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Objectives: Depressive symptoms, anxiety, and post-traumatic stress disorder (PTSD) are common morbidities among coal miners, but the risk of these morbidities has not been analyzed relative to other occupations taking into account relevant covariates. Methods: Using random digit dialing, we surveyed men aged 50 or over with a history of employment who resided in counties in Appalachia with high coal workers' pneumoconiosis (CWP) mortality rates. We used the Primary Care Post-Traumatic Stress (PTSD) Screen and the Brief Trauma Questionnaire to query specific traumatic experiences. We used the Patient Health Questionnaire scale to assess depression symptoms and the Generalized Anxiety Disorder questionnaire to measure anxiety. Multivariable logistic regression analyzed associations between coal mining and depression, anxiety, and PTSD, adjusting for trauma, smoking and demographics. Results: Of 1,428 participants, 233 (16.3%) reported coal mining employment. Coal mining was associated with increased odds of depression (OR 1.6; 95% CI 1.1 to 2.4) and anxiety (OR 1.7; 95% CI 1.1 to 2.7). Among those with any trauma (n = 711), coal mining was not associated with increased risk of PTSD (OR 0.80; 95% CI 0.5 to 1.3]. Non-coal trauma was associated with three-fold increased odds of anxiety (OR 3.2; 95% CI 2.0 to 5.1); for coal trauma, anxiety was associated with six-fold increased odds (OR 6.0; 95% CI 2.9 to 12.4). Conclusions: Appalachian region coal miners carry an increased burden of depression and anxiety. This should be recognized by clinicians and at a population level, as worthy of individual and public health intervention. [ABSTRACT FROM AUTHOR]

KRAS mutations are the most common oncogenic mutations in lung adenocarcinoma in Black Americans. Polyisoprenylated Cysteinyl amide Inhibitors (PCAIs) constitute a group of potential cancer therapy agents that we designed to specifically disrupt and suppress hyperactive G-protein signaling, such as that caused by mutated RAS proteins. Here we determine the effects of PCAIs on the viability, G-protein levels, downstream mediators, and apoptosis-related proteins on the KRAS-mutated, Black American-derived lung adenocarcinoma cell line, NCI-H23. Of the 17 PCAIs tested, compounds NSL-YHJ-2-27 and NSL-YHJ-2-46 showed the most potency with EC50 values of 2.7 and 3.3 μM, respectively. Western blotting was used to determine the effect of the PCAIs on the phosphorylation levels of MAPK pathway enzymes. After 48 h exposure to 5 μM of the PCAIs, NSL-YHJ-2-46, the MAPK proteins BRAF, MEK1/2, ERK1/2, and p90RSK were activated through phosphorylation by 90, 190, 150 and 120%, respectively. However, CRAF/RAF1 phosphorylation decreased by 40%, suggesting significant changes in the KRAS/MAPK signaling patterns. Furthermore, 5 μM of NSL-YHJ-2-27 depleted the singly polyisoprenylated monomeric G-proteins RAC 1/2/3 and CDC42 by 77 and 76%, respectively. The depletion of these key cytoskeletal proteins may account for the observed inhibition of cell migration and invasion, and spheroid invasion observed on exposure to NSL-YHJ-2-27 and NSL-YHJ-2-46. Treatment with 5 μM of NSL-YHJ-2-27 suppressed full-length inactive caspase 3 and 7 levels by 72 and 91%, respectively. An analysis of cells treated with the fluorescently labeled active caspase 3/7 irreversible inhibitor, CaspaTagTM Caspase-3/7 in situ reagent revealed a 124% increase in active caspase at 3 μM over controls. These findings clearly show the direct effects of the PCAIs on the RAS signaling pathway. Given the profound increases observed in RPS6KA1/p90RSK phosphorylation, future work will involve a determination whether the proapoptotic isoforms of RPS6KA1/p90RSK are phosphorylated due to the PCAIs treatments. These results support the potential use of the PCAIs as targeted therapies against cancers with KRAS mutations. [ABSTRACT FROM AUTHOR]

Background: India, with the highest global burden of tuberculosis (TB) and drug-resistant TB, aims to eliminate TB by 2025. Yet, limited evidence exists on drug resistance patterns and retreatment among patients with silico-tuberculosis. This study explores these patterns and assesses the impact of silicosis on TB retreatment in India. Methods: This secondary data analysis stems from a larger retrospective cohort study conducted in Khambhat, Gujarat, between January 2006 and February 2022. It included 138 patients with silico-tuberculosis and 2,610 TB patients without silicosis. Data from the Nikshay TB information portal were linked with silicosis diagnosis reports from the Pneumoconiosis Board using the unique Nikshay ID as the linking variable. Drug-resistant TB was defined as resistance to any anti-TB drug recorded in Nikshay. Retreatment refers to TB patients who have previously undergone anti-TB treatment for one month or more and need further treatment. Recurrent TB denotes patients who were previously declared cured or had completed treatment but later tested positive for microbiologically confirmed TB. Multivariable logistic regression was used to determine the impact of co-prevalent silicosis on drug resistance and retreatment. Results: Patients with silico-tuberculosis showed a higher proportion of retreatment compared to those without silicosis (55% vs. 23%, p < 0.001). Notably, 28% of patients with silico-tuberculosis were recurrent TB cases, compared to 11% among those without silicosis. Regarding drug resistance, the silico-tuberculosis group exhibited a higher rate (6% vs. 3%), largely due to rifampicin resistance (5% vs. 2%, p = 0.022). Co-prevalent silicosis was associated with a 2.5 times greater risk of drug-resistant TB (adjusted OR 2.5, 95% CI, 1.1–5.3; p = 0.021). Additionally, patients with silico-tuberculosis had a fourfold increased risk of retreatment for TB (adjusted OR 4, 95% CI, 3–6; p < 0.001). Conclusions: Co-prevalent silicosis significantly elevates the risk of drug resistance, recurrence, and retreatment among TB patients in India. This study indicates a need for improved treatment protocols and suggests that future research should focus on randomized controlled trials to evaluate appropriate anti-TB regimen and duration of therapy for this high-risk group. Given India's goal to eliminate TB by 2025, addressing the challenges posed by silico-tuberculosis is critical. [ABSTRACT FROM AUTHOR]

Introduction Respirable crystalline silica (RCS) exposures in tanzanite gem mining have been linked to tuberculosis and silicosis among miners. We conducted a plot study to assess RCS exposures and to introduce safer mining practices in one small-scale underground tanzanite mine. Materials and methods Personal and area air samples for RCS were collected during tanzanite mining operations before and after improved work practices employed to reduce exposures and analyzed using X-ray diffraction. Area samples were collected at the rest area, located approximately 300 m underground and 100 m from other work activities. Improved practices included the use of wet drilling methods and drilling with new bits. Results A total of 33 personal and 4 area air samples were collected. Pre-intervention, mean exposures for all operations, drilling operations, non-drilling activities, and area samples were 122 mg/m3, 247 mg/m3, 34.3 mg/m3, and 1.95 mg/m3, respectively which exceeded the U.S. OSHA Permissible Exposure Limit (PEL) by 2,440 times for all operations, by 4,946 times for drilling operations, by 686 times for non-drilling activities and 39 times for area samples collected at an underground rest area. The post-intervention results showed a 99% reduction of RCS exposures for wet drilling operations, 98.5% reduction for non-drilling activities, and 36% reduction for area samples. Despite improvements, post-intervention RCS exposures during drilling had a mean of 2.08 mg/m3 or more than 41 times the OSHA PEL. Conclusions We successfully piloted a program to work with small-scale tanzanite miners to reduce RCS exposures and raise awareness about the occupational health risks of RCS, though additional measures are recommended to further reduce RCS exposures. Similar programs should be taken to scale throughout underground mining sites in Tanzania and other countries. [ABSTRACT FROM AUTHOR]

Background: Currently, Sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrate additional effects beyond glucose control on the gut microbiota and circulating metabolites. The gut microbiota and metabolites have been found to be useful in elucidating potential biological mechanisms of pulmonary diseases. Therefore, our study aims to investigate the effects of gut microbiota and metabolites mediating SGLT2 inhibition in 10 pulmonary diseases through Mendelian randomization (MR) research. Methods: We conducted a two-sample, two-step MR study to assess the association between SGLT2 inhibition and 10 pulmonary diseases and to investigate the mediating effects of gut microbiota and metabolite. Gene-fine mapping and annotation of mediators by FUMA and Magma analyses were performed, and causal associations of mapped genes with diseases were assessed by muti-omics MR analyses. Possible side effects of SGLT2 inhibition were assessed by PheWAS analysis. Results: SGLT2 inhibition was linked to a reduced risk of T2DM, Interstitial lung disease (ILD), Pneumoconiosis, Pulmonary tuberculosis, and Asthma(OR=0.457, 0.054, 0.002, 0.280, 0.706). The family Enterobacteriaceae and order Enterobacteriales were associated with SGLT2 inhibition and ILD(95% CI:0.079-0.138). The family Alcaligenaceae and X-12719 were linked to pneumoconiosis (95% CI: 0.042-0.120, 0.050-0.099). The genus Phascolarctobacterium was connected to pulmonary tuberculosis (95% CI: 0.236-0.703). The degree of unsaturation (Fatty Acids), ratio of docosahexaenoic acid to total fatty acids, and 4-androsten-3beta,17beta-diol disulfate 2, were associated with asthma(95% CI: 0.042-0.119, 0.039-0.101, 0.181-0.473). Furthermore, Fuma and Magma analyses identified target genes for the four diseases, and proteomic MR analysis revealed six overlapping target genes in asthma. PheWAS analysis also highlighted potential side effects of SGLT2 inhibition. Conclusions: This comprehensive study strongly supports a multi-omics association between SGLT2 inhibition and reduced risk of interstitial lung disease, tuberculosis, pneumoconiosis, and asthma. Four identified gut microbiota, four metabolites, sixteen metabolic pathways, and six target genes appear to play a potential role in this association. The results of the comprehensive phenome-wide association analysis also identified the full effect of SGLT2 inhibitors. [ABSTRACT FROM AUTHOR]

The article "The Matter of Material History (and Others)" by Andrea Marston in the Journal of Latin American Geography explores the complexities of Bolivian cooperativa mining, challenging common stereotypes and delving into the intertwined relationships between miners' identities, national sovereignty, and subsoil politics. Marston's material history approach sheds light on the contested dynamics of mining emergence, offering a nuanced perspective on the formation of cooperativas and the tensions between ethnic and mestizo identities. The article also raises important questions about environmental justice, material circulation, and the need for dialogue between mining collectives and communities impacted by the mining sector. [Extracted from the article]

Megacities can be considered excellent laboratories for studying the effects of the urban environment on human health. Typically, exposure to pollution is estimated according to daily or annual averages of pollutant concentrations, collected at monitoring stations, using satellite data for remote sensing of pollutant levels, considering proximity to major roads, or through personal exposure monitoring with portable sensors. However, these approaches fall short in identifying individual exposure values over a lifetime. It is well established that individuals living in large urban areas inhale atmospheric particles containing carbonaceous components, resulting in the deposition of black pigments in lung tissue, known as black carbon or anthracosis. This study aims to detail the procedures for assessing the deposition of such pigments, which serve as an estimate of an individual's exposure to atmospheric pollution particles. Data collection involves administering detailed questionnaires and capturing lung images in the autopsy room. The analysis is based on macroscopic quantification of black pigments, supplemented by an evaluation of personal habits and the clinical histories of the individuals. This method of estimating lifetime exposure to inhaled particles provides a valuable tool for understanding the correlation between urban living and its potential health effects. [ABSTRACT FROM AUTHOR]

Objective: To examine the potential relationship between the presence of asbestos-related diseases (ARDs) in the region of Kastamonu, Turkey. Methods: The places of birth of patients with ARDs and control subjects diagnosed between 2008 and 2019 and identified in a tertiary hospital in Istanbul. Soil samples were taken from plaster surfaces and quarries. The analysis was done with transmission electron microscopy. Results: ARDs was detected in 55(17.9%) of 307 participants. Patients had a mean age of 68 ± 11 years. Residential proximity to ophiolites increased ARDincidence by 6.2%per kilometer (P = 0.003). Birthplaces were identified as being inside an ophiolitic unit, or if they were not, the Google Earth software was used to determine the beeline distance between the settlement's center and the edge of the closest ophiolitic unit. The appropriate threshold for this case is 12.75 km, with 75% sensitivity and 87% specificity. Conclusion: ARDs due to naturally occurring asbestos (NOA) are present in hitherto unknown places. Geological maps including ophiolites can help locate these places. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Silicosis typically has been classified as a chronic disease that develops after at least 10 years of exposure to silica dust, and often is associated with miners and stone workers. As industries have changed over time, other types of workers (including those in artificial stonework, jewelry polishing, and denim production) have become exposed to high levels of silica, leading to the development of acute and accelerated silicosis. Acute silicosis can develop in as little as a few months, and accelerated silicosis can develop in as little as 2 years. No cure exists for any form of silicosis, and lung transplantation is the only lifesaving treatment. Primary care clinicians must understand when patients are at risk for developing silicosis and not assume that a short time of exposure precludes the development of silicosis. [ABSTRACT FROM AUTHOR]

Background: Pneumoconiosis has a significant impact on the quality of patient survival. This study aims to evaluate the performance and application value of improved Unet network technology in the recognition and segmentation of lesion areas of lung CT images in patients with pneumoconiosis. Methods: A total of 1212 lung CT images of patients with pneumoconiosis were retrospectively included. The improved Unet network was used to identify and segment the CT image regions of the patients' lungs, and the image data of the granular regions of the lungs were processed by the watershed and region growing algorithms. After random sorting, 848 data were selected into the training set and 364 data into the validation set. The experimental dataset underwent data augmentation and were used for model training and validation to evaluate segmentation performance. The segmentation results were compared with FCN-8s, Unet network (Base), Unet (Squeeze-and-Excitation, SE + Rectified Linear Unit, ReLU), and Unet + + networks. Results: In the segmentation of lung CT granular region with the improved Unet network, the four evaluation indexes of Dice similarity coefficient, positive prediction value (PPV), sensitivity coefficient (SC) and mean intersection over union (MIoU) reached 0.848, 0.884, 0.895 and 0.885, respectively, increasing by 7.6%, 13.3%, 3.9% and 6.4%, respectively, compared with those of Unet network (Base), and increasing by 187.5%, 249.4%, 131.9% and 51.0%, respectively, compared with those of FCN-8s, and increasing by 14.0%, 31.2%, 4.7% and 9.7%, respectively, compared with those of Unet network (SE + ReLU), while the segmentation performance was also not inferior to that of the Unet + + network. Conclusions: The improved Unet network proposed shows good performance in the recognition and segmentation of abnormal regions in lung CT images in patients with pneumoconiosis, showing potential application value for assisting clinical decision-making. [ABSTRACT FROM AUTHOR]

Purpose: Studies have recently shown a correlation between the elemental components of coal dusts, including potassium aluminosilicates, and the lung response as a potential driver for lung diseases associated with inhalation of coal dust. Here we aimed to systematically review the evidence for the association between exposure to potassium bearing dusts and lung outcomes in human studies as well as adverse cellular response in animal/cell culture studies. Methods: A systematic search of the National Library of Medicine (PubMed), Embase and Web of Science was conducted in May 2024. Studies regarding exposure to potassium bearing dusts and aluminosilicates and respiratory consequence were included in the search. Articles were screened, with a secondary assessment for relevance and extraction of key information using a systematic review process. Results: We identified 64 studies, of which 35 were human studies, 22 involved animal experiments and 12 were in vitro studies with 5 papers having both in vivo and in vitro studies. Our review found some evidence that a range of potassium rich dusts increased incidence of respiratory symptoms and lung diseases, although the effect on radiological changes in the lung and pulmonary function loss was not consistent. The in vivo animal and in vitro studies consistently demonstrated an inflammatory response and cytotoxic effect after exposure to these dusts. Conclusion: Given complexity in the dust compositions and lack of direct evidence attributing these specific responses to potassium, we are not able to conclude the effect of potassium minerals in coal on development of respiratory diseases, warranting further research. [ABSTRACT FROM AUTHOR]

Objective To analyze the pneumoconiosis mortality change trend, influencing factors and differences between Chinese residents from 2002 to 2021. Methods Using the Join-point model of crude pneumoconiosis mortality rate and standardized mortality rate, the annual percentage change (APC) and mean annual percentage change (AAPC) were calculated. The effect of three effects on pneumoconiosis mortality changes was analyzed by the age-period-cohort model. Results The urban standardized mortality rate showed an overall downward trend (APC=-0.2%, P>0.05) and increased in rural areas from 2004 to 2021 (APC=7.9%, P<0.001). The age effect showed that both urban and rural pneumoconiosis mortality rate increased with increasing age. The period effect increased with time, and it was different between urban and rural areas, with the risk of urban death decreasing, and the risk of rural death increasing. The cohort effect showed that the risk of death decreased with later birth, and the rural resident birth cohort showed a fluctuating trend. Conclusion The increasing effect of age, period and cohort will affect rural pneumoconiosis mortality more than in urban areas. [ABSTRACT FROM AUTHOR]

Pneumoconiosis is a common occupational disease that can worsen with accompanying infection. Torque teno virus (TTV) is a prevalent human virus with multiple genotypes that can chronically and persistently infect individuals. However, the prevalence of TTV in pneumoconiosis patients is still unclear. This research aims to detect the presence and prevalence of TTV in the alveolar lavage fluid of pneumoconiosis patients in the Hunan Province of China using PCR. As a result, a 65.5% positive rate (19 out of 29) of TTV was detected. The TTV detection rate varies among different stages of silicosis and different pneumoconiosis patient ages. Nine novel TTV genomes ranging in size from 3719 to 3908 nt, named TTV HNPP1, HNPP2, HNPP3, HNPP4, HNPP5, HNPP6-1, HNPP6-2, HNPP7-1 and HNPP7-2, were identified. A genomic comparison and phylogenetic analysis indicated that these nine TTVs represent five different species with high genetic diversity which belong to the genus Alphatorquevirus. HNPP6-1 and HNPP6-2 belong to TTV3, HNPP5 belongs to TTV13, HNPP1 belongs to TTV24, HNPP4 belongs to TTV20, and the others belong to TTV19. The genomes of TTV HNPP1, HNPP6-1, and HNPP6-2 contain three putative open reading frames (ORFs) coding for proteins, ORF1, ORF2, and ORF3, while the other six TTV genomes contain two ORFs coding for proteins, ORF1 and ORF2. These results provide the first description of TTV epidemiology in pneumoconiosis patients in China. The newly identified TTV genome sequences reveal the high genetic diversity of TTV in pneumoconiosis patients and could contribute to a deeper understanding of TTV retention and infection in humans. [ABSTRACT FROM AUTHOR]

This report presents a unique case of Caplan syndrome that mimicked accelerated progressive massive fibrosis. The patient, a former coal miner, had been diagnosed with coal worker's pneumoconiosis 15 years prior and had been treated for rheumatoid arthritis for over 20 years. Accelerated progressive massive fibrosis and the development of multiple nodules with cavitation in the basal lungs were subsequently observed on serial CT scans. Here, the CT manifestations of Caplan syndrome are highlighted in a case in which Caplan syndrome mimicked accelerated progressive massive fibrosis. [ABSTRACT FROM AUTHOR]

Exposure to respirable coal mine dust (RCMD) still poses health risks to miners. Scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDX) is a powerful tool for RCMD characterization because it provides particle-level data, including elemental ratios (via the EDX signals) that can enable classification by inferred mineralogy. However, if the particle loading density (PLD) is high on the analyzed substrate (filter sample), interference between neighboring particles could cause misclassification. To investigate this possibility, a two-part study was conducted. First, the effect of PLD on RCMD classification was isolated by comparing dust particles recovered from the same parent filters under both low- and high-PLD conditions, and a set of modified classification criteria were established to correct for high PLD. Second, the modified criteria were applied to RCMD particles on pairs of filters, with each pair having one filter that was analyzed directly (frequently high PLD) and another filter from which particles were recovered and redeposited prior to analysis (frequently lower PLD). It was expected that application of the modified criteria would improve the agreement between mineralogy distributions for paired filters; however, relatively little change was observed for most pairs. These results suggest that factors other than PLD, including particle agglomeration, can have a substantial effect on the particle EDX data collected during direct-on-filter analysis. [ABSTRACT FROM AUTHOR]

Context.--The pathology of coal workers' pneumoconiosis (CWP) and its most severe form--progressive massive fibrosis (PMF)--in US coal miners has changed in recent years. Severe disease is occurring in younger miners and has been linked to an increase in silica dust exposure. Objective.--To update the description of the pathologic features of CWP in contemporary miners compared to historical miners. Design.--This study is a retrospective expert classification of lung tissue from 85 historical and contemporary coal miners with PMF. Significant pathologic features were scored by using a standardized instrument with consensus achieved for major findings, including newly defined categories of PMF as coal-type, mixed-type, and silica-type. Results.--Pathologic features associated with silica dust exposure, including silica-type PMF, mineral dust alveolar proteinosis (MDAP), and immature (early stage) silicotic nodules, were increased in contemporary miners. Detailed descriptions of the pathology of contemporary CWP with illustrative figures are provided. Conclusions.--Silica-related pathologies are more common in contemporary miners. Severe forms of CWP can be detected by subtyping PMF lesions (if present) or by identification of mature and immature silicotic nodules, coal mine dust--related alveolar proteinosis, and severe inflammation in coal miners' lungs. Silica-type PMF cases showed significantly higher levels of MDAP than either mixed- or coaltype PMF (P < .001). High profusion of birefringent silica/silicate particles was observed more frequently in cases with immature (early stage) silicotic nodules (P = .04). Severe inflammation was also significantly increased in contemporary miners (P = .03). Our findings underscore the urgent need to revise current exposure limits and monitoring of respirable crystalline silica in US coal mines. [ABSTRACT FROM AUTHOR]

Background: Pneumoconiosis has a significant impact on the quality of patient survival due to its difficult staging diagnosis and poor prognosis. This study aimed to develop a computer-aided diagnostic system for the screening and staging of pneumoconiosis based on a multi-stage joint deep learning approach using X-ray chest radiographs of pneumoconiosis patients. Methods: In this study, a total of 498 medical chest radiographs were obtained from the Department of Radiology of West China Fourth Hospital. The dataset was randomly divided into a training set and a test set at a ratio of 4:1. Following histogram equalization for image enhancement, the images were segmented using the U-Net model, and staging was predicted using a convolutional neural network classification model. We first used Efficient-Net for multi-classification staging diagnosis, but the results showed that stage I/II of pneumoconiosis was difficult to diagnose. Therefore, based on clinical practice we continued to improve the model by using the Res-Net 34 Multi-stage joint method. Results: Of the 498 cases collected, the classification model using the Efficient-Net achieved an accuracy of 83% with a Quadratic Weighted Kappa (QWK) score of 0.889. The classification model using the multi-stage joint approach of Res-Net 34 achieved an accuracy of 89% with an area under the curve (AUC) of 0.98 and a high QWK score of 0.94. Conclusions: In this study, the diagnostic accuracy of pneumoconiosis staging was significantly improved by an innovative combined multi-stage approach, which provided a reference for clinical application and pneumoconiosis screening. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the impact of tetrandrine tablets on cytokines, immune function, blood gas and respiratory function in patients with stage II pneumoconiosis. Methods: 136 subjects with stage II pneumoconiosis diagnosed and treated in People's Hospital of Linyi City, Linyi City, China were divided into control and study cohorts, each with 68 individuals. Patients in control cohort received conventional symptomatic treatment, while study cohort additionally received tetrandrine tablets orally 3 times per day, for 4 weeks. Lung function, serum indicators and blood gas indicators were determined before and after treatment. Results: After treatment, the levels of forced expiratory volume in one second (FEV1) and FEV1/FVC in both groups were significantly increased in both cohorts, with significantly higher values in study cohort. In both cohorts, there were higher post-treatment numbers of CD4+ and CD8+ cells and CD4+/CD8+ ratio than before treatment, but with significantly higher values in study cohort (p < 0.05). After treatment, there were significantly raised levels of peripheral capillary oxygen saturation (SpO2), minute ventilation (VE) and tidal volume (VT) in the two cohorts, with higher values in the study group cohort (p < 0.05). Moreover, treatment resulted in a significant reduction in partial pressure of end-tidal carbon dioxide (PETCO2), with significantly lower levels in study cohort (p < 0.05). After treatment, concentrations of interleukin-1 beta (IL-1β), matrix metalloproteinase-7 (MMP-7), and tumor necrosis factor beta-1 (TNF-β1) in study cohort were significantly reduced, relative to pre-treatment. Conclusion: Tetrandrine tablets are efficacious in stage II pneumoconiosis patients. The drug is beneficial in improving immune function, reducing levels of inflammatory mediators, and improving lung function and blood gas indicators in patients. Future studies incorporating additional parameters and a larger number of patients will be required to provide a more comprehensive understanding of the efficacy and safety of this treatment protocol. [ABSTRACT FROM AUTHOR]

Objectives In Italy, the highest pleural cancer mortality and incidence have been observed among Italian regions where the 2 largest Italian shipyards were (and are) located. The objective of this study was to assess the exposure–response relationship for mesothelioma among male workers employed in the Monfalcone, Italy, shipyard. Methods We conducted a necropsy-based case–control study. Cases (N = 102) were mesothelioma decedents and controls were those with lung cancer (N = 84). Complete job histories were available; the lung fibre content was measured using a scanning electron microscope with X-ray fluorescence, after sample preparation according to the European Respiratory Society guidelines. Odds ratios and 95% confidence intervals of mesothelioma by fibre type and lung fibre burden, as a categorical or continuous variable, were assessed by unconditional logistic regression, adjusted for age and time since exposure cessation. Analyses for the amphibole and chrysotile lung fibre burden were mutually adjusted. We calculated a cumulative exposure index by applying a job-exposure matrix to the job histories of study cases and assessed its correlation with the lung fibre burden. Results We found an odds ratio of 22.0 (confidence intervals 5.66–85.7) for the highest lung fibre burden category (mean 43.8 million total asbestos fibres per gram of dry tissue) compared with the reference (mean 0.48). Using log10-transformed lung fibre burden, we found that the odds ratio was 3.71 (confidence intervals 2.03–6.79) for a 10-fold lung fibre burden increase. Results for the amphibole lung fibre burden were similar. Odds ratios increased over chrysotile lung fibre burden categories (P -trend = 0.025), and the odds ratio for a 10-fold increase was 4.73 (confidence intervals 0.32–70.4). Conclusions The cumulative exposure index was correlated with total and amphibole lung fibre burden, but not with chrysotile lung fibre burden. Mesothelioma risk was proportional to total, amphibole, and chrysotile lung fibre burden in shipyard workers. [ABSTRACT FROM AUTHOR]

Accurate and early detection of pneumoconiosis using chest X-rays (CXR) is important for preventing the progression of this incurable disease. It is also a challenging task due to large variations in appearance, size and location of lesions in the lung regions as well as inter-class similarity and intra-class variance. Compared to traditional methods, Convolutional Neural Networks-based methods have shown improved results; however, these methods are still not applicable in clinical practice due to limited performance. In some cases, limited computing resources make it impractical to develop a model using whole CXR images. To address this problem, the lung fields are divided into six zones, each zone is classified separately and the zone classification results are then aggregated into an image classification score, based on state-of-the-art. In this study, we propose a dual lesion attention network (DLA-Net) for the classification of pneumoconiosis that can extract features from affected regions in a lung. This network consists of two main components: feature extraction and feature refinement. Feature extraction uses the pre-trained Xception model as the backbone to extract semantic information. To emphasise the lesion regions and improve the feature representation capability, the feature refinement component uses a DLA module that consists of two sub modules: channel attention (CA) and spatial attention (SA). The CA module focuses on the most important channels in the feature maps extracted by the backbone model, and the SA module highlights the spatial details of the affected regions. Thus, both attention modules combine to extract discriminative and rich contextual features to improve classification performance on pneumoconiosis. Experimental results show that the proposed DLA-Net outperforms state-of-the-art methods for pneumoconiosis classification. [ABSTRACT FROM AUTHOR]

Objective To provide reference for controlling or delaying the decline of pulmonary ventilation function in male pneumoconiosis patients by studying associations of serum albumin levels with the risk of severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients. Methods A retrospective cohort design was adopted in this study. Male pneumoconiosis patients who were hospitalized in West China Fourth Hospital from January 2012 to December 2021 and did not have pulmonary ventilation dysfunction at baseline were selected as the study objects. Cox proportional hazard regression models were used to calculate HRs and 95% CIs to evaluate the association of baseline serum albumin levels and the risk of severe or very severe pulmonary ventilation dysfunction. Restricted cubic spline plot was used to explore whether there was a dose-response relationship between baseline serum albumin concentrations and the risk of severe or very severe pulmonary ventilation dysfunction. Results A total of 746 subjects were included in this study. Fully adjusted model results of Cox proportional hazard regression analysis showed that male pneumoconiosis patients with serum albumin higher than 40.8 g/L had a reduced risk of severe or very severe pulmonary ventilation dysfunction compared with male pneumoconiosis patients with serum albumin lower than 34.4g/L (HR = 0.660, 95% CI: 0.439-0.992). The restricted cubic spline figure showed that the risk of severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients gradually decreased with the gradual increase of serum albumin concentrations and there was a linear negative relationship between baseline serum albumin concentrations and the incidence risk of severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients (P < 0.05). Conclusion Higher serum albumin is a protective factor for severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients and maintaining the serum albumin concentrations above 40.8 g/L can reduce the risk of severe or very severe pulmonary ventilation dysfunction. [ABSTRACT FROM AUTHOR]

Pneumoconiosis is an important occupational disease; the association between pneumoconiosis and depression was largely unknown. This study aimed to investigate the relationship between pneumoconiosis and the risk of subsequent depression. A retrospective cohort study was conducted using Taiwan's National Health Insurance database. The study included 16,795 patients diagnosed with pneumoconiosis between 2008 and 2018 and a comparison cohort of 67,180 individuals without pneumoconiosis, propensity score matched in a 1:4 ratio based on age, sex, monthly income, residential urbanization level, and date of pneumoconiosis diagnosis. The development of depression was monitored until the end of 2019. The incidence of depression was 1.68 times higher in the pneumoconiosis cohort than that in the comparison cohort, with an incidence rate of 10.07 versus 5.99 per 1000 person-years (adjusted hazard ratio [aHR] = 1.84, 95 % confidence interval [CI] = 1.70–1.99). The risk of depression increased with an increased mean annual number of emergency department visits for pneumoconiosis, with aHRs of 1.34 (95 % CI = 1.13–1.59) and 2.31 (95 % CI = 1.94–2.76) for 1 ≤ n < 2, and n ≥ 2 compared to n < 1, respectively. The database lacked detailed socioeconomic history, family history, and clinical variables. This study found that patients with pneumoconiosis have a significantly higher risk of depression than those without pneumoconiosis. Furthermore, the risk of depression increases with the frequency of emergency department visits for pneumoconiosis. Healthcare professionals should pay close attention to the mental health of patients with pneumoconiosis. • Mental health is an important issue for patients with pneumoconiosis. • This study showed patients with pneumoconiosis have a higher risk of depression. • The risk of depression is amplified for those with more emergency visits. [ABSTRACT FROM AUTHOR]

Medical image classification has become popular in computer-aided diagnosis (CAD) of pneumoconiosis. However, most current work focuses on improving the accuracy of classification results and has overlooked the corresponding medical explanations. With the expectation to achieve these two sub-goals simultaneously, we propose an explainable X-ray image classification method with fine-grained features to diagnose pneumoconiosis. The proposed method consists of three consecutive stages. First, we generate a highlighted discriminative region by gradient-weighted class activation mapping (Grad-CAM) for each sample. Thus, we can give a visual explanation for the basis of classification. Then, we utilize selective convolutional descriptor aggregation (SCDA) to extract fine-grained features from the obtained discriminative region. After dimension reduction of obtained fine-grained features, we finally make a classification with these features to discover which samples are diseased. Extensive experiments on actual pneumoconiosis X-ray image datasets have shown the validity and superiority of our method. [ABSTRACT FROM AUTHOR]

Background: Sculpting is a common occupation in India. However, there have been no studies from India on sculpting-related silicosis. Aims: The aims of this study were to evaluate- 1. awareness of disease related to sculpting. 2. Clinical, radiological, and physiological parameters in "sculpting workers" suffering from silicosis. Settings and Design: This was a retrospective evaluation of data collected during compensation visits for silicosis in workers of the sculpting industries. Methods and Material: The data were collected between January 2021 to April 2023. A total of 114 patients were evaluated. All patients underwent clinical evaluation including awareness about the disease, chest radiography, high-resolution computed tomography (HRCT) scan of the chest, and spirometry. Results: The majority of patients (109) (95%) did not use any personal protective equipment while at work and did not have any awareness regarding preventive measures. On chest radiography, small opacities (rounded or irregular) and large opacities were seen in 84 (73.7%) and 26 (22.8%) patients, respectively. The size of large opacities was significantly proportionate with duration of job (P = 0.019). HRCT chest was more sensitive compared to chest radiographs. 94 (82.4%) patients were having abnormal spirometric findings. Conclusions: The benefits of prevention of silica dust exposure and patient education considerably outweigh the benefits of early detection and treatment of silicosis, as there was an increase in the size of lesions with increasing duration of exposure. There should be a national health program on silicosis to protect worker's health. [ABSTRACT FROM AUTHOR]

Objective To investigate the utilization of outpatient and inpatient services in patients with pneumoconiosis and its influencing factors. Methods By using the convenient sampling method, 199 pneumoconiosis patients were selected from the West China Fourth Hospital, and their population characteristics, medical treatment-seeking behavior, and influencing factors were investigated by using the questionnaire on pneumoconiosis patients and its influencing factors compiled by CDC of China. Multivariate logistic regression model and multivariate poisons regression model were used to analyze the influencing factors of outpatient and inpatient service utilization. Results The two-week outpatient rate of pneumoconiosis patients surveyed was 27.6%, the median number of outpatients used in one year was twice, and the annual hospitalization rate was 61.8%. For hospitalized patients, the median number of hospitalizations per year was 1, and the median cumulative hospitalization days was 30 days. The average visual health scale (VAS) score of patients was 48.3±17.4. Multivariate logistic regression and multivariate poisons regression analysis showed that pneumoconiosis patients with basic health insurance (OR = 0.067, 95% CI: 0.006-0.716), higher frequency of medication (OR=0.100, 95% CI: 0.037-0.269), and lower VAS score (OR = 0.992, 95% CI: 0.988-0.997) had less use of outpatient services. Pneumoconiosis patients with recent exacerbation of cough (OR=5.530, 95% CI: 2.446-12.501), work injury insurance (OR=1.183, 95% CI:1.015-1.379), and lower income (OR=0.980, 95% CI: 0.965-0.997) had more use of outpatient services. Pneumoconiosis patients who were married (OR=0.063, 95% CI: 0.005-0.771) and had lower VAS scores (OR=8.463, 95% CI: 3.090-23.248) had less use of inpatient services. Pneumoconiosis patients with higher frequency of medication (OR=8.463, 95% CI: 3.090-23.248), complicated with core pulmonale (OR = 1.855, 95% CI: 1.307-2.634), pneumoconiosis compensation (OR=3.358, 95% CI: 1.183-9.529), social relief (OR=1.402, 95% CI: 1.047-1.877) and more active communication with patients (OR=2.158, 95% CI: 1.061-4.390) were likely to have more use of inpatient services. Conclusion The utilization rates of outpatients and inpatients with pneumoconiosis are higher than the national average. The health status, economic level, and social support level of patients with pneumoconiosis are important factors affecting their medical treatment behavior. [ABSTRACT FROM AUTHOR]

Objective To construct a deep learning model based on multi -task learning to assist clinicians in differential diagnosis and staging of pneumoconiosis. Methods The digital chest radiographs of 3 600 patients from an occupational disease hospital in Sichuan Province from 2011 to 2022 were collected, and the full convolution neural network (UNet) was used to segment the lung field. Based on multi-task learning, the multi-task model was constructed using the correlation between tasks. The multi -task model was pre -trained on the ChestX -ray14 dataset, whose backbone network was DenseNetl21, and two classifiers were added behind the backbone network. Paired t-test was used to compare the differences in accuracy, precision, sensitivity, and Fl scores between single-task model and multi-task model. Results The test set results showed that the differential diagnosis and diagnostic staging performance of the single-task model was about 90% and 77%, respectively. The differential diagnosis and diagnosis staging performance of the multi-task model was about 94% and 86%, which was higher than that of the single-task model about 4% and 9%, respectively. The difference between the evaluation indexes was statistically significant (P < 0.05). Conclusion The multi-task model has more advantages than the single-task model and can effectively realize the differential diagnosis and accurate staging of pneumoconiosis and pulmonary tuberculosis. [ABSTRACT FROM AUTHOR]

Rationale: Indigenous populations in the United States face numerous health disparities, but the health of Indigenous workers is less well understood. In a recent surveillance study of active Indigenous coal miners, 3% had coal workers' pneumoconiosis/black lung, and 9% had respiratory impairment. However, occupational lung disease prevalence among Indigenous coal miners has not been directly compared with that among other race/ethnicity groups. Coal miners who are totally disabled from black lung may qualify for U.S. Department of Labor (DOL) compensation benefits, but it is unclear how current federal spirometry criteria affect qualification for Indigenous coal miners. Objectives: To compare findings of pneumoconiosis and respiratory impairment in Indigenous and non-Indigenous coal miners in the western United States and assess federal compensation qualification for Indigenous miners using different spirometry standards. Methods: We used voluntary medical surveillance data from 2002 to 2023 to compare the adjusted odds of pneumoconiosis and respiratory impairment between Indigenous/non-Indigenous coal miners. We examined the proportion of Indigenous miners meeting DOL criteria for federal compensation using different spirometry standards. Results: We identified 691 western U.S. coal miners with at least one year of coal mining employment, 289 Indigenous and 402 non-Indigenous (96% White/Hispanic). Indigenous miners had a greater odds ratio for pneumoconiosis for each additional decade of life (2.47 [95% confidence interval (CI), 1.66–3.68]) compared with non-Indigenous coal miners (1.48 [95% CI, 1.19–1.85]). For each decade, Indigenous coal miners also had a greater adjusted odds ratio for respiratory impairment (1.67 [95% CI, 1.25–2.24]) than non-Indigenous miners (1.06 [95% CI, 0.90–1.25]). Indigenous miners had an additional decline of 71 ml (95% CI, 6–136 ml) in forced expiratory volume in 1 second for each decade of life compared with non-Indigenous coal miners. Using the DOL-mandated Knudson (1976) spirometry standard rather than an Indigenous-specific standard, 6 of 18 (33%) Indigenous miners would not qualify for federal compensation. Conclusions: Indigenous coal miners experience greater adjusted odds for pneumoconiosis and respiratory impairment per decade of life and greater decline in forced expiratory volume in 1 second despite lower smoking rates. Structural inequities exist in federal spirometry requirements for Indigenous miners seeking DOL black lung benefits. Regulatory reform is needed to address barriers to compensation for these underrepresented workers. [ABSTRACT FROM AUTHOR]

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). [ABSTRACT FROM AUTHOR]

The article focuses on exploring the feasibility and validity of shorter walk tests, particularly the 1-minute walk test (1MWT), as alternatives to the traditional 6-minute walk test (6MWT) in assessing exercise capacity in cardiorespiratory diseases like pulmonary hypertension (PH) and interstitial lung disease (ILD). It challenges the convention of the six minute duration and investigates the practicality of conducting shorter walk tests in a community setting using digital technology.

Background and Aim: Kathmandu is a densely populated metropolitan city in Nepal. In recent years, however, the metropolis has been ranked as one of the most polluted cities worldwide. Both humans and animals are susceptible to various respiratory diseases due to chronic exposure to polluted air. Due to the relative similarities in the anatomical structure and physiological functions of the respiratory system between humans and dogs, polluted environments may lead to respiratory illness in similar ways in both species living in the valley. On the basis of information on the air quality in the valley, this study was conceived to assess pulmonary illness in street dogs to discern the health hazards caused by polluted air. Materials and Methods: A total of 76 dogs with clinical signs of tachypnea, dyspnea, sneezing, coughing, mucopurulent discharge, moderate hyperthermia, and anorexia admitted from July 2020 to November 2020 in Animal Nepal for treatment were included in this study. Among them, 24 animals responded to treatment, and 52 dogs died during their stay in the hospital. The 52 dead animals were necropsied, and the lesions that resembled pulmonary anthracosis were further studied grossly and histologically in a blinded fashion by trained veterinary pathologists. Results: Significant morphological alterations were observed in the lungs and associated lymph nodes of 25 animals, indicating pulmonary anthracosis. Gross morphological changes included multiple black foci with hemorrhage, congestion, nodular, and emphysema on the parietal and visceral surfaces of the lungs. The alveolar septa and visceral pleura exhibited deposition of black particles. Congestion, emphysema, and inflammatory exudates were also detected in the lung tissues and lymph nodes. Conclusion: The clinical, gross, and microscopic findings accurately resembled those of pulmonary anthracosis. This lifethreatening condition in stray canines may be caused by a critical level of air pollution from different sources and carbon emissions from vehicles. To protect animals and humans living in the Kathmandu Valley, concerned government and nongovernment agencies should work toward reducing air pollution levels as soon as possible. [ABSTRACT FROM AUTHOR]

There is a significant silicosis risk for workers fabricating engineered stone (ES) products containing crystalline silica. The aims of this study by SafeWork NSW were to: (i) assess current worker exposure to respirable dust (RD) and respirable crystalline silica (RCS) following a 5-y awareness and compliance program of inspections in ES workshops and (ii) to identify improvements in work practices from the available evidence base to further reduce exposures. One hundred and twenty-three personal full shift samples taken on as many workers and 34 static samples across 27 workshops fabricating ES were included in the final assessment. The exposure assessment was conducted using Casella Higgins–Dewell cyclones (Casella TSI) placed in the breathing zone of workers attached to SKC Air Check XR 5000 or SKC Chek TOUCH sampling pumps. Sample filters were sent to an ISO (2017) 17025:2017 accredited laboratory for gravimetric analysis for RD and X-Ray Diffraction (XRD) analysis to determine the amount of deposited RCS i.e. alpha-quartz and cristobalite. All workshops used wet methods of fabrication. The geometric mean (GM) of the pooled result for respirable dust (RD) was 0.09 mg/m3 TWA-8 h and 0.034 mg/m3 TWA-8 h for RCS. The highest exposed workers with a GM RCS of 0.062 mg/m3 TWA-8 h were those using pneumatic hand tools for cutting or grinding combined with polishing tasks. Workers operating semiautomated routers and edge polishers had the lowest GM RCS exposures of 0.022 mg/m3 TWA-8 h and 0.018 mg/m3 TWA-8 h respectively. Although ES workers remain exposed to RCS above the workplace exposure limit (WEL) of 0.05 mg/m 3 TWA-8 h, these results point to a very substantial reduction in exposures compared to poorly controlled dry methods of fabrication. Therefore, the wearing of respiratory protection by workers remains necessary until further control measures are more widely adopted across the entire industry e.g. reduction in the crystalline silica content of ES. [ABSTRACT FROM AUTHOR]

Context.--Current approaches for characterizing retained lung dust using pathologists' qualitative assessment or scanning electron microscopy with energy-dispersive spectroscopy (SEM/EDS) have limitations. Objective.--To explore polarized light microscopy coupled with image-processing software, termed quantitative microscopy-particulate matter (QM-PM), as a tool to characterize in situ dust in lung tissue of US coal miners with progressive massive fibrosis. Design.--We developed a standardized protocol using microscopy images to characterize the in situ burden of birefringent crystalline silica/silicate particles (mineral density) and carbonaceous particles (pigment fraction). Mineral density and pigment fraction were compared with pathologists' qualitative assessments and SEM/EDS analyses. Particle features were compared between historical (born before 1930) and contemporary coal miners, who likely had different exposures following changes in mining technology. Results.--Lung tissue samples from 85 coal miners (62 historical and 23 contemporary) and 10 healthy controls were analyzed using QM-PM. Mineral density and pigment fraction measurements with QM-PM were comparable to consensus pathologists' scoring and SEM/EDS analyses. Contemporary miners had greater mineral density than historical miners (186 456 versus 63 727/mm³; P = .02) and controls (4542/mm³), consistent with higher amounts of silica/silicate dust. Contemporary and historical miners had similar particle sizes (median area, 1.00 versus 1.14 µm² P = .46) and birefringence under polarized light (median grayscale brightness: 80.9 versus 87.6; P = .29). Conclusions.--QM-PM reliably characterizes in situ silica/silicate and carbonaceous particles in a reproducible, automated, accessible, and time/cost/labor-efficient manner, and shows promise as a tool for understanding occupational lung pathology and targeting exposure controls. [ABSTRACT FROM AUTHOR]

Union activism, medical lobbying and occupational health and safety prosecutions led to a major public health initiative in Australia - the banning from 1 July 2024 of work with engineered/artificial stone, including manufacturing, supplying, processing and installing it. This editorial contextualises within the history of regulation of workers' exposure to risks of contracting silicosis the growing international awareness of the dangers posed by working with engineered stone, particularly in relation to making and installing kitchen and bathroom benchtops made from engineered stone. It argues that the Australian initiative is an important public health decision that has a sound justification, is likely to save many lives and should be emulated internationally. [ABSTRACT FROM AUTHOR]

A suicide where the deceased has employed more than one means of ending his or her life is defined as a complex suicide (CS). Forensic practitioners may face difficulties caused by the articulated mechanisms underlying this event. Among CS, the combination of hanging and gunshots is unusual. In this study, we present three unique cases of such planned complex suicides (PCS) that we have encountered in our 28 years of activity at the Bureau of Legal Medicine of Milan. Careful inspection of the death scene, precise analysis of the anamnestic-circumstantial data, and accurate medico-legal autopsy examination were the starting points for a better understanding of the causes and manner of death. In particular, the presence of vital reactions of tissues involved in the two different means used, the coherence of the areas involved with a self-inflicted wound, and the absence of signs of third party intervention allowed us to classify these events as suicides. As for the chronology of events, the lethality of the cerebral lesions caused by the gunshots in all cases, in accordance with the cervical lesions caused by hanging, led us to conclude that we were dealing with PCS and catalogue these three cases as unusually planned complex suicides avoiding incorrect and superficial classification. [ABSTRACT FROM AUTHOR]

Asbestos exposure has been proposed as a risk factor for shorter telomere length. The aim of our study was to investigate whether telomere length in leukocytes and hTERT genetic polymorphisms may serve as potential biomarkers for the risk of developing asbestos-related diseases and as biomarkers of progression and chemotherapy response rate in malignant mesothelioma (MM). We conducted two retrospective studies. In the first study, a case-control study, telomere length and hTERT polymorphisms were determined in patients with MM, subjects with pleural plaques and controls without the asbestos related disease, who were occupationally exposed to asbestos. In the second study, a longitudinal observational study, telomere length was also determined in samples from MM patients before and after chemotherapy. Telomere length was determined by monochromatic multiplex quantitative polymerase chain reaction (PCR), while competitive allele-specific PCR was used to genotype hTERT rs10069690, rs2736100 and rs2736098. Logistic regression and survival analysis were used in statistical analysis. Patients with MM had shorter telomere length than subjects with pleural plaques (p < 0.001). After adjustment for age, rs2736098 CT, and rs10069690 TT and CT+TT genotypes were significantly associated with a higher risk of MM (padj = 0.023; padj = 0.026 and padj = 0.017), while rs2736100 AA and CA+AA genotypes conferred to a lower risk for MM compared to all other subjects (padj = 0.017, and padj = 0.026). Telomere length was not associated with a response to chemotherapy (p > 0.05) or time to disease progression (p > 0.05). Carriers of one or two polymorphic rs10069690 T alleles had a good response to chemotherapy (p = 0.039, and p = 0.048), these associations remained statistically significant after adjustment for age (padj = 0.019; padj = 0.017). Carriers of two polymorphic rs2736100 A alleles had a longer time to disease progression (p = 0.038). Shorter telomere length and hTERT polymorphisms may serve as a biomarker for the risk of developing MM. Additionally, rs10069690 and rs2736100 polymorphisms, but not telomere length, were associated with a chemotherapy response or MM progression. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to summarize Coal Workers’ Health Surveillance Program findings since 2014, focusing on prevalence of radiographic pneumoconiosis and abnormal spirometry by region. Methods: Analysis included the most recent Coal Workers’ Health Surveillance Program encounter for working miners during October 1, 2014–June 30, 2022. Central Appalachia consists of Kentucky, Virginia, and West Virginia. Results: Pneumoconiosis prevalence was highest among underground miners, with 318 (6.2%) having radiographic evidence of disease. Central Appalachian miners were more likely to have evidence of pneumoconiosis (relative risk = 4.1 [3.4—5.0]) and abnormal spirometry (relative risk = 1.4 [1.2—1.6]) compared with all others. Conclusions: Central Appalachia is a hotspot for pneumoconiosis, as well as for other indicators of respiratory impairment in coal miners. Outreach for occupational respiratory health surveillance should focus on those areas most heavily affected, ensuring that miners are not hindered by perceived or actual barriers to this secondary intervention. [ABSTRACT FROM AUTHOR]

Occupational diseases and accidents are lagging indicators of occupational health and safety (OHS), and clustering in certain areas suggests that OHS policies have failed in this regard. A cluster of pneumoconiosis cases employed at a refractory concrete factory was noted among those admitted to an occupational disease clinic, with 12 of the total 22 bluecollar workers (54.5%) employed by the small-scale enterprise (SSE) being followed up with a diagnosis of pneumoconiosis. The first case in the SSE was detected in 2017 and regular health audits were initiated following workplace inspections. The median exposure time was 8.5 years, with a range of 4-22 years. During follow-up, one-third of the cases progressed (median 3.5 years). To summarize, the probability of a blue-collar worker in the SSE developing pneumoconiosis is greater than the chance of a coin landing on either heads or tails when they first start their job. Workers in developing countries in particular are more prone to problems related to OHS, particularly in SSEs. [ABSTRACT FROM AUTHOR]

The current global outbreak of artificial stone silicosis is a recrudescence of a major occupational disease in the context of a novel exposure source. Respirable crystalline silica exposure, even without frank pneumoconiosis, is associated with an increased risk of respiratory infection. Empyema is a well-recognized complication of bacterial pneumonia; pneumonia among working-age adults, in turn, has been epidemiologically linked to occupational exposure to fumes and dust, including silica. A connection between empyema and silica dust inhalation has not been reported, however, whether through antecedent pneumonia or another mechanism. We describe a case of silicosis initially presenting with empyema in a 31-year-old Computerized Numerical Control stone-cutting machine operator who had heavy exposure to artificial stone and other rock dust. [ABSTRACT FROM AUTHOR]

Silicosis is a progressive pneumoconiosis caused by inhalation of crystalline silica dust commonly seen in workers of construction sites, flour mills, and mining. Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus antigens commonly encountered in patients with asthma and cystic fibrosis. We report a case of 60-year-old flour mill worker presented with clinico-radiological features of silicosis; further evaluation was found to have an overlap of ABPA in view of severe atopic symptoms. We describe a rare duet of silicosis with ABPA overlap. [ABSTRACT FROM AUTHOR]

Background: Systemic sclerosis is an autoimmune connective tissue disease characterized by fibrosis in skin and internal organs. Chronic exposure to silica may not only lead to silicosis of lungs but also systemic sclerosis. Systemic sclerosis is relatively commoner in females; however, occupational exposure to silica in males makes them vulnerable to silica--associated systemic sclerosis (Erasmus syndrome). Objective: To describe the clinico-epidemiological aspects of systemic sclerosis in males in a retrospective cohort study. Materials and Methods: The data were analysed retrospectively for demographic profile and clinical characteristics including examination findings, laboratory investigations, and treatments of all male patients diagnosed with systemic sclerosis with or without silica exposure, managed from January 2018 to December 2021. Results: Eight out of twelve patients were having silica exposure in the form of stone cutting, cement exposure, and working with concrete. The average age was 55 ± 10.72 years with average smoking exposure of around 24.4 ± 12.8 pack years. Skin thickening was reported by all patients with an average modified Rodnan score of 18.33/51 in diffuse and 7/51 in limited cutaneous systemic sclerosis. Raynaud's phenomenon and sclerodactyly were universal findings, while 9 (75%) patients had digital pitted scars. Antinuclear antibodies were present in all patients and specific antibodies substantiated the clinical assessment in almost all patients. Interstitial lung disease was the most common systemic finding present in 11 (91%) patients and tuberculosis was diagnosed in 2 (25%) cases with silica exposure. Gastrointestinal and cardiac system involvement was seen in 5 (41.6%) and 4 (33.3%) patients, respectively. Conclusion: Systemic sclerosis in males against the gender predilection indicates the role of occupational exposure. Silicosis and systemic sclerosis synergistically add to lung damage, and at the same time, these patients are more prone to infections like tuberculosis. [ABSTRACT FROM AUTHOR]

Background Globally, the number of small-scale miners (SSM) is estimated to be more than 25 million, but it supports the livelihoods of around 100 million individuals. In Tanzania, the number of SSM has increased from an estimated 150,000 in 1987 to ~1.5 million in 2017. The miners are at a high risk of occupational-related health challenges. The study aimed to assess the concentrations of respirable crystalline silica (RCS) and radon among the tanzanite mining communities in Simanjiro District, Tanzania. Methods We carried out a cross-sectional study involving the Mererani mines in Tanzania. These are underground mines comprised of informally employed miners, i.e. SSM. Concentrations of RCS and radon gas were measured in 44 study units, i.e. 22 mining pits and within 22 houses in the general community, e.g. shops in the peri-mining community. A total of 132 respirable personal dust exposure samples (PDS), 3 from each of the study units were taken, but only 66 PDS from the mining pits were analysed, as this was the main interest of this study. Radon concentration was measured by continuous monitoring throughout the working shift (and overnight for residences) using AlphaGuard monitor. The medians and comparison to the reference values, OSHA USA PEL and WHO/IARC references, were done for RCS and radon, respectively, using SPSS Ver. 27.0.0). Results The median time-weighted average (TWA) concentration of the RCS in the mining pits was 1.23 mg/m3. Of all 66 personal dust samples from the mining pits, 65 (98.5%) had concentrations of RCS above the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) of 0.05 mg/m3. Mining pits had a median radon concentration of 169.50 bq/m3, which is above the World Health Organization (WHO)/International Commission on Radiation Protection (ICRP) recommended reference of 100.00 bq/m3 but not above the upper reference of 300.00 bq/m3, while the community buildings had a median radon concentration of 88.00 bq/m3. Overall, 9 (20.5%) and 17 (38.6%) radon measurements were above 300.00 bq/m3 and between 100.00 and 300.00 bq/m3 references, respectively. Specifically, in the mining pits, 9 (40.9%) test results were above 300.00 bq/m3, while none of the test results in the community was above 300.00 bq/m3. Conclusion The tanzanite SSM in Mererani we highly exposed to RCS, which increases the risk of pulmonary diseases, including silicosis, tuberculosis, and pulmonary malignancies. Immediate action by OSHA Tanzania should be enforcement of wearing respirators by all miners throughout the working hours. Health education programmes to the SSM must be strengthened and OSHA Tanzania should adopt the 0.05 mg/m3 PEL, and enforce other occupational health and safety measures, including regular use of dust suppression mechanisms (water spray and wet drilling) and monitoring of RCS exposures among SSM. Monitoring of radon exposure both in the mining pits and community buildings should be conducted, and mitigation measures should be implemented in areas that exceed the reference level of 100.00 bq/m3. [ABSTRACT FROM AUTHOR]

Asbestos cement (AC) is used in water pipes, roofing, exterior siding, water tanks, cooling towers, and other applications. Although the global market for asbestos is slowly shrinking, AC products continue to dominate the remaining uses in many countries. This review focuses on asbestos exposures during the installation, maintenance, and ultimate removal of these materials. This assessment summarizes the available published and unpublished reports of airborne asbestos exposures during the cutting and removal of AC pipes, roofing, sheets, and cooling tower components and the range of exposures associated with the most common work practices. Task-based exposures from cutting AC pipe ranged from 11.3 to 129.0 f/cm3 with a mean exposure of 53.8 f/cm3. Cutting flat boards and corrugated roofing AC sheets resulted in exposures ranging from 1.3 to 130.0 f/cm3 with a mean of 24.0 f/cm3. Exposures for power saw cutting of AC sheets and pipes fit lognormal distributions and suggest that more than 86% of these tasks with AC sheet and 100% of the tasks with AC pipe exceed the US short-term Excursion Limit. Intermittent high exposures from the ongoing use of AC products in countries around the world are associated with an increased lifetime risk of asbestos-related disease. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: Pneumoconiosis can impair lung functions and the exercise capacities of patients. The six-minute walk test (6MWT) is a submaximal cardiopulmonary exercise test. In cases of pneumoconiosis, it may serve as a reliable functional tool for medical, social, and legal assessments. Considering this, we aimed to investigate the value of the 6MWT in pneumoconiosis patients experiencing dyspnea despite normal pulmonary function tests (PFTs). METHODS: This cross-sectional study, conducted from September to December 2015, investigated 85 inpatients with pneumoconiosis who showed symptoms of dyspnea despite having normal results in PFTs. Data on sociodemographic features, occupational history, functional and radiological assessments, and 6MWT results were evaluated. Radiological assessment were performed according to International Labour Organization (ILO) categorization. RESULTS: All patients were male. The mean age of the patients were 41.65±10.8. The majority had q opacity (51.8%) and were in category 1 (67%). 11 (13.0%) patients had a large opacity, and 6 of these were classified as having A opacity in ILO classification. The mean distance in the 6MWT was 488.54±87.54 meters, with 18 (21.1%) patients developing desaturation of more than 4%. A moderate negative correlation was observed between chest X-ray profusion and walking distance (p=0.001, r=-0.365). Walking distance was significantly lower in patients with a profusion of 2/1 or higher (452.29±94.36 m vs. 506.35±78.8 m; p=0.021). Receiver operating curve analysis indicated a cut-off value of 414 meters for category 2 or worse radiology. CONCLUSIONS: This study evaluated pneumoconiosis patients with dyspnea and normal PFT results, showing that the 6MWT is moderately correlated with radiological findings. More extensive disease was associated with a lower walking distance. These results suggest the potential role of the 6MWT in the routine evaluation of pneumoconiosis patients. The 6MWT may be a valuable tool in occupational health for monitoring pneumoconiosis patients. [ABSTRACT FROM AUTHOR]

Health disparities persist among Black men, notably in the context of lung cancer and stress-related health outcomes. This study explores these disparities through a community-based participatory research (CBPR) approach, citizen science, and social network theory, leveraging the expertise and trust of Black barbers as community leaders. The purpose is to understand the nuanced connections between stress and lung cancer in this demographic. Engaging 161 Black men across four Chicago neighborhoods, the study successfully collected hair samples and survey data, emphasizing the importance of culturally sensitive recruitment strategies. Findings highlight the effectiveness of the collaboration, showcasing the role of barbershops as community hubs for research. The study concludes by advocating for sustained partnerships with community leaders, emphasizing transparency in research communication, and promoting culturally grounded approaches to address health disparities and enhance research participation among underrepresented populations. [ABSTRACT FROM AUTHOR]

Background: Occupational lung diseases are some of the more important yet underdiagnosed pulmonary diseases. The more important reason for this is the lack of knowledge in the general public as well as general practitioners. Marble factories are a very common source of occupational dust exposure leading to derangements in lung functions and lung disorders. Pulmonary function tests are an important step in evaluation of lung functions for the sake of diagnosing various lung disorders1. Objective: To determine the relationship between marble factory workers and lung derangements with respect to their place of job. Methodology: This study was conducted in marble factories located on Warsak road, Hayatabad, and suburbs of Peshawar. 2-step randomization was used to initially select factories and then workers in each factory. A total of 45 factories were selected, followed by selection of 357 workers, 8 in each factory with 4 workers from each of the 2 units (polishing and grinding units). Spirometry was then performed on these workers and the obtained data was analyzed using SPSSv22. Results: All the participants were male with mean age of 33. The workers were divided into 2 groups according to work place as grinding unit and polishing unit, 183 workers were from grinding units while 174 workers were from polishing unit. Out of the 183 workers from grinding unit, 137 had normal spirometric findings, 46 workers had abnormal findings on spirometry. In the polishing unit, out of 174 workers, 151 workers had normal spirometric findings, 23 workers had abnormal spirometric findings. ANOVA test was applied. Workers in grinding unit shows more deranged pulmonary functions as compared to workers in polishing unit. Conclusion: Workers in the grinding unit were at greater risk of developing deranged pulmonary functions as compared to workers in polishing unit. [ABSTRACT FROM AUTHOR]

Rationale: The increase in the incidence and the diagnostic limitations of pneumoconiosis have emerged as a public health concern. This study aimed to conduct a computed tomography (CT)- based quantitative analysis to understand differences in imaging results of pneumoconiosis according to disease severity. Methods: According to the International Labor Organization (ILO) guidelines, coal workers’ pneumoconiosis (CWP) are classified into five categories. CT images were obtained only at full inspiration and were quantitatively evaluated for airway structural variables such as bifurcation angle (θ), hydraulic diameter (Dh), wall thickness (WT), and circularity (Cr). Parenchymal functional variables include abnormal regions (emphysema, ground–glass opacities, consolidation, semi consolidation, and fibrosis) and blood vessel volume. Through the propensity score matching method, the confounding effects were decreased. Results: Category 4 demonstrated a reduced θ in TriLUL, a thicker airway wall in both the Trachea and Bronint compared to Category 0, and a decreased Cr in Bronint. Category 4 presented with higher abnormal regions except for ground–glass opacity and a narrower pulmonary blood vessel volume. A negative correlation was found between abnormal areas with lower Hounsfield units (HU) than the normal lung and the ratio of forced expiratory volume in 1 s/ forced vital capacity, with narrowed pulmonary blood vessel volume which is positively correlated with abnormal areas with upper HU than the normal lung. Conclusion: This study provided valuable insight into pneumoconiosis progression through a comparison of quantitative CT images based on severity. Furthermore, as there has been paucity of studies on the pulmonary blood vessel volume of the CWP, in this study, a correlation between reduced pulmonary blood vessel volume and regions with low HU values holds significant importance. [ABSTRACT FROM AUTHOR]