Disclosures: The authors report no relevant financial disclosures.
June 23, 2020
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Pneumoconiosis deaths decreased 40% from 1999 to 2018

Disclosures: The authors report no relevant financial disclosures.
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Deaths related to preventable occupational lung diseases caused by inhaling dust particles such as coal dust and asbestos decreased by 40% from 1999 to 2018, according to a CDC analysis published in Morbidity and Mortality Weekly Report.

The new CDC data add to a previous study that examined pneumoconiosis mortality from 1969 to 2000 and reported a decrease in death trends for all pneumoconiosis types, except for an increase in asbestosis deaths.

Trends in pneumoconiosis mortality among U.S. decedents from 1999 to 2018

“Pneumoconiosis-associated deaths continue to occur, underscoring the importance of occupational dust exposure reduction and early case detection,” Jessica L. Bell-Johnson, MPH, Association of Schools and Programs of Public Health/CDC public health fellow, told Healio. “Medical surveillance can identify at-risk groups of workers, which can help prioritize efforts to reduce exposures.”

The CDC analyzed multiple cause-of-death data to examine trends in pneumoconiosis-associated mortality from 1999 to 2018. Decedents were identified using death certificates listing pneumoconiosis as the underlying or contributing cause of death.

Jessica L. Bell-Johnson
Jessica L. Bell-Johnson

From 1999 to 2018, 43,366 decedents, aged 15 years and older, had pneumoconiosis listed on their death certificates, and 40.5% had pneumoconiosis listed as the underlying cause of death. Among all pneumoconiosis decedents, 41% were aged 75 to 84 years, 96.3% were male, 94.6% were white and 97.6% were non-Hispanic.

Of all pneumoconiosis deaths, asbestosis was associated with 60.1% of deaths, followed by coal workers’ pneumoconiosis in 25.8% and unspecified pneumoconiosis in 7.9%.

The overall annual number of pneumoconiosis deaths decreased by 40.4% from 1999 to 2018. Bell-Johnson and colleagues reported a significant decline began from 2002 to 2018 (P < .05). Age-adjusted death rates decreased from 12.8 deaths per million in 1999 to 5.3 in 2018. However, pneumoconiosis deaths caused by inorganic dusts increased from 12 deaths in 1999 to 25 in 2018 (108.3%; P < .05).

The largest decreases during this period were for deaths associated with coal workers’ pneumoconiosis (69.6%), from 1,002 in 1999 to 305 in 2018, and deaths associated with silicosis (53%), from 185 in 1999 to 87 in 2018.

In other results, age-adjusted death rates varied by geographic location. The largest age-adjusted death rates from 1999 to 2018 were in West Virginia for coal workers’ pneumoconiosis (59.8 per million), Montana for asbestosis (20 per million), Vermont for silicosis (2.3 per million) and West Virginia for unspecified pneumoconiosis (24.1 per million).

The researchers analyzed industry and occupational data available from 6,223 (96.7%) of 6,436 pneumoconiosis-related deaths. The highest number of coal workers’ pneumoconiosis deaths occurred among those working in coal mining industries (74.2%) and among mining machine operators (65%). The highest number of asbestosis-related deaths occurred among those working in construction (25%) and among pipe layers, plumbers, pipefitters and steamfitters (8%). The highest number of silicosis-related deaths occurred among those working in construction (18.9%) and mining machine operators (12.3%).

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“The decrease [in pneumoconiosis deaths in this study] likely reflects the impacts over the past several decades of prevention strategies and also less people in the U.S. working in jobs with heavy exposure to mineral or cotton dust,” Bell-Johnson said. “Despite the decline, it is important to recognize that pneumoconiosis-associated deaths do not typically occur until many decades after exposures to causative dust. More recent outbreaks of pneumoconiosis, such as in coal miners or artificial stone countertop workers, are not reflected in mortality data.”

According to Bell-Johnson, further study and monitoring of pneumoconiosis trends over time focusing on attributable to inorganic dusts are needed.

For more information:

Jessica L. Bell-Johnson, MPH, can be reached at onm0@cdc.gov.