Impact of reactive iron in coal mine dust on oxidant generation and epithelial lung cell viability.

Coal workers' pneumoconiosis (CWP) is a preventable occupational lung disease caused by the chronic inhalation of coal mine dust. The inhalation of coal mine dusts can result in the development of a range of lung diseases termed coal mine dust lung diseases, which is not limited to CWP and includes silicosis, bronchitis, emphysema and cancer. For decades, the presence of elemental Fe, C and Si has been proposed to be the causal factors underlying CWP. The recent resurgence of CWP globally with examination of cases in the United States suggesting a potential but inconclusive role of Fe(II)-sulfide minerals. To obtain a better understanding of Australian coals, the existence and potential adverse impacts of iron minerals were examined using 24 representative Australian coal samples. The results of this work revealed that reduced iron minerals were widely distributed within samples obtained from Australian coal mines with pyrite and siderite being particularly abundant. Compared with carbon and crystalline silica, the presence of these specific iron minerals were negatively correlated to the viability of both alveolar macrophages (NR8383) and human lung epithelial cells (A549) (R2 = 0.689) under scenarios reflecting biologically-relevant inflammatory response conditions. Further analysis using Welch's unpaired t-test indicated that the presence of reduced iron minerals statistically enhanced acellular oxidant production (90% CI [0.74 to 2.55]) and inflammatory response (90% CI [0.15 to 36.96]). Compared with Fe(II)-hydroxide, Fe(II)- and Fe(III)-(phyllo)silicate and Fe(II)-sulfate mineralogies, pyrite and siderite bearing dusts are likely to have greater adverse impacts on epithelial lung cells under inflammatory response conditions in view of both their iron content and reactivity.

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.

A Methodology to Monitor Airborne PM10 Dust Particles Using a Small Unmanned Aerial Vehicle.

Throughout the process of coal extraction from surface mines, gases and particles are emitted in the form of fugitive emissions by activities such as hauling, blasting and transportation. As these emissions are diffuse in nature, estimations based upon emission factors and dispersion/advection equations need to be measured directly from the atmosphere. This paper expands upon previous research undertaken to develop a relative methodology to monitor PM10 dust particles produced by mining activities making use of small unmanned aerial vehicles (UAVs). A module sensor using a laser particle counter (OPC-N2 from Alphasense, Great Notley, Essex, UK) was tested. An aerodynamic flow experiment was undertaken to determine the position and length of a sampling probe of the sensing module. Flight tests were conducted in order to demonstrate that the sensor provided data which could be used to calculate the emission rate of a source. Emission rates are a critical variable for further predictive dispersion estimates. First, data collected by the airborne module was verified using a 5.0 m tower in which a TSI DRX 8533 (reference dust monitoring device, TSI, Shoreview, MN, USA) and a duplicate of the module sensor were installed. Second, concentration values collected by the monitoring module attached to the UAV (airborne module) obtaining a percentage error of 1.1%. Finally, emission rates from the source were calculated, with airborne data, obtaining errors as low as 1.2%. These errors are low and indicate that the readings collected with the airborne module are comparable to the TSI DRX and could be used to obtain specific emission factors from fugitive emissions for industrial activities.

Emergence of pneumococcal 19A empyema in UK children.

INTRODUCTION: Invasive pneumococcal disease due to serotype 19A has become a major concern, particularly in the USA and Asia. We describe the characteristics of pneumococcal serotype 19A related empyema and changes in its incidence in the UK. METHODS: Data from paediatric empyema patients between September 2006 and March 2011 were collected from 17 respiratory centres in the UK. Pneumococcal serotypes were identified as part of the Health Protection Agency enhanced paediatric empyema surveillance programme. RESULTS: Four serotypes accounted for over 80% of 136 cases (Serotype 1 : 43%, 3 : 21%, 7 : 11% and 19A:10%). The incidence of empyema due to serotype 19A quadrupled from 0.48 (0.16-1.13) cases per million children in 2006/2007 to 2.02 (1.25-3.09) in 2010/2011. Severity of disease was significantly increased in children with 19A infection when compared to other serotypes. CONCLUSIONS: The incidence of empyema due to pneumococcal serotype 19A infection has increased significantly and is associated with substantial morbidity.

Tenofovir use in human immunodeficiency virus-1-infected children in the United kingdom and Ireland.

BACKGROUND: Tenofovir disoproxil fumarate (TDF) is neither licensed for use nor extensively studied in HIV-infected children. The only available formulation is an adult tablet, introducing the possibility of dosing errors in children. TDF interacts with other antiretrovirals and has been associated with decline in renal function and CD4 count. We describe the use of TDF in a cohort of HIV-1-infected children in the United Kingdom and Ireland. METHODS: Children ever prescribed TDF and followed in the Collaborative HIV Pediatric Study cohort since 2001 were included in analyses of dosing, adverse events, and virologic and immunologic response. Suspected adverse drug reactions to TDF reported to the Medicines and Healthcare products Regulatory Agency during the same time were also reviewed. RESULTS: One hundred fifty-nine of 1253 children had taken TDF. They were older and had clinically more advanced disease than the rest of the cohort. Eighteen percent received >120% and 37% received <80% of the suggested pediatric dose (8 mg/kg). Thirty-seven percent of new TDF regimens contained didanosine (ddI), though few since 2005. Twelve of 159 (7.5%) children experienced serious adverse events and stopped TDF permanently, 11 taking concurrent lopinavir-ritonavir, and 10 ddI; 5 had renal toxicity. Viral load suppressed to < or =50 copies/mL at 12 months in 38% of those starting TDF. Median increase in CD4 count at 12 months was +110 cells/mL (interquartile range, 9-270), but only 3 cells/mL in those taking concurrent ddI. CONCLUSIONS: TDF seems to be an effective antiretroviral drug in this pediatric cohort, although considerable underdosing and overdosing occurs. A small number of children experienced serious adverse events while taking TDF; half were renal toxicity, most associated with concurrent ddI and lopinavir-ritonavir use.