The incidence and prevalence of subjects awarded disability pensions and the prevalence of subjects receiving free medicines because of rheumatoid arthritis were studied in a Finnish cohort of 1026 granite workers hired between 1940 and 1971 and followed up until 31 December 1981. The incidence of awards of disability pensions because of rheumatoid arthritis during 1969-81, the prevalence of rheumatoid arthritis on 31 December 1981, and the prevalence of subjects receiving free medicines for rheumatoid arthritis at the end of 1981 were significantly higher among the granite workers than in the general male population of the same age. Retrospective analysis of the records of all patients with rheumatoid arthritis in the cohort showed a predominance of a severe, serologically positive and erosive form of rheumatoid arthritis, usually with an age at onset of 50 or over. The possible aetiological or pathophysiological role of granite dust in rheumatoid arthritis may be based on the effects of quartz on the immune system.
Cites: J Exp Med. 1966 Aug 1;124(2):141-544288309
Cites: Arthritis Rheum. 1962 Feb;5:10-813909330
Cites: Acta Med Scand. 1968 Nov;184(5):395-4024308036
Cites: Ann N Y Acad Sci. 1972 Dec 29;200:94-1054122427
Cites: Am J Med. 1973 Oct;55(3):515-244355171
Cites: Am Rev Respir Dis. 1974 Aug;110(2):115-254137927
Cites: Am Rev Respir Dis. 1976 Mar;113(3):393-51083176
Work related dust exposure is a risk factor for acute and chronic respiratory irritation and inflammation. Exposure to dust and cigarette smoke predisposes to exogenous viral and bacterial infections of the respiratory tract. Respiratory infection can also act as a risk factor in the development of atherosclerotic and coronary artery disease.
To investigate the association of dust exposure and respiratory diseases with ischaemic heart disease (IHD) and other cardiovascular diseases (CVDs).
The study comprised 6022 dust exposed (granite, foundry, cotton mill, iron foundry, metal product, and electrical) workers hired in 1940-76 and followed until the end of 1992. National mortality and morbidity registers and questionnaires were used. The statistical methods were person-year analysis and Cox regression.
Co-morbidity from cardiovascular and respiratory diseases ranged from 17% to 35%. In at least 60% of the co-morbidity cases a respiratory disease preceded a cardiovascular disease. Chronic bronchitis, pneumonia, and upper respiratory track infections predicted IHD in granite workers (rate ratio (RR) = 1.9; 95% CI 1.38 to 2.72), foundry workers (2.1; 1.48 to 2.93), and iron foundry workers (1.7; 1.16 to 2.35). Dust exposure was not a significant predictor of IHD or other CVD in any group. Dust exposure was related to respiratory morbidity. Thus, some respiratory diseases appeared to act as intermediate variables in the association of dust exposure with IHD.
Dust exposure had only a small direct effect on IHD and other CVD. IHD morbidity was associated with preceding respiratory morbidity. A chronic infectious respiratory tract disease appeared to play an independent role in the development of IHD.
Cites: Circulation. 1998 Feb 24;97(7):633-69495296
The objective of the present study was to investigate the mortality, disability, and long-term morbidity of granite workers. The study included 1,026 workers hired between 1940 and 1971 and followed until the end of 1981. The total number of deaths was 235, and the expected number was 229.7. Excess mortality rates were observed for respiratory diseases (observed/expected = 28/13.9). The number of tumor deaths was 46 (expected 44.9). Excess lung cancer mortality was evident at 15 to 35 years of latency; the observed number of lung cancer deaths for the follow-up period of 25 to 29 years was 8, while 2.1 were expected. Mortality from cardiovascular diseases and violent deaths was slightly less than expected. The results for disability and long-term morbidity showed elevated incidence and prevalence rates for respiratory diseases and rheumatoid arthritis. The observed number of disability pensions due to rheumatoid arthritis in 1981 was 10 observed versus 1.8 expected, and the observed number of patients granted free medication was 19 versus 8.1 expected. The results indicate that granite dust exposure per se may be an etiologic and pathogenetic factor for lung cancer, cancer of the gastrointestinal tract, and some extrapulmonary nonmalignant chronic diseases.
A retrospective cohort study was undertaken to investigate the cancer mortality of granite workers. The study comprised 1,026 workers hired between 1940 and 1971. The number of person-years was 20,165, and the number of deaths 235. During the total follow-up 46 tumors were observed and 44.9 were expected. An excess mortality from tumors was observed for the workers followed for 20 years or more, the greatest excess occurring during the follow-up period of 25-29 years (observed 11, expected 5.2). Of the 46 tumors, 22 were lung cancers (expected 17.1) and 15 were gastrointestinal cancers (expected 9.7), nine of which were cancers of the stomach (expected 6.0). Mortality from lung cancer was excessive for workers with at least 15 years since entry into granite work (latency) (21 observed and 9.5 expected), being highest during the follow-up period of 25-29 years (observed 8, expected 2.1). The results indicate that granite exposure per se may be an etiologic factor in the initiation or promotion of malignant neoplasms.
By means of epidemiological, clinico-functional, experimental, pathomorphological, histological and mathematical-statistical methods the authors showed that hard physical work under conditions of heating microclimate promoted quick development and advance of coronary heart disease in deeply working coal miners. Negative dynamics of sudden coronary death (SCD) rate was established, its pathophysiological mechanisms were specified. SCD risk factors were singled out and arranged accordingly to their importance. SCD in miners was suggested to be considered as professionally conditioned state.
For optimal treatment IHD complicated by ventricular extrasystoles (VE) in the course of ambulatory treatment with antiarrhythmic membrane-stabilizing drugs, the authors evaluated dosage, combinations of rhythmilen, ethacirine, ethmorin with allapinin and obtained a stable antiarrhythmic effect. The pathogenetic aspects of VE were considered.
The authors studied autopsy protocols, microscopic and histochemical data on the heart for miners who had died suddenly. No positive trend in the sudden coronary death incidence in miners was reported. A great number of sudden deaths were registered in mines. The deaths are attributed to severe atherosclerosis responsible for irreversible changes in the myocardium, coronary vascular spasms, emergence of pathological agitation triggering lethal ischemia.
The article is devoted to coronary disease in miners of deep Donbass mines. Data of its prevalence, chemical and functional features are given. Rapid progress of the disease was found to correlate with unfavourable factors of occupational environment. Mechanisms of dangerous heart rythm disorders formation during the work are shown. The main points of the programme improving the health care of miners suffering from coronary heart disease are described.
The article contains a study of 529 myocardial infarction cases in coal miners with provisional assessments of their health states after the rehabilitation course. Inadequacy of the resort treatment procedures was established, the clinico-functional examinations of the patients were irregular and limited to one or two procedures, which hampered the objective assessment of the measures taken. The drug treatment procedures were also inadequate both in respect of the patients' health conditions and with regard to specific drug prescriptions, dosages and frequency of administration. The results of the prolonged study revealed that 50% rehabilitation cases were unduly handled and returned to clinic with health complications after 6 months. The rehabilitation course did not include the psychotherapeutic rehabilitation component, which would be of paramount importance for the patients under the new health circumstances. Out-patient admission epicrises were not performed whatsoever, or were of a low quality, thus accounting for future rehabilitation failures.