (CWP) after cessation of exposure remains poorly understood. METHODS: We characterised the development of and progression to radiographic progressive massive fibrosis (PMF) among former US coal miners who applied for US federal benefits at least two times between 1 January 2000 and 31 December 2013. International Labour Office classifications of chest radiographs (CXRs) were used to determine initial and subsequent disease severity. Multivariable logistic regression models were used to identify major predictors of disease progression. RESULTS: A total of 3351 former miners applying for benefits without evidence of PMF at the time of their initial evaluation had subsequent CXRs. On average, these miners were 59.7 years of age and had 22 years of coal mine employment. At the time of their first CXR, 46.7% of miners had evidence of simple CWP. At the time of their last CXR, 111 miners (3.3%) had radiographic evidence of PMF. Nearly half of all miners who progressed to PMF did so in 5 years or less. Main predictors of progression included younger age and severity of simple CWP at the time of initial CXR. CONCLUSIONS: This study provides further evidence that radiographic CWP may develop and/or progress absent further exposure, even among miners with no evidence of radiographic pneumoconiosis after leaving the industry. Former miners should undergo regular medical surveillance because of the risk for disease progression.

Constraints of coal mining safety management efficiency.

BACKGROUND: Investigation of the safety management efficiency in a coal mine aims to improve its safety management level thus ensuring coal mining safety. However, the safety management efficiency is affected by many factors especially for those coal mines operated underground. Furthermore, the constraint factors that are difficult to be identified and eliminated may impede safety management efficiency. OBJECTIVE: This work aims to explore the constraints affecting safety management efficiency through a mathematical model accompanied by some effective measures guided by the theory of constraint (TOC). METHODS: An index system for coal mining safety management efficiency (CMSME) is first established. Then a mathematical model roughly identifying the constraint factors is constructed. The principle of the proposed model is a comparison with the changes of the ratio of integrated CMSME and the ratio of each impact factor over a certain period. Thus, a constraint factor may be one whose ratio changes at a slower rate than that of the integrated CMSME. Following this, some measures are adopted to identify one, or more, real constraints. Finally, the constraints may be broken by internal, or external, means. RESULTS: A case study from Quandian coal mine verified the proposed method: the constraints affecting CMSME could be identified and broken through during the production. This research currently is applied to coal mining activities in a few coal mines, and it will be widely used in the future. CONCLUSIONS: This paper provides a novel method investigating the constraints affecting CMSME and breaking through them. The case study shows that breaking through constraints during the production is beneficial to CMSME. Furthermore, a coal mine with a high CMSME index may still, at some time, have one, or more, bottleneck constraints.

Early life exposures associated with risk of small intestinal neuroendocrine tumors.

Small intestinal neuroendocrine tumors (SINT) are rare with incidence increasing over the past 40 years. The purpose of this work is to examine the role of environmental exposures in the rise of SINT incidence using the Utah Population Database, a resource of linked records including life events, cancer diagnoses and residential histories. SINT cases born in Utah were identified through the Utah Cancer Registry with: diagnosis years of 1948 to 2014 and age at diagnosis of 23 to 88 years. Controls were matched to cases 10:1 based on sex, birth year and residence time in Utah. Cases and controls were geocoded to their birth locale. An isotonic spatial scan statistic was used to test for the occurrence and location(s) of SINT clusters. Potential environmental exposures and economic conditions in the birth locales at the time of the birth (1883-1982) were generated using historical references. Conditional logistic regression was used to estimate odd ratios. We report a spatial cluster central to historic coal mining communities, associated with a 2.86 relative risk (p = 0.016) of SINT. Aspatial analyses of industry and mining exposures further suggest elevated risk for early life exposure near areas involved in the construction industry (OR 1.98 p = 0.024). Other exposures approached significance including coal, uranium and hard rock mining during the earliest period (1883-1929) when safety from exposures was not considered. We do observe a lower risk (OR 0.58 p = 0.033) associated with individuals born in rural areas in the most recent period (1945-1982). Environmental exposures early in life, especially those from industries such as mining, may confer an elevated risk of SINT.

Work-family conflict and mental health among Chinese underground coal miners: the moderating role of psychological capital.

Work-family conflict among underground coal miners not only leads their mental disorders but also may cause coal accidents. The purpose of the study is to explore the relationship between Work-family conflict (WFC) and mental health, testing the Psychological capital (PsyCap) plays a moderating role in this relationship. The cross-sectional survey was performed in Shanxi Province, China during the August to October 2017. 986 miners from five coal mines were recruited in this study. Hierarchical linear regression analyses were performed to explore the moderating role of psychological capital. The result showed that Work-family conflict was positively related to Anxiety Symptoms and Depressive Symptoms. Psychological capital (PsyCap) moderated the relationship between WFC and Anxiety, Depressive Symptoms. The findings illustrate that psychological capital was an important way to improve miners' mental health. Managers should promote organization support and investment in PsyCap to improve miners' mental health.

Factors influencing high respiratory mortality in coal-mining counties: a repeated cross-sectional study.

BACKGROUND: Previous studies have associated elevated mortality risk in central Appalachia with coal-mining activities, but few have explored how different non-coal factors influence the association within each county. Consequently, there is a knowledge gap in identifying effective ways to address health disparities in coal-mining counties. To specifically address this knowledge gap, this study estimated the effect of living in a coal-mining county on non-malignant respiratory diseases (NMRD) mortality, and defined this as "coal-county effect." We also investigated what factors may accentuate or attenuate the coal-county effect. METHODS: An ecological epidemiology protocol was designed to observe the characteristics of three populations and to identify the effects of coal-mining on community health. Records for seven coal-mining counties (n = 19,692) were obtained with approvals from the Virginia Department of Health Office of Vital Statistics for the years 2005 to 2012. Also requested were records from three adjacent coal counties (n = 10,425) to provide a geographic comparison. For a baseline comparison, records were requested for eleven tobacco-producing counties (n = 27,800). We analyzed the association of 57,917 individual mortality records in Virginia with coal-mining county residency, county-level socioeconomic status, health access, behavioral risk factors, and coal production. The development of a two-level hierarchical model allowed the coal-county effect to vary by county-level characteristics. Wald tests detected sets of significant factors explaining the variation of impacts across counties. Furthermore, to illustrate how the model estimations help explain health disparities, two coal-mining county case studies were presented. RESULTS: The main result revealed that coal-mining county residency increased the probability of dying from NMRD. The coal-county effect was accentuated by surface coal mining, high smoking rates, decreasing health insurance coverage, and a shortage of doctors. In Virginia coal-mining regions, the average coal-county effect increased by 147% (p-value< 0.01) when one doctor per 1000 left, and the effect increased by 68% (p-value< 0.01) with a 1% reduction of health insurance rates, holding other factors fixed. CONCLUSIONS: This study showed a high mortality risk of NMRD associated with residents living in Virginia coal-mining counties. Our results also revealed the critical role of health access in reducing health disparities related to coal exposure.

Increased Dementia Mortality in West Virginia Counties with Mountaintop Removal Mining?

Atmospheric particulate matter (PM) is elevated in areas of mountaintop removal mining (MTM), a practice that has been ongoing in some counties of West Virginia (WV) USA since the 1970s. PM inhalation has been linked to central nervous system pathophysiology, including cognitive decline and dementia. Here we compared county dementia mortality statistics in MTM vs. non-MTM WV counties over a period spanning 2001-2015. We found significantly elevated age-adjusted vascular or unspecified dementia mortality/100,000 population in WV MTM counties where, after adjusting for socioeconomic variables, dementia mortality was 15.60 (±3.14 Standard Error of the Mean (S.E.M.)) times higher than that of non-MTM counties. Further analyses with satellite imaging data revealed a highly significant positive correlation between the number of distinct mining sites vs. both mean and cumulative vascular and unspecified dementia mortality over the 15 year period. This was in contrast to finding only a weak relationship between dementia mortality rates and the overall square kilometers mined. No effect of living in an MTM county was found for the rate of Alzheimer's type dementia and possible reasons for this are considered. Based on these results, and the current literature, we hypothesize that inhalation of PM associated with MTM contributes to dementia mortality of the vascular or unspecified types. However, limitations inherent in ecological-type studies such as this, preclude definitive extrapolation to individuals in MTM-counties at this time. We hope these findings will inspire follow-up cohort and case-controlled type studies to determine if specific causative factors associated with living near MTM can be identified. Given the need for caregiving and medical support, increased dementia mortality of the magnitude seen here could, unfortunately, place great demands upon MTM county public health resources in the future.

Current Review of Pneumoconiosis Among US Coal Miners.

PURPOSE OF REVIEW: This review summarizes recent research on pneumoconiosis in coal workers following the identification of the resurgence of this disease among US coal miners in the early 2000s. We describe the impact of this research and how this has led to increased public attention, benefitting affected miners. RECENT FINDINGS: The latest research shows that the prevalence of pneumoconiosis, including progressive massive fibrosis, continues to increase, especially in central Appalachia. Contributing factors may include mining of thin coal seams or cutting rock to access coal, which may expose miners to coal mine dust with a higher content of silica and silicates than in the past. The impact of recently implemented changes, such as the reduced occupational exposure limit for respirable coal mine dust and the introduction of continuous personal dust monitors, will likely take years to appropriately evaluate.

The utility of health belief model to explain self-protective behaviour against pneumoconiosis in Chinese underground coal miners: a cross-sectional study.

OBJECTIVES: Coal workers' pneumoconiosis is caused by exposure to respirable coal mine dust. The self-protection of underground coal miners (UCM) plays an irreplaceable role against this threat. The purpose of this study was to evaluate the predictors of self-protective behaviour (SPB) in Chinese UCM based on the health belief model (HBM). METHODS: A cross-sectional study was conducted among 341 UCM in January 2016 in Pingdingshan City, Henan Province, People's Republic of China. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, HBM variables and SPB. An exploratory factor analysis of the principal components with varimax rotation was carried out on the HBM-related items. Pearson's correlation and multiple linear regression analysis were used to assess the relationship between sociodemographic characteristics, HBM variables and SPB. RESULTS: Multiple regression analysis demonstrated the monthly income (B=0.403, p=0.001), the internal cues to action (B=0.380, p<0.001) and external cues to action (B=0.401, p<0.001) as the predictors of UCM's SPB, accounting for 24.8% of total variance (F=34.96, p<0.001), while the cognition variables of HBM were not significantly associated with SPB. CONCLUSION: The results suggested that both internal and external cues to action were powerful predictors for SPB. These findings highlight that further efforts are required to provide the UCM with periodic health check-up reports and promote the active role of doctors and family members in miners' decision-making to simulate them for better SPB. ETHICS APPROVAL: All data collection procedures received ethical approval from the Ethics Committee of Xuhui District Centre for Disease Control and Prevention (XHHEC-2016-7).

Air Quality in Association With Rural Coal Mining and Combustion in New South Wales Australia.

PURPOSE: Rural areas may face under-recognized threats to air quality. We tested 2 hypotheses that 1) rural areas in New South Wales, Australia, would have better air quality than metropolitan Sydney, and that 2) the rural Upper Hunter region characterized by coal mining and coal combustion would have worse air quality than other rural areas of the state. METHODS: We analyzed 2017 daily mean values for New South Wales, Australia, for particulate matter (PM2.5 and PM10), sulfur dioxide (SO2 ), nitric oxide (NO), nitrogen dioxide (NO2 ), and NOx (sum of NO and NO2 ). Forty-six air monitoring stations were grouped into 6 rural and urban regional areas. Linear regression models examined pollution levels in association with rural and urban regions and meteorological covariates. RESULTS: Findings show that daily mean pollutant levels in the rural Upper Hunter were the highest of all regions, and were significantly higher than metropolitan Sydney, with and without control for weather conditions, for every pollutant. For example, daily mean PM2.5 was 8.64 µg/m3 in the rural Upper Hunter, compared to 7.23 µg/m3 in metropolitan Sydney. CONCLUSIONS: Results highlight the need to consider both urban and rural sources of pollution in air quality studies, and appropriate policy steps to address likely rural air pollution from coal mining.

A systems approach to extraordinarily major coal mine accidents in China from 1997 to 2011: an application of the HFACS approach.

This study aimed to provide a greater understanding of the systemic factors involved in coal mine accidents and to examine the relationships between the contributing factors across all levels of the system. Ninety-four extraordinarily major coal mine accidents that occurred in China from 1997 to 2011 were analyzed using the human factors analysis and classification system (HFACS). The empirical results showed that the frequencies of unsafe behaviors, inadequate regulation and failure to correct hidden dangers were the highest among five levels, 14 categories and 48 indicators, respectively. The odds ratio technique was applied to quantitatively examine the relationships between contributing factors. Various statistically significant associations were discovered and should receive greater attention in future attempts to develop accident measures. In addition, several strategies concerning the main contributing factors and routes to failure are proposed to prevent accidents from reoccurring in an organization.

DNA damage assessment with buccal micronucleus cytome assay in Turkish coal miners.

The aim of this study was to assess DNA damage in Turkish coal miners with the buccal micronucleus cytome (BMCyt assay as the least invasive and therefore most practical method that may find wider application in coal miner biomonitoring. Buccal epithelial cell samples were taken from 54 coal miners and 42 controls from Zonguldak, Turkey to establish their micronucleus (MN), binucleus (BN), condensed chromatin (CC), karyorrhectic (KHC), karyolytic (KYL), nuclear bud (NBUD), and pyknotic (PYC) frequencies. We also analysed the effects of confounding factors such as age, years of work at the mine, smoking, alcohol drinking, and use of protective equipment on differences in MN frequencies. Two miners had confirmed and three suspect pneumoconiosis, whereas 49 displayed normal chest radiographs. MN, BN, KHC, and NBUD frequencies were significantly higher in coal miners than controls. Years of work at the mine also showed a significant effect on buccal MN frequencies in coal miners, but we found no correlation between MN frequencies and age, smoking, and alcohol consumption. In conclusion, BMCyt assay proved itself an accurate and practical screening method, as it can detect DNA damage much earlier than pneumoconiosis develops.

Focusing on Coal Workers' Lung Diseases: A Comparative Analysis of China, Australia, and the United States.

China has high and increasing annual rates of occupational lung diseases such as pneumoconiosis and silicosis. In contrast, Australia and the United States of America (USA) have greatly lowered their annual rates of lung diseases since the 1970s. This paper systematically compared and analysed the multi-elements of coal dust management and health management in these three countries to provide a reference for China. Regarding coal dust management, this paper found that coal workers in China are more susceptible to lung diseases compared to workers in the USA and Australia, considering fundamental aspects such as mine type, coal rank, and geological conditions. In addition, the controllable aspects such as advanced mitigation, monitoring methods, and the personal protective equipment of coal dust were relatively inadequate in China compared to the USA and Australia. Health management in China was found to have multiple deficiencies in health examination, co-governance, and compensations for coal workers suffering from lung diseases and healthcare for retired coal workers. These deficiencies may be attributed to insufficient medical resources, the Chinese government-dominated governance, ineffective procedures for obtaining compensation, and the lack of effective and preventive healthcare programs for the retired coal workers. Based on the USA and Australia experience, some suggestions for improvement were proposed.

Ischemic Heart Disease Mortality and Diesel Exhaust and Respirable Dust Exposure in the Diesel Exhaust in Miners Study.

Diesel exhaust is a suggested risk factor for ischemic heart disease (IHD), but evidence from cohorts using quantitative exposure metrics is limited. We examined the impact of respirable elemental carbon (REC), a key surrogate for diesel exhaust, and respirable dust (RD) on IHD mortality, using data from the Diesel Exhaust in Miners Study in the United States. Using data from a cohort of male workers followed from 1948-1968 until 1997, we fitted Cox proportional hazards models to estimate hazard ratios for IHD mortality for cumulative and average intensity of exposure to REC and RD. Segmented linear regression models allowed for nonmonotonicity. Hazard ratios for cumulative and average REC exposure declined relative to the lowest exposure category before increasing to 0.79 and 1.25, respectively, in the highest category. Relative to the category containing the segmented regression change points, hazard ratios for the highest category were 1.69 and 1.54 for cumulative and average REC exposure, respectively. Hazard ratios for RD exposure increased across the full exposure range to 1.33 and 2.69 for cumulative and average RD exposure, respectively. Tests for trend were statistically significant for cumulative REC exposure (above the change point) and for average RD exposure. Our findings suggest excess risk of IHD mortality in relation to increased exposure to REC and RD.

Evaluating hearing loss risks in the mining industry through MSHA citations.

A new noise regulation for the mining industry became effective in 2000, providing a consistent regulatory requirement for both coal and non-coal mining divisions. The new rule required mines to implement hearing conservation programs, including a system of continuous noise monitoring, provision of hearing protection devices, audiometric testing, hearing loss training, and record keeping. The goal of this study was to assess hearing conservation program compliance, and excessive noise exposure and hearing loss risks for both coal and non-coal mining divisions through evaluating MSHA citations. We analyzed 13,446 MSHA citations from 2000-2014 pertinent to 30 CFR Part 62. Descriptive statistics were generated and comparisons were made among mines of different commodities. In addition, one-way ANOVA on ranks was conducted to estimate the correlation between excess risks and establishment size. Results showed that 25.6% of coal mines and 14.7% of non-coal mines were cited at least once during this period of time. Larger numbers of noncompliance were seen in stone, sand, and gravel mines (SSG). Results also suggested inadequate efforts in both audiometric testing and minimizing risk after excessive noise exposure. Finally, establishment size of mine was correlated with the increasing risk of noncompliance. We anticipate that this study can guide resource allocation for preventing noise-induced hearing loss, and help improve risk management in mining.

Estimated economic costs of coal workers' pneumoconiosis among coal workers redeployed from the Fuxin mining group in China.

Our research estimated the economic costs of possible cases of coal workers' pneumoconiosis (CWP) among redeployed coal workers from the Fuxin Mining Industry Group. The study cohort included 19,116 coal workers between 1965 and 2012. We estimated direct and indirect economic costs due to possible current and future CWP cases among redeployed coal workers. We found as of 2012 that 141 possible CWP cases might have resulted in economic costs of $37.52 million ($33.84 million were direct and $3.68 million indirect). Moreover, 221 possible future CWP cases would result in economic costs of $63.89 million ($57.20 million direct and $6.69 million indirect). Neither the Fuxin Mining Industry Group nor Fuxin could cover the costs of CWP screening and diagnosis, or social security payments for redeployed coal workers. We suggest that China's national government help Liaoning Province and Fuxin focus on health care and social security.