CHEST Guidelines-Lung-Transplantation-in-Coal-Workers-Pneumoconiosi

Lung-Transplantation-in-Coal-Workers-Pneumoconiosi

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This document outlines key findings related to lung transplantation in patients with coal workers’ pneumoconiosis (CWP), primarily among coal miners in the Appalachian region of the United States, which has seen an increase in the incidence of progressive massive fibrosis (PMF) among young miners. The data, drawn from a study at the University of Kentucky Transplant Center, focuses on eight coal miners who underwent lung transplants due to severe, life-threatening pneumoconiosis. The survival times for these patients varied, with some living up to 88 months post-transplantation, indicating outcomes comparable to other causes of lung transplantation. <br /><br />The letter highlights that while mortality and morbidity from CWP have decreased over the last 50 years, there has been a resurgence in diagnoses, especially among miners too young to have been exposed to pre-1969 federal safety standards. This situation emphasizes the urgent need for targeted interventions to reduce dust exposure and improve lung health among coal miners.<br /><br />The document further criticizes the mining industry's failure to control dust effectively, pointing out that PMF is entirely preventable with adequate measures. The authors advocate for increased awareness and prompt referral for lung transplant evaluations among younger miners afflicted with significant dust-related lung damage. <br /><br />Additionally, the document touches on unrelated findings regarding serum procalcitonin levels in asthma exacerbations, indicating that despite increased symptoms, patients with asthma did not show heightened procalcitonin levels, unlike those with pneumonia. <br /><br />In conclusion, the document stresses the necessity for more robust interventions to prevent excessive dust inhalation and advocates for lung transplantation as a viable option for miners severely affected by CWP, while underlining the importance of eliminating the disease through improved industrial practices.

Keywords

lung transplantation

coal workers’ pneumoconiosis

progressive massive fibrosis

Appalachian miners

dust exposure

University of Kentucky

mining industry

serum procalcitonin

asthma exacerbations

industrial practices