Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Terry Bunn, PhD

Committee Member

Svetla Slavova, PhD

Committee Member

David Mannino, MD



Background: Despite ongoing surveillance efforts, mortality rates associated with total pneumoconiosis, and particularly coal worker’s pneumoconiosis, have remained elevated. Methods: Kentucky death certificate data from 2003-2011 was statistically compared to other coal mining states and descriptively analyzed from 2011-2013 to determine the mortality burden and public health implications of pneumoconiosis and coal worker pneumoconiosis (CWP) on Kentucky residents from 2003-2013. Results: Kentucky’s total pneumoconiosis and coal workers’ pneumoconiosis mortality rates decreased from 2003-2009, then increased in following years, showing a significant quadratic trend from 2003-2013 (p<.05) compared to West Virginia, Pennsylvania, and the overall United States rates that had significant negative linear trends from 2003-2011(p<.05). Deaths from pneumoconiosis primarily occurred in white males from CWP in the Appalachian region. Individuals diagnosed with pneumoconiosis died from respiratory illness 50% of the time, heart-related problems (23%) and cancer (12%). Autopsies were only performed on 12% of decedents over the three year study period and the primary locations of death were in hospital (47%) and at home (36%). Conclusions: Increased coal mining industry worker environmental exposure protection should be enhanced in Kentucky. Additionally, healthcare efforts should focus on increasing patient education to ensure early detection and treatment for individuals suffering from pneumoconiosis as well as for comorbid conditions such as Chronic Obstructive Pulmonary Disease. To further target healthcare and treatment of pneumoconiosis patients, increased autopsies of individuals with pneumoconiosis should be performed to identify involvement of other conditions such as silicosis and optimize pneumoconiosis fatality surveillance.

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