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  • Title: Radiological findings, pulmonary function and dyspnea in underground coal miners.
    Author: Bauer TT, Heyer CM, Duchna HW, Andreas K, Weber A, Schmidt EW, Ammenwerth W, Schultze-Werninghaus G.
    Journal: Respiration; 2007; 74(1):80-7. PubMed ID: 16369125.
    Abstract:
    BACKGROUND: Respiratory disability induced by dust exposure in coal workers is assessed by pulmonary function tests and radiological evidence of pneumoconiosis. High-resolution computed tomography (HR-CT) improves the visibility of tissue changes, but the value of the findings for the clinical evaluation is controversial. OBJECTIVES: It was the aim of this study to evaluate the correlation between the International Labour Office (ILO) classification and the degree of emphysema in HR-CT with self-reported dyspnea and pulmonary function tests including diffusion capacity for CO (DL,CO). METHODS: We investigated 87 coal miners (aged 67+/-6 years), having worked underground for 26+/-9 years, with pulmonary function tests and HR-CT. Univariate associations were tested with correlation coefficients, and multivariable analyses used a stepwise forward regression model. RESULTS: No aspect of the ILO classification showed a univariate correlation with dyspnea or forced expiratory flow in 1 s (FEV1). Emphysema CT score was strongly associated with DL,CO (rs=-0.40; p<0.001) and FEV1/maximal vital capacity (r=-0.38; p<0.001) in univariate analysis, but not with the clinical grade of dyspnea (r=-0.14; p=0.256). CT emphysema score but not ILO classification was associated with FEV1 in multivariable analyses (rs=-0.37; p<0.001). Dyspnea was best approximated by DL,CO (r=-0.312; p=0.008). CONCLUSION: The clinical grade of breathlessness was best approximated by DL,CO. HR-CT showed a good association with expiratory flow limitation. ILO classification of the chest radiograph may be a marker of exposure but conveys little information about the degree of respiratory impairment.
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