Respiratory Symptoms in Working Miners are not explained by Airway Hyperreactivity

In certain populations, nonspecific airway hyperreactivity (HR) is associated with increased respiratory symptoms and decreased lung function. We analyzed standardized pulmonary symptom questionnaires and pre-shift spirometry with methacholine inhalation challenge (Chatham, M. et al, Chest 82: 15) on 228 control workers (C) with no known exposure to occupational hazards, and 200 underground bituminous coal miners (M). M and c were similar in age, height, sex, and smoking status. HR (defined as >15% fall in FEVI after up to 5 vital capacity breaths of 25mg% methacholine) was found in 25% of M and 28% of C (NS). M showed higher% predicted FEVI (%PFEV) than c (M 107%, C 104%*). 28% of current smokers showed HR versus 22% of never smokers (NS). Current smokers showed reduced %PFEV but were not different from lifelong non-smokers regarding prevalence of HR. Subjects with HR showed reduced %PFEV, (HR 101%, not HR 107%*) but M and c with HR showed similar reductions. M had more dyspnea and chronic cough than c*. Hyperreactivity was associated with increased symptoms in controls but not miners. In our study, the prevalence of HR in coal miners was similar to nonminers, and did not explain miners' respiratory symptoms. * P < 0.05