{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T22:34:54Z","timestamp":1747175694855,"version":"3.37.3"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Industrial Med"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The US Department of Labor (DOL) does not fund diffusing capacity (D<jats:sub>LCO<\/jats:sub>) or metabolic measurements from cardiopulmonary exercise testing (CPET) for coal miners' disability evaluations. Although exercise arterial blood gas testing is covered, many miners are unable to perform maximal tests, and sampling at peak exercise can be challenging. We explored the relationship between resting D<jats:sub>LCO<\/jats:sub>, radiographic disease severity, and CPET abnormalities in former US coal miners.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed data from miners evaluated between 2005 and 2015. Multivariable linear and logistic regression analyses were used to examine relationships between percent predicted (pp) forced expiratory volume in 1 s (FEV<jats:sub>1<\/jats:sub>pp), D<jats:sub>LCO<\/jats:sub>pp, VO<jats:sub>2<\/jats:sub>maxpp, A\u2010a oxygen gradient (A\u2010a)pp, dead space fraction (Vd\/Vt), disabling oxygen tension (PO<jats:sub>2<\/jats:sub>), and radiographic findings of pneumoconiosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 2015 male coal miners was analyzed. Mean tenure was 28 years (SD 8.6). Thirty\u2010twopercent had an abnormal A\u2010a gradient (&gt;150\u2009pp), 20% had elevated Vd\/Vt (&gt;0.33), and 34% a VO<jats:sub>2<\/jats:sub>max &lt; 60\u2009pp. D<jats:sub>LCO<\/jats:sub>pp strongly predicted a disabling PO<jats:sub>2<\/jats:sub>, with an odds ratio (OR) of 2.33 [2.09\u22122.60], compared to 1.18 [1.08\u22121.29] for FEV<jats:sub>1<\/jats:sub>. Each increase in subcategory of small opacity (simple) pneumoconiosis increased the odds of a disabling PO<jats:sub>2<\/jats:sub> by 42% [1.29\u22121.57], controlling for age, body mass index, pack\u2010years of tobacco smoke exposure, and years of coal mine employment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>D<jats:sub>LCO<\/jats:sub> is the best resting pulmonary function test predictor of CPET abnormalities. Radiographic severity of pneumoconiosis was also associated with CPET abnormalities. These findings support funding D<jats:sub>LCO<\/jats:sub> testing for impairment and suggest the term \u201csmall opacity\u201d should replace \u201csimple\u201d pneumoconiosis to reflect significant associations with impairment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajim.23621","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:13:16Z","timestamp":1717459996000},"page":"732-740","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Resting diffusing capacity and severity of radiographic disease predict gas exchange abnormalities with exercise in former US coal miners"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7141-8795","authenticated-orcid":false,"given":"Robert A.","family":"Cohen","sequence":"first","affiliation":[{"name":"Environmental and Occupational Health Sciences Division, School of Public Health University of Illinois Chicago Chicago Illinois USA"},{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard H. T.","family":"Go","sequence":"additional","affiliation":[{"name":"Environmental and Occupational Health Sciences Division, School of Public Health University of Illinois Chicago Chicago Illinois USA"},{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9312-6099","authenticated-orcid":false,"given":"Lee","family":"Friedman","sequence":"additional","affiliation":[{"name":"Environmental and Occupational Health Sciences Division, School of Public Health University of Illinois Chicago Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4134-8789","authenticated-orcid":false,"given":"Lauren M.","family":"Zell\u2010Baran","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecile S.","family":"Rose","sequence":"additional","affiliation":[{"name":"Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8405-6997","authenticated-orcid":false,"given":"Kirsten S.","family":"Almberg","sequence":"additional","affiliation":[{"name":"Environmental and Occupational Health Sciences Division, School of Public Health University of Illinois Chicago Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304517"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201804-261OC"},{"key":"e_1_2_12_4_1","unstructured":"International Labour Office. 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