Chronic obstructive pulmonary disease in Welsh slate miners

<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Exposure to respirable crystalline silica (RCS) causes emphysema, airflow limitation and chronic obstructive pulmonary disease (COPD). Slate miners are exposed to slate dust containing RCS but their COPD risk has not previously been studied.<div class="boxTitle">Aims</div>To study the cumulative effect of mining on lung function and risk of COPD in a cohort of Welsh slate miners and whether these were independent of smoking and pneumoconiosis.<div class="boxTitle">Methods</div>The study was based on a secondary analysis of Medical Research Council (MRC) survey data. COPD was defined as forced expiratory volume in 1 s/forced vital capacity (FEV₁/FVC) ratio <0.7. We created multivariable models to assess the association between mining and lung function after adjusting for age and smoking status. We used linear regression models for FEV₁ and FVC and logistic regression for COPD.<div class="boxTitle">Results</div>In the original MRC study, 1255 men participated (726 slate miners, 529 unexposed non-miners). COPD was significantly more common in miners (<span style="font-style:italic;">n</span> = 213, 33%) than non-miners (<span style="font-style:italic;">n</span> = 120, 26%), <span style="font-style:italic;">P</span> < 0.05. There was no statistically significant difference in risk of COPD between miners and non-miners when analysis was limited to non-smokers or those without radiographic evidence of pneumoconiosis. After adjustment for smoking, slate mining was associated with a reduction in %predicted FEV₁ [β coefficient = −3.97, 95% confidence interval (CI) −6.65, −1.29] and FVC (β coefficient = −2.32, 95% CI −4.31, −0.33) and increased risk of COPD (odds ratio: 1.38, 95% CI 1.06, 1.81).<div class="boxTitle">Conclusions</div>Slate mining may reduce lung function and increase the incidence of COPD independently of smoking and pneumoconiosis.</span>

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