title: Severe occupational pneumoconiosis among West Virginian coal miners: one hundred thirty-eight cases of progressive massive fibrosis compensated between 2000 and 2009.
abstract: BACKGROUND
  Miners inhale dust at work and are at a risk for coal workers pneumoconiosis (CWP), a preventable and potentially fatal lung disease. After regulations were implemented in the 1970s, declines were reported in both dust levels and the prevalence of simple and advanced CWP until about 2001, when despite stable reported dust levels, disease levels sharply increased.
  
  
  METHODS
  A structured, retrospective chart review was performed to describe the demographics and disease progression for 138 coal miners with progressive massive fibrosis (PMF) whose claims were approved by the West Virginia State Occupational Pneumoconiosis Board between January 2000 and December 2009.
  
  
  RESULTS
  PMF, a complication of CWP, developed in 138 West Virginian coal miners at a mean age of 52.6 years after an average of 30 years work tenure. The time of progression averaged 12.2 years from the last normal chest radiograph until PMF was detected. Lung function declined sharply in both smokers and nonsmokers, averaging 87 mL/y for FEV(1) and 74 mL/y for FVC. The board has confirmed 21 deaths in this group. The most common job activities were operating continuous-mining machines (41%) and roof bolting (19%). Virtually all of these miners' dust exposures occurred after the implementation of current federal dust regulations.
  
  
  CONCLUSIONS
  Contemporary occupational dust exposures have resulted over the past decade in rapidly progressive pneumoconiosis and massive fibrosis in relatively young West Virginian coal miners, leading to important lung dysfunction and premature death.
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, West Virginia University School of Medicine, Morgantown, WV. Electronic address: walexwade@gmail.com.
authors.forename: W Alex
authors.initials: WA
authors.lastname: Wade
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, West Virginia University School of Medicine, Morgantown, WV.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Petsonk
authors.affiliation: Occupational Lung Center, Charleston Area Medical Center, Charleston, WV.
authors.forename: Byron
authors.initials: B
authors.lastname: Young
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Department of Medicine, West Virginia University School of Medicine, Morgantown, WV.
authors.forename: Idrees
authors.initials: I
authors.lastname: Mogri
mesh_terms: D000328:Adult; D000368:Aged; D055008:Anthracosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D003032:Coal Mining / Q000331:legislation & jurisprudence*; D015331:Cohort Studies; D018450:Disease Progression; D005541:Forced Expiratory Volume; D006801:Humans; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D011859:Radiography; D013997:Time Factors; D014797:Vital Capacity; D014903:West Virginia