Presence and HRCT quantification of bronchiectasis in coal workers

Abstract

Purpose: The purpose of this study was to evaluate the presence of bronchiectasis in coal workers with or without coal worker pneumoconiosis (CWP) and to assess the extent of bronchiectasis, severity of bronchial wall dilatation and thickening by high resolution computed tomography (HRCT). Materials and methods: The retrospective study consisted of HRCT archieves of 93 coal workers. The coal workers with previous diagnosis of COPD (six), asthma (one) and tuberculosis (three) were excluded. Five coal workers with progressive massive fibrosis were not included into the study. The resulting patient group consisted of 78 patients (43 CWP; 35 non-CWP). Pneumoconiosis profusions of CWP workers were between p0/1 and p2/2 according to ILO 1980 chest X-ray classification. HRCT examinations of all subjects were evaluated for the presence, extent, dilatation and thickness of bronchiectasis. Analysis of extent, dilatation and thickness were performed according to established criteria. Results: The diagnosis of bronchiectasis was put on 19 of 43 CWP (44.1%) and 7 of 35 non-CWP workers (20.0%). There were statistically significant differences between bronchiectasis positive and negative coal workers with CWP concerning age and exposure duration (P = 0.012 and 0.009, respectively). Then, multiple logistic regression analysis was performed to define exact risk factors. Exposure duration was only found to be related with presence of bronchiectasis [(odds ratio) OR = 1.494, 95% confidence interval 1.168–1.912]. Conclusions: The data from the present study shows that bronchiectasis is frequent and severe in CWP workers than without. Bronchiectasis is influenced by coal dust exposure. Thus, coal dust protection measures must be controlled efficiently to prevent bronchiectasis in coal workers.

Introduction

Bronchiectasis is a chronic bronchial disease, and has a significant impact on health care worldwide. There are many diseases associated with bronchiectasis. Personal and environmental factors such as cigarette smoking, air pollution and insufficient immunization for pertusis, measles in childhood period may also lead to bronchiectasis. Traction bronchiectasis associated with pulmonary fibrosis is one of the disease entities that can cause bronchiectasis [1], [2].

Coal workers’ pneumoconiosis (CWP) is the parenchymal lung disease that results from the inhalation and deposition of coal mine dust. It is an inflammatory disease and characterized by round-nodular and irregular lesions (pulmonary fibrosis) [3].

To best our knowledge, in the literature, there is no study to show presence and frequency of bronchiectasis in coal workers. So the purpose of this study, therefore, was to evaluate the presence of bronchiectasis in coal workers with CWP and non-CWP and to assess extent of bronchiectasis, severity of bronchial wall dilatation and thickening by high-resolution CT (HRCT).