Advertisement

Occupational emphysema in South African miners at autopsy; 1975–2014

  • Sithembile L. Mabila
  • Kirsten S. Almberg
  • Lee Friedman
  • Robert Cohen
  • Ntombizodwa Ndlovu
  • Naseema Vorajee
  • Jill Murray
Original Article
  • 72 Downloads

Abstract

Purpose

To determine the associations between exposure duration, measured by employment tenure, and emphysema presence and severity in black and white South African miners at autopsy.

Methods

We examined the association between mining tenure and emphysema presence or severity using the Pathology Automation (PATHAUT) database, 1975–2014. We used logistic regression models adjusted for age, tuberculosis, HIV status, and year of death. The effect of smoking on the presence and severity of emphysema was assessed in a sub-analysis of white miners.

Results

Mining tenure was significantly associated with increased odds of emphysema presence in black and white miners. For every 10-year increase in tenure, black miners had a 17% increase in odds of emphysema [ORblack = 1.17 (95% CI 1.12, 1.22)] and white miners had a 7% increase in odds of the disease [ORwhite = 1.07 (95% CI 1.04, 1.10)]. Tenure was significantly associated with emphysema severity among black miners [ORseverity = 1.16 (95% CI 1.06, 1.28)]. In a subset of white miners with smoking status, we found that for every 10 years of tenure, there is a significant increase in odds of emphysema presence and severity [ORpresence = 1.14 (95% CI 1.09, 1.19); ORseverity = 1.06 (95% CI 1.00, 1.10)] after adjusting for smoking.

Conclusions

We observed a significant relationship between mining tenure and emphysema severity among South African miners in PATHAUT between 1975 and 2014. This relationship was evident in multi-variable analyses adjusted for smoking among white miners. Hazards from long term exposure to inhaled mineral dust leading to lung damage (silicosis, fibrosis, COPD) is evident and warrants further improvement of working conditions and prevention measures in South African mines especially for black workers. Further research is needed to determine if there is an effect of TB and HIV co-infection on the development of emphysema.

Keywords

Emphysema Mining Occupation COPD South Africa PATHAUT 

Notes

Funding

The research and researchers were supported in part by the National Institute of Occupational Safety and Health (NIOSH) Training Program Grant # T42/OH008672.

Compliance with ethical standards

Conflict of interest

All authors have declared that they have no conflicts of interest that may be relevant to the submitted work.

References

  1. Berg K, Wright JL (2016) The pathology of chronic obstructive pulmonary disease. Arch Pathol Lab Med 140:1423–1428.  https://doi.org/10.5858/arpa.2015-0455-RS CrossRefGoogle Scholar
  2. Buist AS, McBurnie MA, Vollmer WM et al (2007) International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet Lond Engl 370:741–750.  https://doi.org/10.1016/S0140-6736(07)61377-4 CrossRefGoogle Scholar
  3. Chakrabarti B, Calverley PM, Davies PD (2007) Tuberculosis and its incidence, special nature, and relationship with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2:263–272Google Scholar
  4. Finney LJ, Feary JR, Leonardi-Bee J et al (2013) Chronic obstructive pulmonary disease in sub-Saharan Africa: a systematic review [Review article]. Int J Tuberc Lung Dis 17:583–589.  https://doi.org/10.5588/ijtld.12.0619 CrossRefGoogle Scholar
  5. Fukuchi Y (2009) The aging lung and chronic obstructive pulmonary disease. Proc Am Thorac Soc 6:570–572.  https://doi.org/10.1513/pats.200909-099RM CrossRefGoogle Scholar
  6. Halbert RJ, Natoli JL, Gano A et al (2006) Global burden of COPD: systematic review and meta-analysis. Eur Respir J 28:523–532.  https://doi.org/10.1183/09031936.06.00124605 CrossRefGoogle Scholar
  7. Hessel P, Goldstein B, Davies J et al (1987a) Pathological findings in mine workers: I. Description of the PATHAUT database. Am J Ind Med 12:71–80CrossRefGoogle Scholar
  8. Hessel PA, Hnizdo E, Goldstein B, Sluis-Cremer GK (1987b) Pathological findings in mine workers: II. Quality of the PATHAUT data. Am J Ind Med 12:81–89.  https://doi.org/10.1002/ajim.4700120109 CrossRefGoogle Scholar
  9. Hnizdo E, Vallyathan V (2003) Chronic obstructive pulmonary disease due to occupational exposure to silica dust: a review of epidemiological and pathological evidence. Occup Environ Med 60:237–243.  https://doi.org/10.1136/oem.60.4.237 CrossRefGoogle Scholar
  10. Hnizdo E, Sluis-Cremer GK, Abramowitz JA (1991) Emphysema type in relation to silica dust exposure in South African gold miners. Am Rev Respir Dis 143:1241–1247.  https://doi.org/10.1164/ajrccm/143.6.1241 CrossRefGoogle Scholar
  11. Hnizdo E, Sluis-Cremer GK, Baskind E, Murray J (1994) Emphysema and airway obstruction in non-smoking South African gold miners with long exposure to silica dust. Occup Environ Med 51:557–563CrossRefGoogle Scholar
  12. Hnizdo E, Singh T, Churchyard G (2000) Chronic pulmonary function impairment caused by initial and recurrent pulmonary tuberculosis following treatment. Thorax 55:32–38.  https://doi.org/10.1136/thorax.55.1.32 CrossRefGoogle Scholar
  13. Huang X, Laurent PA, Zalma R, Pezerat H (1993) Inactivation of alpha 1-antitrypsin by aqueous coal solutions: possible relation to the emphysema of coal workers. Chem Res Toxicol 6:452–458CrossRefGoogle Scholar
  14. Kuempel ED, Wheeler MW, Smith RJ et al (2009) Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States. Am J Respir Crit Care Med 180:257–264.  https://doi.org/10.1164/rccm.200806-840OC CrossRefGoogle Scholar
  15. Lamprecht B, McBurnie MA, Vollmer WM et al (2011) COPD in never smokers. Chest 139:752–763.  https://doi.org/10.1378/chest.10-1253 CrossRefGoogle Scholar
  16. Lancaster J, Tomashefski J (1963) Tuberculosis—a cause of emphyema. Am Thorac Soc 83:435–437Google Scholar
  17. Lowe R, Murray J (1994) Tuberculosis at autopsy in black mine workers. National Centre for Occupational Health, NCOH Report No. 6/94. Johannesburg, South AfricaGoogle Scholar
  18. Lurie M, Williams M, Zuma K et al (2003) The Impact of Migration on HIV-1 Transmission in South Afric… Sexually Transmitted Diseases. Am Sex Transm Dis 30:149–156CrossRefGoogle Scholar
  19. Mather NL, Padmakumar AD, Milton R, Lumb AB (2012) Emphysema, lung volume reduction and anaesthesia. Trends Anaesth Crit Care 2:166–173.  https://doi.org/10.1016/j.tacc.2012.03.005 CrossRefGoogle Scholar
  20. Murray J, Davies T, Rees D (2011) Occupational lung disease in the South African mining industry: research and policy implementation. J Public Health Policy 32:S65–S79.  https://doi.org/10.1057/jphp.2011.25 CrossRefGoogle Scholar
  21. Naidoo RN, Robins TG, Murray J (2005) Respiratory outcomes among South African coal miners at autopsy. Am J Ind Med 48:217–224.  https://doi.org/10.1002/ajim.20207 CrossRefGoogle Scholar
  22. Ndlovu N, Nelson G, Vorajee N, Murray J (2016) 38 years of autopsy findings in South African mine workers. Am J Ind Med 59:307–314.  https://doi.org/10.1002/ajim.22574 CrossRefGoogle Scholar
  23. Nelson G, Girdler-Brown B, Ndlovu N, Murray J (2010) Three decades of silicosis: disease trends at autopsy in South African gold miners. Environ Health Perspect 118:421–426.  https://doi.org/10.1289/ehp.0900918 CrossRefGoogle Scholar
  24. NIOH (2015) National Health Laboratory Services Annula Report—2013–2014. National Institute of Occupational Health, South Africa. http://www.nioh.ac.za/assets/files/NIOH_ANNUAL_REVIEW_2013-2014.pdf
  25. Ramos LMM, Sulmonett N, Ferreira CS et al (2006) Functional profile of patients with tuberculosis sequelae in a university hospital. J Bras Pneumol 32:43–47.  https://doi.org/10.1590/S1806-37132006000100010 CrossRefGoogle Scholar
  26. Reddy P, Zuma K, Shisana O et al (2015) Prevalence of tobacco use among adults in South Africa: results from the first South African National Health and Nutrition Examination Survey. S Afr Med J 105:648–655CrossRefGoogle Scholar
  27. Rees D, Murray J, Nelson G, Sonnenberg P (2010) Oscillating migration and the epidemics of silicosis, tuberculosis, and HIV infection in South African gold miners. Am J Ind Med 53:398–404.  https://doi.org/10.1002/ajim.20716 CrossRefGoogle Scholar
  28. Ross MH, Murray J (2004) Occupational respiratory disease in mining. Occup Med 54:304–310.  https://doi.org/10.1093/occmed/kqh073 CrossRefGoogle Scholar
  29. RSA (1973) Occupational disease in mines and works act. Government Printer, PretoriaGoogle Scholar
  30. Stuckler D, Steele S, Lurie M, Basu S (2013) ‘Dying for gold’: the effects of mineral mining on HIV, tuberculosis, silicosis and occupational diseases in southern Africa. Int J Health Serv Plan Adm Eval 43:639–649CrossRefGoogle Scholar
  31. van Walbeek C (2002) Recent trends in smoking prevalence in South Africa–some evidence from AMPS data. S Afr Med J 92:468–472Google Scholar
  32. World Health Organization (2015) WHO global report on trends in prevalence of tobacco smoking 2015, pp 297–298. http://apps.who.int/iris/bitstream/handle/10665/156262/9789241564922_eng.pdf;jsessionid=69D601358FE4DB085A0AA4368D041298?sequence=1
  33. Zay K, Loo S, Xie C et al (1999) Role of neutrophils and alpha1-antitrypsin in coal- and silica-induced connective tissue breakdown. Am J Physiol 276:L269–L279Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Environmental and Occupational Health Sciences, School of Public HealthUniversity of Illinois at ChicagoChicagoUSA
  2. 2.National Institute of Occupational HealthJohannesburgSouth Africa
  3. 3.School of Public HealthUniversity of WitwatersrandJohannesburgSouth Africa
  4. 4.School of PathologyUniversity of WitwatersrandJohannesburgSouth Africa

Personalised recommendations