posted on 2024-08-01, 00:00authored byAlissa Marie Devaughn
RATIONALE The prevalence of progressive massive fibrosis, as well as significant lung function impairment, has increased dramatically among U.S. coal miners particularly in Central Appalachia. Most research on coal miners has focused on physical health with little attention to mental health, despite biological, behavioral, and social factors that increase the risk for chronic lung and cardiovascular diseases in the industry. This study evaluated the prevalence of and associations between antidepressant and/or anxiolytic medication usage and indices of physical health.
METHODS Records of demographic, occupational, and clinical data of coal miners was examined from a West Virginia clinic between 2004-2015. The prevalence of depression/anxiety, defined as current use of antidepressant and/or anxiolytic medications was calculated. The International Labour Office chest radiograph classification of pneumoconiosis and pre-bronchodilator FEV1 percent predicted (pp) using NHANES III reference equations was recorded. The relationship between lung function impairment and radiographic severity of coal workers’ pneumoconiosis (CWP) was examined with anxiety and depression through multivariable logistic models.
RESULTS This population of miners (n = 3,207) was overwhelmingly male (>99%) and non-Hispanic white (>98%). Mean age was 62 years with mean coal mine employment of 27 years. Thirty-three percent were taking antidepressant and/or anxiolytic medications and 39% reported current prescription opioid use. Multivariable logistic modeling demonstrated a significant inverse relationship between DLCO percent predicted (pp) and use of antidepressant and/or anxiolytic medication (OR per 10-unit decrease in DLCO pp 1.07, 95% CI 1.03 – 1.11), controlling for age, pack years of cigarette smoking, length of coal mine employment, opioid use, PTSD history, hypertension and cardiovascular disease. PTSD use was the strongest predictor of use of antidepressant and/or anxiolytic medication (OR 4.67, 95% CI 2.99 - 7.44).
CONCLUSIONS Multiple consistent relationships were found between indicators of physical health and depression and/or anxiety medication usage. Impaired diffusion capacity of the lungs, chronic pain as indicated by reported prescribed opioid use, hypertension, cardiovascular disease, and PTSD were all significantly associated with increased odds of taking antidepressants and/or anxiolytic medications in this population.
History
Advisor
Almberg, Kirsten Staggs
Department
Public Health Sciences-Environmental and Occupational Health Sciences