Jessica Bell-Johnson, a graduate of the University of Memphis School of Public Health and a current Public Health Fellow at the Center for Disease Control and Prevention (CDC), recently published an article in the Morbidity and Mortality Weekly Report (MMWR) titled Trends in Pneumoconiosis Deaths — United States, 1999–2018. During the first year of her ASPPH/CDC fellowship, Bell-Johnson was located at the CDC’s National Institute for Occupational Safety and Health (NIOSH) in Morgantown, West Virginia. Working as a fellow in the Surveillance Branch within the Respiratory Health Division, Jessica focused her research on occupational lung diseases.
Pneumoconioses are a group of preventable occupational lung diseases caused by inhaling mineral dust particles. Examples of diseases within this classification include asbestosis, coal workers’ pneumoconiosis (also known as Black Lung), silicosis, and siderosis. A previous CDC report analyzed death trends of pneumoconioses from the years 1968 to 2000 and concluded that deaths associated with pneumoconioses decreased with the exception of asbestosis. Bell-Johnson’s article served as an update on pneumoconioses death trends, analyzing the years 1999–2018.
To assess recent deaths associated with pneumoconioses, Jessica analyzed multiple cause-of-death data for persons aged 15 years old or older for the years 1999–2018, as well as the industry and occupation data collected from 26 states for the years 1999, 2003, 2004, and 2007–2013. During the period, a total of 43,366 persons aged 15 years old or older had pneumoconiosis listed on their death certificates, including 17,578 (40.5%) for whom pneumoconiosis was listed as the underlying cause of death. Asbestosis was associated with the largest amounts of deaths (26,059; 60.1%), followed by coal workers’ pneumoconiosis (11,203; 25.8%), and unspecified pneumoconiosis (3,409; 7.9%). The demographic breakdowns of those who died from the disease are as follows: 17,797 (41.0%) were aged 75–84 years old, 41,777 (96.3%) were male, 41,029 (94.6%) were white, and 42,339 (97.6%) were non-Hispanic. Industries most affected by pneumoconioses were coal mining and construction, and the occupations mostly affected by pneumoconioses were mining machine operators, pipe layers, pipefitters, and steamfitters.
Analysis of death trends from 1999–2018 expressed that deaths decreased for all pneumoconioses types except for those attributed to other inorganic dusts, which increased (108.3%; p-value for time trend: p<0.05). The largest decreases over the time period were deaths associated with CWP (69.9%; p<0.05) and silicosis (53.0%; p<0.05). Age-adjusted death rates varied across geographic location for each pneumoconiosis type. The highest rates for CWP were in West Virginia, asbestosis was in Montana, and unspecified pneumoconiosis was also in West Virginia.
Although overall deaths associated with pneumoconioses continue to decrease and regulations have updated addressing occupational exposures to dangerous dusts, deaths still occur, thus highlighting the importance of maintaining exposure prevention measures and continued surveillance.