Identification and classification of high risk groups for Coal Workers' Pneumoconiosis using an artificial neural network based on occupational histories: a retrospective cohort study.
BACKGROUND
Coal workers' pneumoconiosis (CWP) is a preventable, but not fully curable occupational lung disease. More and more coal miners are likely to be at risk of developing CWP owing to an increase in coal production and utilization, especially in developing countries. Coal miners with different occupational categories and durations of dust exposure may be at different levels of risk for CWP. It is necessary to identify and classify different levels of risk for CWP in coal miners with different work histories. In this way, we can recommend different intervals for medical examinations according to different levels of risk for CWP. Our findings may provide a basis for further emending the measures of CWP prevention and control.


METHODS
The study was performed using longitudinal retrospective data in the Tiefa Colliery in China. A three-layer artificial neural network with 6 input variables, 15 neurons in the hidden layer, and 1 output neuron was developed in conjunction with coal miners' occupational exposure data. Sensitivity and ROC analyses were adapted to explain the importance of input variables and the performance of the neural network. The occupational characteristics and the probability values predicted were used to categorize coal miners for their levels of risk for CWP.


RESULTS
The sensitivity analysis showed that influence of the duration of dust exposure and occupational category on CWP was 65% and 67%, respectively. The area under the ROC in 3 sets was 0.981, 0.969, and 0.992. There were 7959 coal miners with a probability value < 0.001. The average duration of dust exposure was 15.35 years. The average duration of ex-dust exposure was 0.69 years. Of the coal miners, 79.27% worked in helping and mining. Most of the coal miners were born after 1950 and were first exposed to dust after 1970. One hundred forty-four coal miners had a probability value > or =0.1. The average durations of dust exposure and ex-dust exposure were 25.70 and 16.30 years, respectively. Most of the coal miners were born before 1950 and began to be exposed to dust before 1980. Of the coal miners, 90.28% worked in tunneling.


CONCLUSIONS
The duration of dust exposure and occupational category were the two most important factors for CWP. Coal miners at different levels of risk for CWP could be classified by the three-layer neural network analysis based on occupational history.
Division of Pneumoconiosis, School of Public Health, China Medical University, Shenyang, PR China. liuhbabc@163.com
Hongbo
H
Liu
Zhifeng
Z
Tang
Yongli
Y
Yang
Dong
D
Weng
Gao
G
Sun
Zhiwen
Z
Duan
Jie
J
Chen
D003032:Coal Mining; D015331:Cohort Studies; D004391:Dust; D004651:Employment; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016273:Occupational Exposure; D011009:Pneumoconiosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D011859:Radiography; D012179:Retirement; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D004391:Dust