title: Lung-function impairment among US underground coal miners, 2005 to 2009: geographic patterns and association with coal workers' pneumoconiosis.
abstract: OBJECTIVE
  To investigate contemporary geographic distributions of lung-function impairment and radiographic evidence of coal workers' pneumoconiosis (CWP) and their associations.
  
  
  METHODS
  From 2005 to 2009, 6373 underground coal miners completed a health survey, including spirometry testing and chest radiography. Coal workers' pneumoconiosis and progressive massive fibrosis were determined by NIOSH B readers, using the International Labour Office classification. Prevalences of CWP and spirometry less than lower normal limits were mapped by county, and their association assessed.
  
  
  RESULTS
  The prevalences of abnormal spirometry results and CWP were 13.1% and 4.0%, respectively. Counties with elevated prevalences for both the outcomes were located in contiguous areas of southeastern Kentucky, western Virginia, southern West Virginia, and eastern Pennsylvania. Prevalence of abnormal spirometry results increases with increasing category of simple CWP and progressive massive fibrosis.
  
  
  CONCLUSIONS
  Abnormal spirometry in coal miners is associated with CWP; these two health outcomes have similar geographic distributions.
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA. mlw4@cdc.gov
authors.forename: Mei Lin
authors.initials: ML
authors.lastname: Wang
authors.forename: Lu-Ann
authors.initials: LA
authors.lastname: Beeckman-Wagner
authors.forename: Anita L
authors.initials: AL
authors.lastname: Wolfe
authors.forename: Girija
authors.initials: G
authors.lastname: Syamlal
authors.forename: Edward L
authors.initials: EL
authors.lastname: Petsonk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003032:Coal Mining; D005260:Female; D005541:Forced Expiratory Volume; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011009:Pneumoconiosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D016016:Proportional Hazards Models; D011859:Radiography; D013147:Spirometry; D014481:United States / Q000453:epidemiology; D014797:Vital Capacity; D055815:Young Adult