Effects of occupational exposure to dust on chest radiograph, pulmonary function, blood pressure and electrocardiogram among coal miners in an eastern province, China.

BACKGROUND: Coal dust is one of the most serious risk factor that leads to respiratory diseases and cardiovascular diseases in miners. This study aimed to observe the effects of occupational dust exposure on chest radiograph, pulmonary function (PF), blood pressure (BP) and electrocardiogram (ECG) indexes in coal miners and explore the related risk factors. METHODS: In the Chinese Occupational Disease Monitoring and Occupational Health Risk Assessment Program, a total of 11,061 subjects in 2015 and 12,597 subjects in 2016 were recruited in this study. The chest radiograph, PF, BP and ECG of coal miners were surveyed using radiograph machine, spirometer, sphygmomanometer and electrocardiograph, respectively. RESULTS: The prevalence of aberrant BP was the highest in coal miners, followed by abnormal ECG, PF and radiograph. Significant differences in abnormal BP, ECG, PF and radiograph of coal miners were closely associated with age, years of dust exposure, smoking, drinking, working types and size of mines. A total of 80 persons diagnosed with coal workers' pneumoconiosis (CWP) in 2015-2016, which occupied 0.34% of the coal miners. CONCLUSION: Abnormal BP, ECG, PF and radiograph of coal miners are highlighted health problems in China and require serious attention. Feasible health promotion and protective facilities should be adopted to guarantee coal miners' health.

Characteristics and Trends of Pneumoconiosis in the Jiangsu Province, China, 2006⁻2017.

This study aims to describe the characteristics and trends of pneumoconiosis in the Jiangsu Province, China, and provide information for the occupational diseases control. We collected and analyzed the data of pneumoconiosis cases reported annually from 2006 to 2017. The information of the cases mainly includes case distributions, clinical types and stages, enterprise types and scales, as well as diagnosis age and exposure duration. A total of 9243 pneumoconiosis cases were reported between 2006 and 2017, among which silicosis and coal workers' pneumoconiosis accounted for the vast majority (87.5%). The incidence of pneumoconiosis was relatively higher in Wuxi, Yancheng, Suzhou and Xuzhou, compared to the other district. Most pneumoconiosis cases occurred in the state-owned (58.4%) and collective enterprises (23.8%). Most cases worked in industries related to geology and coal production. The median exposure duration and diagnosis age of the total pneumoconiosis cases was 13.2 and 61.0 years, respectively. Therefore, more measurements are needed to control pneumoconiosis in the Jiangsu Province.

Survival Analysis of Coal Workers' Pneumoconiosis (CWP) Patients in a State-Owned Mine in the East of China from 1963 to 2014.

To investigate the mortality probability, life expectancy of coal workers' pneumoconiosis (CWP), and related factors of life expectancy, a total of 495 patients with CWP were diagnosed and reported from 1963 to 2014 in a state-owned mine in the east of China. The life table method, log rank method, and Cox regression model were used for survival analysis. 95 out of 495 CWP died during this period. The mortality rate was 19.19%. The average life span was 12.1 (0.0-33.2) years and average death age was 57.4 (33.0-83.0) years. The life table indicated that overall mortality probability increased with the age of CWP patients. Life expectancy of CWP patients was prolonged to 4.3, 1.4, 1.2, and 1.4 years without death caused by pneumoconiosis, tuberculosis, lung cancer, and pulmonary heart disease respectively. The survival curve of CWP patients without pulmonary tuberculosis was higher (average 37.9 years) than patients with pulmonary tuberculosis (average 34.1 years). There was significant difference observed (χ² = 6.196, p < 0.05). Three risk factors that include initial dust exposure year, age of onset, and first diagnostic stage were put into the Cox regression model for evaluation. The data indicated that prevention and treatment of CWP complication is important to improve patients' survival rates.

Proteomic profiling change during the early development of silicosis disease.

BACKGROUND: Silicosis is one of several severe occupational diseases for which effective diagnostic tools during early development are currently unavailable. In this study we focused on proteomic profiling during the early stages of silicosis to investigate the pathophysiology and identify the proteins involved. METHODS: Two-dimensional (2D) gel electrophoresis and MALDI-TOF-MS were used to assess the proteomic differences between healthy individuals (HI), dust-exposed workers without silicosis (DEW) and silicosis patients (SP). Proteins abundances that differed by a factor of two-fold or greater were subjected to more detailed analysis, and enzyme linked to immunosorbent assay (ELISA) was employed to correlate with protein expression data. RESULTS: Compared with HI, 42 proteins were more abundant and 8 were less abundant in DEW, and these were also differentially accumulated in SP. Closer inspection revealed that serine protease granzyme A, alpha-1-B-glycoprotein (A1BG) and the T4 surface glycoprotein precursor (TSGP) were among the up-regulated proteins in DEW and SP. Significant changes in serine proteases, glycoproteins and proto-oncogenes may be associated with the response to cytotoxicity and infectious pathogens by activation of T cells, positive regulation of extracellular matrix structural constituents and immune response, and fibroblast proliferation. Up-regulation of cytokines included TNFs, interferon beta precursor, interleukin 6, atypical chemokine receptor 2, TNFR13BV, and mutant IL-17F may be involved in the increased and persistent immune response and fibrosis that occurred during silicosis development. CONCLUSIONS: Granzymes, glycoproteins, cytokines and immune factors were dramatically involved in the immune response, metabolism, signal regulation and fibrosis during the early development of silicosis. Proteomic profiling has expanded our understanding of the pathogenesis of silicosis, and identified a number of targets that may be potential biomarkers for early diagnosis of this debilitating disease.

Proteomic profiling differences in serum from silicosis and chronic bronchitis patients: a comparative analysis.

BACKGROUND: Silicosis is a severe occupational disease characterized by pulmonary fibrosis, whereas chronic bronchitis (CB) is an acute inflammation of the airways. Differences in the mechanisms of pathogenesis of these diseases are not well understood, therefore we performed proteomic profiling of silicosis and CB patients and, compared the results. METHODS: Two-dimensional gel electrophoresis and MALDI-TOF-MS (matrix assisted laser desorption ionization time of flight mass spectrometry) were used to identify differentially accumulated proteins in stage I of silicosis (SI), stage II of silicosis (SII) and CB. Enzyme linked immunosorbent assay (ELISA) was employed to validate protein expression data. RESULTS: A total of 28 and 10 proteins were up- and down-regulated in SI, and 21 and 9 proteins were up- and down-regulated SII, compared with CB. Transforming growth factor beta-1 precursor and interferon beta precursor were up-regulated in CB, while interleukin 6, tumor necrosis factor (TNF) and a variant TNF receptor 13B were down-regulated in CB. Additionally, glycoprotein- and apolipoprotein-associated proteins including apolipoprotein A-IV and α-1-B-glycoprotein were up-regulated in CB, indicating an involvement in the pathogenesis of CB but not silicosis. By contrast, HLA-DRB1, medullasin and the proto-oncogene c-Fos were up-regulated in CB. CONCLUSIONS: The immune, metabolism and apolipoprotein-related proteins were identified as playing specific and different roles in silicosis and CB. These proteomic profiling differences would facilitate further studies on the mechanisms underlying silicosis and CB, and may also prove useful to disease diagnosis and treatments.

[Comparative analysis of serum proteomic profiles between patients with silicosis and chronic bronchitis].

OBJECTIVE: To analyze the differences in serum proteomic profiles between patients with silicosis and chronic bronchitis and to investigate the pathogenesis, clinical diagnosis, and treatment of these two disease. METHODS: Serum samples from patients with stage I silicosis and chronic bronchitis were collected. Two-dimensional gel electrophoresis was performed and protein plots with expression differences higher than 2-fold were identified and further analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. RESULTS: Compared with the silicosis group, the chronic bronchitis group had 11 up-regulated proteins and 23 down-regulated proteins. The chronic bronchitis group had high expression of proteins such as interferon beta precursor, apolipoprotein precursor, and transforming growth factor beta1 precursor. The silicosis group had high expression of proteins such as interleukin-6, granzyme A, cathepsin G, and glycoprotein precursor. CONCLUSION: The differentially expressed proteins are mainly involved in the activity of serine enzymes, cytotoxicity, inflammation response, and apolipoprotein transfer and play different roles in silicosis and chronic bronchitis.

[Changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer].

OBJECTIVE: To investigate the changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer. METHODS: Serum samples of patients with silicosis, tuberculosis, and lung cancer were collected. The variation trends of the expression of granzyme A, cathepsin G, apolipoprotein A, and interferon-ß (IFN-ß) were analyzed using enzyme-linked immunosorbent assay. RESULTS: The concentration of apolipoprotein A of the silicosis group was 200 µg/ml, significantly higher than those of the tuberculosis and lung cancer groups (P < 0.05), and the lung cancer group had a significantly higher concentration of apolipoprotein A compared with the tuberculosis group (P < 0.05). The silicosis group had significantly higher expression of cathepsin G compared with the tuberculosis and lung cancer groups (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in the concentration of cathepsin G (P > 0.05). The tuberculosis group had a significantly higher concentration of granzyme A than the silicosis and lung cancer groups (P < 0.05), and the silicosis group and lung cancer group had similar protein concentration trends (P > 0.05). The tuberculosis group and lung cancer group had significantly higher concentration of IFN-ß compared with the silicosis group (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in IFN-ß concentration (P > 0.05). CONCLUSION: This study may offer diagnostic markers for the clinical diagnosis of silicosis, tuberculosis, and lung cancer, and could provide a basis for the research, as well as potential molecular targets for the diagnosis and treatment of these diseases.

Prevalence Characteristics of Coal Workers' Pneumoconiosis (CWP) in a State-Owned Mine in Eastern China.

Coal Workers' Pneumoconiosis (CWP) is the primary occupational disease in China. However, information about the definite prevalence of CWP is only partially available. The aims of our study were to assess the prevalence characteristics of CWP in a state-owned coal mine, evaluate the effects of control measures and develop further preventive strategies for CWP. The total study population included 495 cases who were diagnosed with CWP from the construction of this coal mine to the end of October 2014. Individuals' information, including duration of dust exposure, job titles, age as first diagnosis, stages of CWP, CWP progress, complications with pulmonary tuberculosis, death and others were collected and analyzed. The results showed that 71.11% of 495 CWP cases were stage I and 90.71% were involved in tunneling or coal mining. The mean dust exposure period in CWP patients was 26.7 years, the mean latent period was 29.3 years and the mean diagnosed age was 50.3 years old. The proportion of CWP diagnosed after ending dust exposure were remarkably increased with the time passing. Among the CWP cases, 36 (7.27%) were complicated with pulmonary tuberculosis. The mortality of patients with stage III was the highest (60.71%) (p < 0.0001). Our data obviously show that more strict policies to protect coal miners are needed to be implemented in China, especially for tunneling and mining workers.

[Analysis of reports of cases of pesticide poisoning in Jiangsu Province, China, from 2006 to 2013].

OBJECTIVE: To investigate the characteristics of pesticide poisoning in Jiangsu Province, China, and to provide a scientific basis for developing effective intervention measures and prevention strategies. METHODS: The data from report cards of pesticide poisoning in Jiangsu Province from 2006 to 2013 were arranged using EXCEL tables, and assessed. Statistical analysis was applied to the epidemiological data using SPSS. RESULTS: From 2006 to 2013, a total of 32672 cases of pesticide poisoning were reported in Jiangsu Province. Most of the cases were caused by non-occupational poisoning (life poisoning) (72.78%). A majority of patients with pesticide poisoning were 35-54 years old (40.85%) or older than 65 years (15.69%). There were more female patients (58.22%) than male patients (41.78%). Among patients with occupational poisoning, male patients (50.90%) were more than female patients. Among patients with non-occupational poisoning, female patients were more than male patients (38.37%). Pesticide poisoning mainly occurred from July to September. The case-fatality rate of occupational poisoning (0.47%) was lower than that of non-occupational poisoning (7.10%). All 13 cities in Jiangsu Province reported cases of pesticide poisoning. There were more cases in the northern regions than in the southern regions. Pesticide poisoning was mainly caused by organophosphorus insecticides including methamidophos, dichlorvos, dimethoate, omethoate, and parathion, which accounted for 65.58%of all cases. Paraquat had the highest case-fatality rate (10.06%) among all pesticides, followed by tetramine (10.00%), dimethoate or omethoate (7.85%), methamidophos (7.79%), and dimehypo (7.68%). CONCLUSION: Pesticide poisoning cannot be ignored. The management and control should be improved in production and usage of highly toxic pesticides including organophosphorus insecticides, rodenticides, and herbicides. More attention should be paid to the protection of vulnerable groups including women, children, and the elderly.

[Analysis of 2 patients with occupational hard mental lung disease].

OBJECTIVE: We sought to master the clinical characteristics and prognosis of hard mental lung disease, improving this disease's diagnosis and treatment quality. METHODS: We recruited two suspected patients with hard mental lung disease and collected their occupational history, examination results of occupational health, and past medical records. By virtue of laboratory tests, high Kv chest radiography, CT and HRCT of chest, fiberoptic bronchoscopy and ECG examination, diagnostic report was synthesized respectively by respiratory physicians and pathologist from three different agencies. Then the report was submitted to diagnosis organizations of occupational disease, and diagnostic conclusion of occupational disease was drawn after discussion by at least three diagnosticians of occupational disease. RESULTS: We found that both of the two suspected patients were exposed to dusts of hard metal, and length of exposure service ranged from 8 to 9 years. Clinical manifestations were dominated by dry cough, wheezing after activities, and pathological manifestation was characteristic giant cell interstitial pneumonia. The prognosis and outcome of the disease were different. CONCLUSION: According to exact occupational exposure history, clinical manifestations, combined with the results of high Kv chest radiography, CT of chest and pathological manifestation, it can be diagnosed with hard mental lung disease.

[Occupational noise-induced deafuess diaqnosis analysis in Jiangsu from 2006 to 2009].

OBJECTIVE: In order to provide the evidence for taking the measures to prevent noise hazards, the condition sand influence factors of occupational noise deafness diagnosis in Jiangsu province from 2006 to 2013 were analyzed. METHODS: According to the 13 administrating personnel report of noise deafness diagnosed occupational disease prevention and control institutions in Jiangsu province from 2006 to 2013, the diagnosis of occupational noise deafness were retrospectively analyzed. RESULTS: By the end of December 31 2013, 297 cases of noise deafness were diagnosis occupational disease within this province. Occupational noise deafness has localized on the machinery industry, textile and light industry. Regional distribution mainly concentrated in Suzhou, Yangzhou, Nanjing, Nantong. 83.16% in 297 cases were mild noise deafness. CONCLUSION: The distribution of occupational noise deafness cases in Jiangsu province has specific charateristics. It is not balanced in different regions, and most of them are the mild noise deafness, male, length of service in more than 15 years, the onset age is 40~60 years old, According to characteristics of the occupational noise deafness cases in Jiangsu province, Specific occupational health service will help to reduce the occurrence of occupational noise deafness, and protect the worker's health effectively.

[Characteristics analysis on acute occupational poisoning accident from 2006 to 2013 in Jiangsu Province].

OBJECTIVE: To analyze the characteristics of acute occupational poisoning accidents reported in Jiangsu Province between 2006 to 2013. METHODS: Based on the reported data of occupational diseases, we analysis indicators such as type, gender, age, and enterprise size of acute occupational poisoning. RESULTS: (1) There were 226 acute occupational poisoning accidents for 8 years with 436 workers poisoned and 13 died. The Poisoning mortality rate was 2.98%. (2) The accidents occurred more frequently from March to August each year. (3) Asphyxiating gases, irritant gases and organic solvents are the main chemicals which caused these poisoning accidents. (4) Most of the cases come from the chemical industry and light industry . They more occurred in men and presented the trend of aging. (5) Most of them are from the south of Jiangsu and coastal areas. New cases of acute occupational poisoning mainly concentrated in small businesses. CONCLUSION: Strengthening the supervision on high incidence area and high-risk industry is the key point to reduce the incidence of acute occupational poisoning accident.

[Changes in activities of SOD and GSH-Px in induced sputum and their significance among silicosis patients].

OBJECTIVE: To observe the changes in activities of superoxide dismutase (SOD) and glutathione peroxide (GSH-Px) in the induced sputum of silicosis patients, and to investigate the roles of SOD and GSH-Px in the development and progression of silicosis and the significance of measuring activities of SOD and GSH-Px in induced sputum among silicosis patients. METHODS: Fifty hotel attendants were chosen as control group, 50 workers with more than one year of silica dust exposure as dust exposure group, 32 silica dust-exposed workers as observation subject group, and 52 silicosis patients as silicosis group. The activities of SOD and GSH-Px in their induced sputum were measured by enzyme-linked immunosorbent assay. RESULTS: Compared with the control group, the observation subject group and silicosis group had significantly decreased SOD activity (68.16 ± 30.17 and 66.38 ± 47.32 U/ml vs 75.81 ± 11.92 U/ml, P < 0.05); compared with the dust exposure group, the silicosis group had significantly decreased SOD activity (66.38 ± 47.32 U/ml vs 70.12 ± 14.31 U/ml, P < 0.05). Compared with the control group and dust exposure group, the observation subject group and silicosis group had significantly increased GSH-Px activity (268.21 ± 15.45 and 279.34 ± 29.26 U/ml vs 224.22 ± 12.64 and 236.41 ± 14.54 U/ml, P < 0.05 or P < 0.01). CONCLUSION: The SOD activity in dust exposure group and silicosis group decreased, but there were no significant differences between patients with different stages of silicosis. The GSH-Px activity in dust exposure group and silicosis group was significantly higher than that in control group, and there were significant differences between patients with different stages of silicosis. These suggest that the imbalance of oxidative/antioxidant systems is associated with the development and progression of silicosis.