Pneumoconiosis incidence and prevalence among US Medicare beneficiaries, 1999–2019

Abstract

AbstractBackgroundPneumoconiosis is a group of occupational lung diseases caused by dust and fiber exposure. This study analyzes Medicare claims to estimate the burden of pneumoconiosis among fee‐for‐service (FFS; Medicare Parts A and B) Medicare beneficiaries during 1999–2019 in the United States.MethodsClaim and enrollment information from 81 million continuously enrolled FFS Medicare beneficiaries were analyzed. Beneficiaries with any pneumoconiosis and cause‐specific pneumoconiosis (e.g., asbestosis, silicosis) were identified using three case definitions (broad, intermediate, and narrow) with varying diagnostic criteria based on claim International Classification of Diseases, Clinical Modification (ICD‐CM) diagnosis codes and Healthcare Common Procedure Coding System codes. Results are presented as ranges of values for the three case definitions.ResultsThe 21‐year prevalence range for any pneumoconiosis was 345,383–677,361 (412–833 per 100,000 beneficiaries) using the three case definitions. The highest prevalence was among those ≥75 years of age, males, Whites, and North American Natives. Most claims (70.0%–72.5%) included an ICD‐CM diagnosis code for asbestosis. The broad pneumoconiosis prevalence rate increased significantly (p < 0.001) during 2002–2009 by 3%–10% annually and declined significantly by 3%–5% annually starting in 2009. The average annual broad incidence rate declined significantly by 7% annually during 2009–2019.ConclusionsDespite the decline in rate for any pneumoconiosis among Medicare beneficiaries, which is primarily attributed to a decline in asbestosis, pneumoconiosis is prevalent among FFS Medicare beneficiaries.