Risk of Active Pulmonary Tuberculosis among Patients with Coal Workers'Pneumoconiosis:A Case-control Study in China

The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis（PTB） among coal workers＇ pneumoconiosis（CWP） patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.

Association oftransforming growth factor-β1 gene variants with risk of coal workers'pneumoconiosis

Objective： The aim of this case-control study was to explore whether five tagging single nucleotide poly- morphisms （tSNPs） within the transforming growth factor-ill （TGF-fll） gene were involved in manifestation of inflammatory and fibrotic processes associated with coal workers pneumoconiosis （CWP）. Methods： The study included 508 CWP patients and 526 controls who were underground coal miners from Xuzhou Mining Business Group. Five tSNPs were selected from the HapMap and detected by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） method. Results： The single SNP analysis showed that the genotype frequencies of SNP2 （rs1800470, ＋869T/C, extron 1） and SNP5 （rs11466345, intron 5） in CWP cases were significantly different from those in controls. Multivariate logistic regression analysis revealed that SNP2 （rs1800470） CC genotype was associated with decreased risk of CWP （OR = 0.50, 95% CI = 0.32-0.78）, which was evident among subgroups of those never smoke （OR = 0.40, 95%CI = 0.24-0.66）, cases with stage Ⅱ（OR = 0.41, 95%CI = 0.22-0.76） and exposure period （〈 28 y： OR = 0.54, 95%CI = 0.31-0.95; ≥ 28 y： OR = 0.52, 95%CI = 0.32-0.96）. However, the SNP5 （rs11466345） GG genotype was associated with an increased risk of CWP （OR = 2.5, 95%CI = 1.36-4.57）, and further stratification analysis showed that the risk of CWP was increased in both smoking and nonsmoking groups, shorter and longer exposure groups, while the risk of CWP was only increased in patients with stage I and Ⅱ. Conclusion： This study suggests that TGF-β1 polymorphisms may contribute to susceptibility of CWP.

An analysis of contributing mining factors in coal workers’pneumoconiosis prevalence in the United States coal mines,1986-2018

In the United States,an unexpected and severe increase in coal miners’lung diseases in the late 1990s prompted researchers to investigate the causes of the disease resurgence.This study aims to scrutinize the effects of various mining parameters,including coal rank,mine size,mine operation type,coal seam height,and geographical location on the prevalence of coal worker’s pneumoconiosis(CWP)in surface and underground coal mines.A comprehensive dataset was created using the U.S.Mine Safety and Health Administration(MSHA)Employment and Accident/Injury databases.The information was merged based on the mine ID by utilizing SQL data management software.A total number of 123,589 mine-year observations were included in the statistical analysis.Generalized Estimating Equation(GEE)model was used to conduct a statistical analysis on a total of 29,707,and 32,643 mine-year observations for underground and surface coal mines,respectively.The results of the econometrics approach revealed that coal workers in underground coal mines are at a greater risk of CWP comparing to those of surface coal operations.Furthermore,underground coal mines in the Appalachia and Interior regions are at a higher risk of CWP prevalence than the Western region.Surface coal mines in the Appalachian coal region are more likely to CWP development than miners in the Western region.The analysis also indicated that coal workers working in smaller mines are more vulnerable to CWP than those in large mine sizes.Furthermore,coal workers in thin-seam underground mine operations are more likely to develop CWP.

Association of TNF-α-238G/A and 308 G/A Gene Polymorphisms with Pulmonary Tuberculosis among Patients with Coal Worker’s Pneumoconiosis

Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α gene polymorphism with pulmonary tuberculosis （TB） among patients with coal worker＇s pneumoconiosis （CWP）. Methods A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-α gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism （PCR-RFLP）. Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher＇s exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplieative model with combined OR. All data were analyzed using SAS version 8.2 software. Results No significant difference in frequency of the TNF-α-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls （2,2=5.44, P=-0.07）. But difference in frequency of the TNF-α-308 A allele was identified between them （2,2-5.14, P=0.02）. No significant difference in frequencies of the TNF-α-238 genotype and allele （P=0.23 and P=0.09, respectively） was found between cases and controls either, with combined （GG and AA） OR of 3.96 （95% confidence interval of 1.30-12.09） at the -308 locus of the TNF-α gene, as compared to combination of the TNF-α-238 GG and TNF-α-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-α-238 GG and TNF-α-308 GA genotypes was 1.98 （95% CI of 1.06-3.71） for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-a-308 GG genotype and body mass index （OR=4.92）, as well as an interaction between the TNF-α-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-α-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated. Conclusions TNF-α-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-α-238 A allele was otherwise.

Application of a light-weighted convolutional neural network for automatic recognition of coal workers'pneumoconiosis in the early stage

Objective To construct and verify a light-weighted convolutional neural network(CNN),and explore its application value for screening the early stage(subcategory 0/1 and stage Ⅰ of pneumoconiosis) of coal workers’ pneumoconiosis(CWP) from digital chest radiography(DR).Methods A total of 1 225 DR images of coal workers who were examined at an Occupational Disease Prevention and Control Institute in Anhui Province from October 2018 to March 2021 were retrospectively collected.All DR images were collectively diagnosed by3 radiologists with diagnostic qualifications and diagnostic results were given.There were 692 DR images with small opacity profusion 0/-or 0/0 and 533 DR images with small opacity profusion 0/1 to stage Ⅲ of pneumoconiosis.

A systematic review of occupational exposure to respirable coal mine dust(RCMD)in the U.S.mining industry

Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.

我国非煤矿山职业健康防控技术研究现状、挑战及展望

矿业是现代工业的粮食,在国民经济发展中发挥着不可替代的作用,但采矿过程伴随众多职业危害因素,给工人职业健康与安全造成极大影响。采用文献查阅、现场调研、访谈交流等方法,并基于团队已有研究积累,对新中国成立以来我国非煤矿山职业健康防控技术研究现状进行了综述,并分析了当前面临的主要挑战。结果表明:我国非煤矿山职业危害主要涉及粉尘、噪声、高温等7类因素,存在“点多、面广、源强”的显著特点,防治难度大;在7类职业危害因素中,粉尘危害最为突出,且爆破粉尘、强疏水性微细粉尘、井下喷浆粉尘与高寒、低气压、超大规模开采粉尘防治是目前面临的主要挑战。在上述分析的基础上,指出我国非煤矿山职业健康防护技术未来发展方向为健全非煤矿山职业危害监管体系、强化职业危害控制科技创新与实践、推行职业危害防控专业化社会服务、坚持职业危害个性化与综合防治、探索职业危害智能化防治技术,逐步形成以监管落实为驱动、科技创新为抓手、社会服务为目标的科学发展模式,切实提高非煤矿山职业危害因素防治效果,保障工人职业健康与安全。

基于转录组测序的煤工尘肺大鼠模型中线粒体相关差异基因筛选及分析

目的应用高通量转录组测序技术,对煤工尘肺大鼠模型中线粒体相关差异基因进行筛选及分析。方法选取无特定病原体(SPF)级SD雄性大鼠30只,根据随机数表法分为对照组、煤尘组、矽尘组,每组10只,采用一次性非暴露式气管内灌注法造模,并常规饲养90 d。取肺组织制作病理标本,观察其病理改变,采用Masson染色观察其纤维化情况,免疫组化检测肺组织的胶原蛋白Ⅰ(COL-Ⅰ)表达情况来确定造模情况。利用转录组测序技术对样本间基因进行差异表达分析,筛选出差异表达基因,然后对差异基因进行GO和KEGG生物信息学分析,进一步筛选出大鼠煤工尘肺模型中与线粒体有关的差异基因,并进行生物信息学分析。结果HE、Masson染色及免疫组化结果显示,煤尘组与矽尘组中COL-Ⅰ表达量增高。对对照组与煤尘组的差异基因进行筛选,其中与线粒体有关的基因一共35个(上调28个和下调7个)。对对照组与矽尘组的差异基因进行筛选,其中与线粒体有关的基因一共302个(上调202个和下调100个)。通过GO富集分析发现,在生物过程中,细胞过程、单一的有机体过程较为重要;在分子功能中,以活动分子传感器、催化活性为主;在细胞组分中,以细胞部分、细胞为主。对照组与矽尘组中与线粒体相关的差异基因通过KEGG显著富集到前20条通路中,氧化磷酸化、产热、帕金森综合征、朊病毒病等通路富集到的基因最多。结论通过转录组高通量测序,筛选分析了煤工尘肺大鼠模型中线粒体相关差异基因,以期为后续探索煤工尘肺与线粒体的关系提供依据。

煤工尘肺合并慢性阻塞性肺疾病再次急性加重的临床分析

目的探讨煤工尘肺合并慢性阻塞性肺疾病患者出院1年再次急性加重的影响因素。方法回顾分析我院确诊为煤工尘肺合并慢阻肺的患者,在出院时进行基本情况调查、在出院后12个月调查其急性加重情况。并根据其是否急性加重分为对照组及急性加重组,并分析两组间差异。结果共入选220例患者,随访12个月82例患者出现急性加重;随访12个月与煤工尘肺合并慢阻肺急性加重相关的因素有:年龄、病程、过去1年是否出现频繁急性加重、生存质量评分(CAT)、FVC及FEV_(1)、咳嗽、咳痰评分(P<0.05);过去1年出现频发急性加重(OR=3.932,95 CI:1.931~8.008)、病程≥10年(OR=1.589,95 CI:1.367~1.946)、CAT积分≥10分(OR=1.004,95 CI:1.001~1.007)以及低FVC值(OR=0.626,95 CI:0.398~0.985)是煤工尘肺合并慢阻肺急性加重的影响因素(P<0.05)。结论临床中若能够早识别影响煤工尘肺合并慢阻肺再次急性加重的因素并重视这些因素,有望能够减少煤工尘肺合并慢阻肺急性加重的发生,改善患者预后。

煤工尘肺患者的结核潜伏感染风险及危险因素分析

目的:分析煤工尘肺结核潜伏感染风险及危险因素。方法:选取2020年1月至2023年7月赣州市第五人民医院救治的煤工尘肺患者80例,采用X线胸片和干扰素释放试验(QuantiFERON-TB GOLD,QFT)筛查结核潜伏感染情况,通过病历档案收集患者临床资料,采用Logistic回归模型分析此类患者结核潜伏感染的危险因素。结果:80例煤工尘肺患者结核潜伏感染率为63.75%,划作结核潜伏感染组、无结核潜伏感染组分别有51例和29例。两组在工种、工作场所通风情况和吸烟频率的比较差异有统计学意义(P<0.05);但在年龄、文化程度、婚姻状况等其他资料比较,差异无统计学意义。Logistic回归模型结果显示,混合工种、工作场所通风情况差是煤工尘肺结核潜伏感染的独立危险因素(P<0.05)。结论:煤工尘肺结核潜伏感染风险较高,混合工种、工作场所通风情况差是煤工尘肺结核潜伏感染的独立危险因素,应加强煤工尘肺患者结核预防意识,降低感染风险。

煤矿事故应急状态下井下作业人员行为反应影响因素分析

煤矿事故应急状态是煤矿事故即将发生或已经发生初步事故的突发紧急状况,此时煤矿井下作业人员能否及时察觉异常状况、提前做好准备、从容应对突发情况,对降低煤矿事故损失非常关键。主要研究了煤矿事故应急状态下人的行为反应影响因素,通过模糊德尔菲法(FDM)对井下作业人员应急状态下人的行为反应影响因素进行筛选,并结合模糊决策与评价试验(Fuzzy-DEMATEL)和解释结构模型(ISM)对人的行为反应影响因素进行系统的分析与讨论。结果表明,情绪类型、个性、应急知识、群体行为4个因素是决定人在应急状态下表现的关键因素,未来对工人应加强在该方面的培养。研究煤矿事故应急状态下人的行为反应影响因素可为提升煤矿生产安全、增强工人应急行为能力提供理论和实践基础。

用智能化技术优化煤矿作业流程及安全管理

随着科技的发展,智能化技术越来越多地应用于煤矿作业中,为提高煤矿作业效率和保障工人安全提供了新的途径。分析当前煤矿作业的现状,指出煤矿作业的特点以及存在的效率和安全问题,概述智能化技术在煤矿作业中的应用情况。在此基础上,提出应用智能化技术提升煤矿作业效率的策略,包括采集与分析煤矿作业数据、应用机器学习优化作业流程、使用智能站控进行煤矿作业等;提出应用智能化技术提升煤矿工人安全的策略,包括智能监测工人健康与安全状况、利用AI技术进行危险预测与预防、提升应急响应能力等。通过对煤矿作业智能化的深入分析,为煤矿生产的安全高效提供新的解决方案。

煤工尘肺中医证候与理化检查指标的关系

目的探讨煤工尘肺中医证候与理化检查指标的关系。方法2017年1月至2020年12月,收集在北京中医药大学房山医院就诊的208例煤工尘肺患者中医四诊信息以及血常规、血气检查结果。统计分析中医证候与血常规、血气分析的关系。结果出现频率>1%的中医证候有15个,以肺气虚证为主。中医证候在血小板计数(PLT)、氧分压(PaO_(2))比较,差异有统计学意义(P<0.05)。PLT是风寒犯肺证的独立危险因素,PLT越高,风寒犯肺证可能性越小(P<0.05,OR<1)。PaO_(2)是血瘀证、痰湿阻肺证独立危险因素,PaO_(2)越高,血瘀证可能性越大(P<0.05,OR>1),痰湿阻肺的可能性越小(P<0.05,OR<1)。结论煤工尘肺患者中医证候以肺气虚证为主,PLT、PaO_(2)可作为中医证候分型参考标准。

近代开滦煤矿工人生存状况探析

开滦煤矿是洋务运动中较早开办的民用企业,吸纳了大量失业农民、手工业者等社会底层群体,是近代中国工人阶级的重要集聚地。近代开滦煤矿井下劳动环境恶劣,工伤事故频发;工人食宿条件差,常常入不敷出;挣扎在生存边缘的矿工,往往通过祭拜神灵、信奉天主教寻求精神寄托。在中国共产党的宣传动员下,开滦煤矿工人的革命意识与阶级觉悟逐渐增强,其精神归属亦突破个人范畴,开始与国家前途、民族命运交织在一起,逐渐发展成为中国北方无产阶级的重要力量。

《女工绘》:爱的艺术与记忆的表征

刘庆邦的长篇小说《女工绘》是一部关于女性矿工群体的记忆文本,其创作源于作者不能忘却的煤矿生活记忆和对女性矿工群体的爱。小说在对煤矿日常生活的再现中,表征出作者对煤矿工业生活的记忆和爱恋;在展现华春堂形象的过程中,再现了青春记忆中的爱情之美;同时在日常生活叙事中,揭示被遮蔽的创伤记忆,表现出对青春之美的惋惜和对命运的感叹。小说蕴含多重爱的记忆和深层的历史意识,在政治世界与日常生活世界之间的张力空间中,彰显生命与存在的真实。

淮北市煤矿2019—2020年重点职业病危害调查与分析

为了解淮北市内煤矿主要职业病危害情况,2019—2020年,采用整群随机抽样方法选择淮北市全部16家煤矿对调查对象,对主要岗位的呼吸性粉尘、噪声进行监测,并职业病发病情况进行调查。结果表明:淮北市煤矿主要职业病危害仍为粉尘、噪声;呼尘岗位超标率为51.88%,噪声岗位超标率为34.7%,采煤工接触的呼吸性粉尘浓度高于掘进工、辅助工,掘进工暴露噪声强度高于采煤工、辅助工;针对煤矿工人职业健康检查工作开展较好,但接触噪声工人体检率(34.49%)较低;新发尘肺病患者为采煤工、掘进工等;不同工种中新发尘肺病人的接尘工龄、发病潜伏期不同,应进一步加强针对采煤、掘进岗位的粉尘、噪声危害的治理。

CT双期增强扫描对煤工尘肺进行性大块纤维化的诊断价值

目的探讨CT双期增强扫描对煤工尘肺进行性大块纤维化(PMF)的诊断价值。方法对45位煤工尘肺患者的86个PMF行CT平扫及血管期、实质期双期增强扫描,根据平扫PMF影像表现分为均质组、钙化组、坏死组、空洞组、钙化并坏死组5组,测量其增强前后各期扫描的CT值,计算并分析血管期、实质期强化绝对值(强化后CT值-平扫CT值),总结PMF CT影像表现及双期增强扫描强化特点。结果PMF影像表现以团块状大阴影为主,密度较高(73.7±9.49Hu),容易钙化,增强扫描均质组、钙化组及所有病例PMF血管期、实质期强化绝对值有统计学意义,所有病例血管期强化幅度为(5.27±4.24 Hu),实质期强化幅度为(12.04±5.91 Hu);均质组血管期强化幅度为(5.81±4.29),实质期强化幅度为(12.36±5.33 Hu);钙化组血管期强化幅度为(4.92±4.28 Hu),实质期强化幅度为(11.50±6.59Hu)。结论CT双期增强扫描对PMF的诊断及鉴别诊断具有一定价值。

厚朴麻黄汤加减治疗煤工尘肺合并急性感染的临床观察

目的观察厚朴麻黄汤加减联合常规抗感染治疗煤工尘肺合并急性感染的临床疗效。方法将68例尘肺患者随机分为两组。两组均给予常规抗感染治疗,治疗组加用厚朴麻黄汤加减。观察两组临床综合疗效及治疗前后中医证候评分、肺功能指标、炎症指标。结果治疗组临床总有效率明显高于对照组(P<0.05);两组治疗后中医证候评分、肺功能指标[第1秒用力呼气量(FEV1)、用力肺活量(FVC)、第1秒用力呼气量/用力肺活量(FEV1/FVC)]、炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)]均明显优于治疗前(P<0.05),治疗组上述指标均优于对照组(P<0.05)。结论在常规抗感染治疗基础上联合应用厚朴麻黄汤加减可明显改善煤工尘肺合并急性感染患者的临床证候、肺功能指标及炎症指标,疗效确切。

基于数据挖掘的尘肺病农民工健康信念影响因素研究

为提升尘肺病农民工的生存质量,明晰其健康信念的影响因素及生成机制,基于扎根理论方法,对115名受访者访谈资料和20篇文献进行整理分析,并进行开放式编码、主轴编码和选择性编码,构建尘肺病农民工健康信念影响机制理论模型,同时基于关联规则,对初始范畴进行数据挖掘分析。研究结果表明:尘肺病农民工健康信念影响机制遵循“组织情境刺激—健康信念感知—健康信念—健康信念调控”的逻辑过程,即尘肺病农民工在组织情境刺激下,逐渐形成健康信念感知,进而引发健康情感,由健康情感驱动生成健康信念,同时进行信念调控,实现健康信念良性生成循环;同时得出以健康信念类别初始范畴为前项的7类强规则关联因素组合。研究结果可为尘肺病农民工健康干预实践提供理论参考。