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Prevalence of Reduced Mid-Expiratory Flow Among Coal Workers' Health Surveillance Program Participants
Laura Kurth1, Noemi B Hall1, Brian Ansell1
1Centers for Disease Control and Prevention, Surveillance Branch, Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
American Journal of Industrial Medicine
|September 1, 2025
Summary
Reduced mid-expiratory flow is common in coal miners without obstructive lung disease, especially retired miners. This finding highlights its potential as an early indicator of serious respiratory issues in this population.
Area of Science:
- Occupational Health
- Pulmonary Medicine
- Respiratory Epidemiology
Background:
- Small airways disease is a known risk factor for obstructive lung disease.
- Coal miners may have small airways disease even without current obstructive impairment.
- This study investigates the prevalence of reduced mid-expiratory flow in coal miners without obstructive ventilatory impairment.
Purpose of the Study:
- To estimate the prevalence of reduced spirometric mid-expiratory flow (FEF25%-75% < 65% predicted) among coal miners without obstructive ventilatory impairment.
- To identify risk factors associated with reduced mid-expiratory flow in this population.
Main Methods:
- Utilized data from the Coal Workers' Health Surveillance Program (CWHSP) between 2014-2022.
- Included coal miners with spirometry (FEV1, FVC) meeting quality criteria.
- Defined reduced mid-expiratory flow as FEF25%-75% < 65% predicted.
Main Results:
- Overall prevalence of reduced mid-expiratory flow was 7.1% among miners without obstructive impairment.
- Prevalence was higher in retired miners (10.7%) and those with coal workers' pneumoconiosis (CWP) (16.8%).
- Reduced flow was more common in older miners with longer tenure.
Conclusions:
- Reduced mid-expiratory flow is a significant finding in coal miners without current obstructive impairment.
- It serves as a potential early warning sign for developing obstructive lung disease and other serious respiratory conditions.
- Surveillance for reduced mid-expiratory flow can aid in early detection and intervention for coal miners' respiratory health.
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