High Blood Pressure and Obesity in Miners

Little is known about the cardiovascular risks for miners in the US as most research to date has focused on respiratory illness. Potential mining-related risk factors for cardiovascular disease such as particulate matter, carbon monoxide, noise, vibration, temperature extremes, and shift work combined with personal risk factors can put miners at greater risk of poor cardiovascular health.  In an effort to better understand miners’ risk, the National Institute for Occupational Safety and Health (NIOSH) examined blood pressure and obesity, both risk factors for cardiovascular disease, among 1,402 miners in 2015.  The research, recently released in the Journal of the American Society of Hypertension, revealed that among the coal miners studied, blood pressures in the hypertensive range and obesity were higher than what would be expected for the US adult population. Nearly 8 of every 10 coal miners evaluated had blood pressure readings indicating either prehypertension or hypertension and nearly 9 of 10 were overweight or obese.

NIOSH offers free health screenings for all coal miners through the mobile Enhanced Coal Workers’ Health Surveillance Program..   Radiographic examinations, blood pressure (BP) screenings, and occupational and health history questionnaires are provided. Lung function testing (spirometry) is also performed if no medical issues are identified. A limited assessment of cardiovascular health risk factors, including hypertension and obesity, can be made using information gathered during these evaluations.

A majority of the 1,402 participants were male (94%), white (93%), and non-Hispanic (94%). The median age was 54 years with a range of 15–88 years. The data revealed that 46% of participants had a blood pressure reading consistent with prehypertension and 31% had a reading consistent with hypertension.  Among the 440 individuals with blood pressure in the hypertensive range, 24 (5%) had a blood pressure reading consistent with a hypertensive crisis. This represented 2% of all program participants and was 60% higher than what would be expected for the US adult population. Additionally, 87% of coal miners participating in the program were found to be either overweight (35%) or obese (52%), which is also higher than expected.

These findings indicate a need for cardiovascular health interventions to improve the health of coal miners. Early detection of hypertension and appropriate referral and follow-up treatment of hypertension, obesity, and other cardiovascular risk factors can prevent stroke, heart attack, and other cardiovascular events. Existing mobile occupational health surveillance programs such as the NIOSH Enhanced Coal Workers’ Health Surveillance Program could offer opportunities to identify coal miners at risk for poor cardiovascular health outcomes and refer them for medical evaluation and treatment.  If you are aware of efforts to prevent cardiovascular disease among miners, please share them in the comment section below.

For more information on the mobile Enhanced Coal Workers’ Health Surveillance Program (ECWHSP) visit the website.

Michelle Martin, MS, is a health communication specialist in the NIOSH Respiratory Health Division.

LT Megan Casey, RN, BSN, MPH, is a Nurse Epidemiologist in the NIOSH Respiratory Health Division.