Home
|
Inbox
|
Search
|
View Abstract
Patterns of Progressive Massive Fibrosis on Coal Miner Chest Radiographs 2000 to 2015
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A6065 - Patterns of Progressive Massive Fibrosis on Coal Miner Chest Radiographs 2000 to 2015
Author Block: C. Halldin1, D. Blackley2, T. Markle1, R. A. Cohen3, A. S. Laney4; 1Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States, 2CDC/NIOSH, Morgantown, WV, United States, 3EOHS, Univ of Illinois at Chicago, Chicago, IL, United States, 4Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, United States.
Rationale: Classic clinical teaching generally asserts that large opacities of progressive massive fibrosis (PMF) on chest radiographs occur primarily in the upper lung zones bilaterally in subjects with an elevated background profusion of small opacities. However, the contemporary scientific basis for these descriptions is limited. Therefore, we examined contemporary radiographs with PMF from the Coal Workers’ Health Surveillance Program (CWHSP) to formally characterize the appearance of large opacities.
Methods: Radiographs taken for the Coal Workers’ Health Surveillance Program during 2000–2015 and previously determined to have large opacities (‘PMF radiographs’, n = 204) and were independently re-classified by three NIOSH CWHSP B Readers. International Labour Office classification procedures were supplemented by a custom questionnaire designed to record the shape, size, and location of each large opacity. Small and large opacity patterns were analyzed overall, and for each Reader.
Results: Readers confirmed the presence of large opacities in 82% to 92% of the PMF radiographs. Large opacities were located frequently in the upper right (41%) or upper left (28%) lung zone, but nearly a third of large opacities were located in middle (25%) or lower lung zones (6%). Unilateral involvement was observed in 34% of readings, with right lung predominance (82%). Over one-third of large opacities were noted on a background of low small opacity profusion (category 1).
Conclusions: These findings support the clinical teaching that PMF in coal miners is predominantly in the upper lung zones, with right lung preponderance. However, the ‘classic’ descriptions of PMF as bilateral, associated with elevated background profusions of small pneumoconiotic opacities, were each absent in nearly a third of coal miners. These results may be useful as a baseline to evaluate disease patterns over time.
Author Block: C. Halldin1, D. Blackley2, T. Markle1, R. A. Cohen3, A. S. Laney4; 1Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States, 2CDC/NIOSH, Morgantown, WV, United States, 3EOHS, Univ of Illinois at Chicago, Chicago, IL, United States, 4Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, United States.
Rationale: Classic clinical teaching generally asserts that large opacities of progressive massive fibrosis (PMF) on chest radiographs occur primarily in the upper lung zones bilaterally in subjects with an elevated background profusion of small opacities. However, the contemporary scientific basis for these descriptions is limited. Therefore, we examined contemporary radiographs with PMF from the Coal Workers’ Health Surveillance Program (CWHSP) to formally characterize the appearance of large opacities.
Methods: Radiographs taken for the Coal Workers’ Health Surveillance Program during 2000–2015 and previously determined to have large opacities (‘PMF radiographs’, n = 204) and were independently re-classified by three NIOSH CWHSP B Readers. International Labour Office classification procedures were supplemented by a custom questionnaire designed to record the shape, size, and location of each large opacity. Small and large opacity patterns were analyzed overall, and for each Reader.
Results: Readers confirmed the presence of large opacities in 82% to 92% of the PMF radiographs. Large opacities were located frequently in the upper right (41%) or upper left (28%) lung zone, but nearly a third of large opacities were located in middle (25%) or lower lung zones (6%). Unilateral involvement was observed in 34% of readings, with right lung predominance (82%). Over one-third of large opacities were noted on a background of low small opacity profusion (category 1).
Conclusions: These findings support the clinical teaching that PMF in coal miners is predominantly in the upper lung zones, with right lung preponderance. However, the ‘classic’ descriptions of PMF as bilateral, associated with elevated background profusions of small pneumoconiotic opacities, were each absent in nearly a third of coal miners. These results may be useful as a baseline to evaluate disease patterns over time.
|
Home
|
Inbox
|
Search
|