Definition

Hospitalizations from or with pneumoconiosis as primary diagnosis for persons 15 years or older. ICD-9 codes: 500-505 ICD-10 codes: J60-J66

Numerator

Number of inpatient hospital discharges with a primary diagnosis of pneumoconiosis, coal workers' pneumoconiosis, asbestosis, silicosis, or other or unspecified pneumoconiosis.

Denominator

Total number of persons aged 15 years or older in the population.

Data Interpretation Issues

Because pneumoconioses are typically diseases of long latency, current incidence is not likely to be indicative of current exposure. It may be many years before reductions in occupational exposures affect the number of hospitalizations.

Why Is This Important?

Pneumoconiosis is a class of lung diseases which are usually incurable and may lead to death. Pneumoconioses includes silicosis, asbestosis, coal workers' pneumoconiosis, and other and unspecified pneumoconiosis. Nearly all pneumoconioses are attributable to occupational exposures and millions of workers are at risk. Complications of various pneumoconioses and other conditions associated with exposure to the same dusts that cause pneumoconiosis include respiratory infections (including tuberculosis); chronic bronchitis; emphysema; lung cancer; pleuritis; progressive systematic sclerosis; renal disease and respiratory failure.

How Are We Doing?

There have been over 27,000 cases of pneumoconioses in New Jersey (NJ) between 2000 and 2019. Of the reported cases of pneumoconiosis hospitalizations, 92% (25,604) were due to asbestosis. The NJ annual, age-standardized rate of asbestosis between 2000 and 2019 is 66-277 hospitalizations/million residents. Rates of asbestosis in NJ may be higher than other parts of the US because of the production of asbestos products and use of asbestos, especially in New Jersey's many shipyards. Several NJ studies have documented excess mesothelioma among NJ workers in industries with asbestos exposure, including New Jersey's most well-known asbestos products manufacturer, the Manville Corporation in Somerset County. The NJDOH has estimated that as many as 500,000 NJ workers may have been exposed to asbestos since 1940.

What Is Being Done?

New Jersey law requires the reporting of the most common pneumoconiosis, including those that are coded as unspecified, by hospitals and health care providers (NJAC 8:58). Pneumoconioses frequency varies geographically and is largely determined by local industrial activities and migration of affected individuals. Control of occupational dust exposure is the single most effective means of preventing pneumoconiosis. Tracking of pneumoconiosis is essential for measuring progress towards elimination of the disease, as well as for targeting prevention and disease management programs. Because of the serious health effects that exposure to asbestos can cause, the handling of asbestos-containing materials is regulated in NJ. In NJ all asbestos abatement work must be conducted by a NJ Department of Labor and Workforce Development (DOLWD) licensed asbestos abatement contractor. All of the contractor's employees who conduct asbestos abatement must have a valid NJ DOLWD supervisor or worker permit. All licensed contractors are required to submit notice to designated agencies of any asbestos abatement covered by NJAC 8:60 and NJAC 5:16 at least 10 days in advance of the beginning of the work. All schools are required to maintain asbestos management plans for each of their buildings. These plans are required to include the type and location of any asbestos in the building, regular updates on the condition of the asbestos and, if applicable, when it was abated (removed). The New Jersey Silicosis Outreach and Research (SOAR) Alliance is a multiple-partner team consisting of industry, labor, state (including the NJ Department of Health) and federal representatives whose mission is to address issues associated with silica exposure among New Jersey highway construction and repair workers. This is done by increasing awareness of the silicosis hazard, identifying exposure sources and promoting control measures to reduce exposure [http://nj.gov/health/workplacehealthandsafety/occupational-health-surveillance/silicosis/] The Occupational Health Surveillance Unit conducts surveillance for silicosis under the National Institute for Occupational Safety and Health (NIOSH) Fundamental grant program. [http://www.nj.gov/health/workplacehealthandsafety/occupational-health-surveillance/statistics/nj_ohi.shtml]

Available Services

Additional information on the prevention of work-related injuries and illnesses can be obtained from: NJ Department of Health Occupational Health Surveillance Unit PO Box 369 Trenton, NJ 08625-0369 Phone: (609) 826-4984 Fax: (609) 826-4983 [http://nj.gov/health/workplacehealthandsafety/occupational-health-surveillance/]

Health Program Information

Asbestos is regulated by the NJ Departments of Health, Labor & Workforce Development, Community Affairs, and Environmental Protection as follows: Environmental and Occupational Health Assessment Program is the agency responsible for asbestos and environmental information; provides training and accreditation for asbestos training providers; conducts studies to evaluate asbestos abatement and management methods; and administers the Asbestos Hazard Emergency Response Act (AHERA) and the National Emission Standards for Hazardous Air Pollutants (NESHAP), on behalf of the US Environmental Protection Agency (USEPA). Phone: (609) 826-4950 Fax: (609) 826-4975 [http://www.nj.gov/health/ceohs/asbestos/] Public Employees Occupational Safety and Health (PEOSH) Unit enforces the occupational health regulations for public employees who work with asbestos-containing materials in general industry (General Industry Asbestos Standard, 29 CFR 1910.1001) and employees who work with asbestos-containing building materials during construction (Construction Asbestos Standard, 29 CFR 1926.1101) Phone: (609) 984-1863 Fax: (609) 984-2779 [http://nj.gov/health/workplacehealthandsafety/peosh/] NJ Department of Labor and Workforce Development (NJDLWD) Asbestos Control and Licensing licenses asbestos abatement contractors and issues performance permit identification cards to abatement workers and supervisors employed by those contractors; enforces the NJ Asbestos Control and Licensing Act (N.J.S.A. 34:5A-32 et seq.) by conducting inspections involving the abatement of friable and non-friable asbestos containing materials in all private, public, commercial and residential buildings in New Jersey, including those asbestos projects performed in schools and public buildings under the Asbestos Hazard Abatement Sub-Code; and investigates illegal or improper abatements in any type of building, and routinely inspects the work of licensed contractors and their employees. Phone: (609) 633-0664 Fax: (609) 633-0664 [http://lwd.dol.state.nj.us/labor/lsse/employee/asbestos_control_and_licensing.html] NJ Department of Community Affairs (NJDCA) -- Asbestosis/Lead Unit certifies asbestos safety technicians and authorizes asbestos safety control monitoring firms; enforces the provisions of the Asbestos Hazard Abatement Sub-Code (N.J.A.C. 5:23-8) which pertains to educational facilities, public buildings, daycare centers and nurseries; provides information and interpretation of the code on methods of asbestos remediation for projects under the jurisdiction of N.J.A.C. 5:23-8; investigates complaints and routinely inspects the work of monitors; issues asbestos permits for state-owned facilities; and issues variations to N.J.A.C. 5:23-8. Phone: (609) 633-6224 Fax: (609) 633-1040 [http://www.nj.gov/dca/divisions/codes/offices/asbestos.html] NJ Department of Environmental Protection (NJDEP) regulates the transportation and disposal of asbestos-containing materials and investigates reports of unregistered transporters and illegal disposal in concert with county health departments. Phone: (609) 633-1418 Fax: (609) 633-1112 [http://www.nj.gov/dep/dshw/rrtp/asbestos.htm]

Data Notes

All Pneumoconiosis: ICD-9-CM 500-505, ICD-10-CM J60-J66. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition. The US 2000 Standard population ([http://www.cdc.gov/nchs/data/statnt/statnt20.pdf]) was used to calculate the annual age-standardized death rate. Number of deaths in NJ and state census population data were broken down into the following age groups: 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and 85 plus. US data for 2011-2019 are not available.

Data Notes

Asbestosis: ICD-9-CM 501, ICD-10-CM J61. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition. The US 2000 Standard population ([http://www.cdc.gov/nchs/data/statnt/statnt20.pdf]) was used to calculate the annual age-standardized death rate. Number of deaths in NJ and state census population data were broken down into the following age groups: 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and 85 plus. US data for 2011-2019 are not available.

Data Notes

Coal Workers' Pneumoconiosis: ICD-9-CM 500, ICD-10-CM J60. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition. The US 2000 Standard population ([http://www.cdc.gov/nchs/data/statnt/statnt20.pdf]) was used to calculate the annual age-standardized death rate. Number of deaths in NJ and state census population data were broken down into the following age groups: 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and 85 plus. US data for 2011-2019 are not available.

Data Notes

Silicosis: ICD-9-CM 502, ICD-10-CM J62. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition. The US 2000 Standard population ([http://www.cdc.gov/nchs/data/statnt/statnt20.pdf]) was used to calculate the annual age-standardized death rate. Number of deaths in NJ and state census population data were broken down into the following age groups: 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and 85 plus. US data for 2011-2019 are not available.

Data Notes

Other and Unspecified Pneumoconiosis: ICD-9-CM 503-505, ICD-10-CM J63-J66. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition. The US 2000 Standard population ([http://www.cdc.gov/nchs/data/statnt/statnt20.pdf]) was used to calculate the annual age-standardized death rate. Number of deaths in NJ and state census population data were broken down into the following age groups: 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and 85 plus. US data for 2008 and 2011-2019 are not available.