title: Coal dust exposure and mortality from ischemic heart disease among a cohort of U.S. coal miners.
abstract: BACKGROUND
  Particulate exposure from air pollution increases the risk of ischemic heart disease (IHD) mortality. Although coal miners are highly exposed to coal dust particulate, studies of IHD mortality risk among coal miners have had inconsistent results. Previous studies may have been biased by the healthy worker effect.
  
  
  METHODS
  We examined the dose-response relationship between cumulative coal dust exposure, coal rank, and IHD mortality among a cohort of underground coal miners who participated in the National Study of Coal Workers' Pneumoconiosis.
  
  
  RESULTS
  After adjusting for age, smoking, and body mass index, risk of IHD mortality increased at higher levels of coal dust exposure. Mortality risk was also associated with coal rank region.
  
  
  CONCLUSIONS
  There was an increased risk of mortality from IHD associated with cumulative exposure to coal dust, and with coal rank. The effect of coal rank may be due differences in the composition of coal mine dust particulate. The association of risk of IHD mortality with cumulative particulate exposure is consistent with air pollution studies.
authors.affiliation: Office of Mine Safety and Health Research, National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania, USA. dlanden@cdc.gov
authors.forename: Deborah D
authors.initials: DD
authors.lastname: Landen
authors.forename: James T
authors.initials: JT
authors.lastname: Wassell
authors.forename: Linda
authors.initials: L
authors.lastname: McWilliams
authors.forename: Ami
authors.initials: A
authors.lastname: Patel
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D003031:Coal / Q000009:adverse effects* / Q000145:classification; D003032:Coal Mining; D004391:Dust; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D052638:Particulate Matter / Q000009:adverse effects; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000395:Air Pollutants, Occupational; D003031:Coal; D004391:Dust; D052638:Particulate Matter