[Bronchial cancer in miners from the coal beds of the Lorraine basin]. / Le cancer bronchique chez les mineurs des houillères du Bassin de Lorraine.

The present study examines the mortality levels from primary bronchial cancer in the miners of Houillieres du Bassin de Lorraine, including pneumoconiotics and non-pneumoconiotics aged more than 45. 48, or 8.87% of deaths of known cause occurring between 1977 and 1981 amongst pneumoconiotics were due to a primary bronchial cancer, proved cytologically and histologically. This level did not differ from that of 7.66% seen in 796 coal miners who had worked for more than 15 years underground and unscathed by any occupational disorder, nor for the 8.57% level of men residing in the Moselle department. It is, on the other hand, significantly elevated versus the 6.34% of Frenchmen for the same age range. Tobacco consumption and industrial atmospheric pollution in the Moselle is more important than in most other French departments and should be considered when interpreting this excess mortality for bronchial cancer in this department when compared to the french national average. For the coal miners of Lorraine this study had not established a correlation between the work, the pneumoconiotic lesions and the frequency of primary bronchial cancer.

A longitudinal study of pulmonary function in coal miners in Lorraine, France.

A longitudinal study of pulmonary function and radiological change has been conducted on 141 nonsmoking coal miners and 256 smoking coal miners from Lorraine, France. At the time of the first examination occasioned by radiological change or shortness of breath, the men averaged between 46.6 years and 50.9 years of age, and they retired approximately 8 years after entering the study. They have been followed for average periods of about 18 years and a mean of five FEV1 observations per man were made over that period. Changes in radiological category have been documented. Average rates of decline of FVC and FEV1 were similar, and varied between -47 ml/yr in nonsmoking miners still alive, to -78 ml/yr in deceased smoking miners. These accelerated rates were similar before and after retirement from the mine.

[Small irregular pulmonary radiological anomalies seen in coal miners in the Lorraine region]. / Les petites anomalies radiologiques pulmonaires irrégulières observées chez les mineurs de charbon lorrains.

Amongst the pulmonary radiological abnormalities more or less suggestive of pneumoconiosis seen in 1 044 miners from Lorraine, there were 976 cases of typical pneumoconiosis: 154 "P.M.F." forms and 890 forms with small round opacities. In the other 68 cases, hence in a proportion of 1 in 15, the X-ray appearance consisted of small irregular opacities which have only been introduced by the I.L.O. into the international nomenclature on pneumoconiosis since 1968 (symbols: s, t, u, according to their size). These forms with small irregular abnormalities are associated with obstructive spirographic ventilatory disorders and a decrease in CO transfer (steady-state) on average greater than those seen in forms with classical round opacities. Age is greater and tobacco consumption higher, but long exposure to pneumoconiosis risk (26.9 years, on average) must also be taken into consideration in interpreting the singular prevalence of

[Functional respiratory disorders in miners of the Lorraine coal basin at the time of their retirement]. / Troubles fonctionnels respiratoires des mineurs des houillères du bassin de Lorraine à l'heure de la retraite.

A clinical, radiological (RX) and spirographic examination and a measurement of lung transfer for CO (TCO), following the steady state method, were performed in 655 coal-miners. They had worked for an average of 30 years in the Lorraine coal-mines and their mean age was 50 years. Among the non-pneumoconiotics, 20% of non-smokers and 35% of smokers displayed ventilatory obstructive disturbances. In miners with simple pneumoconiosis, this percentage rose to 29 and 52.5% respectively. Abnormally low values of TCO were observed in 6% of non-smokers and in 22% of smokers without pneumoconiosis, while this was 35 and 41% respectively in pneumoconiotic workers. Finally, by using spirography and TCO simultaneously, we found respiratory troubles in at least 63% of pneumoconiotic miners and in 43% of those without such disturbances.

[Silicosis with a rapid and pseudo-tumoral course occurring in a case of pre-existant progressive and treated pulmonary sarcoidosis in a miner little exposed to silicosis risk : sarcoido-silicosis (author's transl)]. / Silicose d'évolution rapide et pseudo-tumorale greffée sur une sarcoïdose pulmonaire évolutive et traitée chez un mineur peu exposé au risque silicotique : la sarcoïdo-silicose.

The authors report the case of a miner suffering from pulmonary and nodal sarcoidosis treated with corticosteroids where during a multivisceral exacerbation with iritis and erythema nodosum there developed rapidly progressive pseudo-tumoral silicosis. Pulmonary and nodal biopsies by thoracotomy revealed silicotic masses in the upper lobe, penetrated and bordered by sarcoid granulomas. In the middle lobe and hilar nodes, only sarcoid process was present. This new entity, sarcoido-silicosis, follows its own course, insensitive to corticosteroids. By virtue of its immune status, sarcoidosis favourised the rapid development of silicosis, the latter being unexpected since exposure had been moderate. Deficiency in the elimination of silica particles from the lungs is discussed. A trial of treatment using aluminium hydroxy-allantoinate did not lead to any conclusion.

[A method of estimating alveolo-arterial gradient and arterial pressure of CO2, without analysis of blood]. / Méthode non sanglante d'estimation du gradient alvéolo-artériel et de la pression artérielle de CO2

In 31 normal and 378 patients suffering from various bronchopulmonary diseases, a relation was established experimentally between TCO and the alveolo-arterial gradient of CO2. From TCO and CO2 output, this relation allows to obtain a reproducible estimation of the alveolo-arterial gradient and of the arterial pressure of CO2 by a non-bloody method with sufficient clinical accuracy. Moreover, this methods permits to interpret TCO steady state more easily and especially so under unusual ventilatory conditions.