{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:55Z","timestamp":1787017135944,"version":"build-2736575974"},"reference-count":29,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100013594","name":"Alpha Foundation for the Improvement of Mine Safety and Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013594","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2024,6,6]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Spirometry is the primary lung function test utilised for medical surveillance and disability examination for coal mine dust lung disease. However, spirometry likely underestimates physiologic impairment. We sought to characterise abnormalities of single-breath diffusing capacity for carbon monoxide (D\n                      <jats:sub>LCO<\/jats:sub>\n                      ) among a population of former coal miners.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from 3115 former coal miners evaluated at a West Virginia black lung clinic between 2006 and 2015 were retrospectively analysed to study the association between diffusion impairment (abnormally low D\n                      <jats:sub>LCO<\/jats:sub>\n                      ), resting spirometry and the presence and severity of coal workers\u2019 pneumoconiosis on chest radiography. We developed ordinary least squares linear regression models to evaluate factors associated with per cent predicted D\n                      <jats:sub>LCO<\/jats:sub>\n                      (D\n                      <jats:sub>LCO<\/jats:sub>\n                      pp).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diffusion impairment was identified in 20.2% of subjects. Ten per cent of all miners with normal spirometry had diffusion impairment including 7.4% of never smokers. The prevalence of diffusion impairment increased with worsening radiographic category of pneumoconiosis. Mean D\n                      <jats:sub>LCO<\/jats:sub>\n                      pp decreased with increasing small opacity profusion subcategory in miners without progressive massive fibrosis. Linear regression analysis also showed significant decreases in D\n                      <jats:sub>LCO<\/jats:sub>\n                      pp with increasing small opacity profusion and presence of large opacities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Diffusion impairment is common among former coal miners, including among never smokers, miners without radiographic pneumoconiosis and miners with normal spirometry. These findings demonstrate the value of including D\n                      <jats:sub>LCO<\/jats:sub>\n                      testing in disability examinations of former coal miners and an important role for its use in medical surveillance of working miners to detect early chronic lung disease.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2023-109380","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T13:22:17Z","timestamp":1718630537000},"page":"296-301","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Measuring lung diffusing capacity: an opportunity for improved medical surveillance and disability evaluation of coal miners"],"prefix":"10.1136","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8756-8090","authenticated-orcid":false,"given":"Leonard H T","family":"Go","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8405-6997","authenticated-orcid":false,"given":"Kirsten S","family":"Almberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9312-6099","authenticated-orcid":false,"given":"Lee S","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Zell-Baran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile S","family":"Rose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7141-8795","authenticated-orcid":false,"given":"Robert A","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"key":"2024071021501175000_81.6.296.1","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.2105\/AJPH.2018.304517","article-title":"Continued increase in prevalence of coal workers\u2019 pneumoconiosis in the United States, 1970\u20132017","volume":"108","author":"Blackley","year":"2018","journal-title":"Am J Public Health"},{"key":"2024071021501175000_81.6.296.2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201804-261OC"},{"key":"2024071021501175000_81.6.296.3","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-203108"},{"key":"2024071021501175000_81.6.296.4","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02377-2014"},{"key":"2024071021501175000_81.6.296.5","doi-asserted-by":"publisher","DOI":"10.4065\/82.1.48"},{"key":"2024071021501175000_81.6.296.6","doi-asserted-by":"publisher","DOI":"10.1136\/thx.37.3.193"},{"key":"2024071021501175000_81.6.296.7","doi-asserted-by":"publisher","DOI":"10.1136\/thx.40.2.132"},{"key":"2024071021501175000_81.6.296.8","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/145.3.605"},{"key":"2024071021501175000_81.6.296.9","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2021-107872"},{"key":"2024071021501175000_81.6.296.10","unstructured":"International Labour Office . Guidelines for the use of the ILO international classification of radiographs of pneumoconioses. 2011th edn. Geneva: International Labour Office, 2011."},{"key":"2024071021501175000_81.6.296.11","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034805"},{"key":"2024071021501175000_81.6.296.12","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034905"},{"key":"2024071021501175000_81.6.296.13","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"2024071021501175000_81.6.296.14","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00010-2017","article-title":"Official ERS technical standards: global lung function initiative reference values for the carbon monoxide transfer factor for caucasians","volume":"50","author":"Stanojevic","year":"2017","journal-title":"Eur Respir J"},{"key":"2024071021501175000_81.6.296.15","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e31828dc985"},{"key":"2024071021501175000_81.6.296.16","unstructured":"SAS Institute, Inc . SAS. 2011."},{"key":"2024071021501175000_81.6.296.17","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1164\/rccm.202206-1041ST","article-title":"Syndrome of combined pulmonary fibrosis and emphysema: an official ATS\/ERS\/JRS\/ALAT research statement","volume":"206","author":"Cottin","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2024071021501175000_81.6.296.18","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0274(199705)31:5<495::AID-AJIM2>3.0.CO;2-T"},{"key":"2024071021501175000_81.6.296.19","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/(SICI)1097-0274(199902)35:2<124::AID-AJIM3>3.0.CO;2-M","article-title":"Respiratory symptoms and pulmonary function in coal miners: looking into the effects of simple pneumoconiosis","volume":"35","author":"Wang","year":"1999","journal-title":"Am J Ind Med"},{"key":"2024071021501175000_81.6.296.20","doi-asserted-by":"publisher","DOI":"10.1097\/00043764-200011000-00009"},{"key":"2024071021501175000_81.6.296.21","doi-asserted-by":"publisher","DOI":"10.1136\/oem.53.5.312"},{"key":"2024071021501175000_81.6.296.22","unstructured":"Francois P , Prevost JM , Courtois G , et al . Pneumoconiosis of delayed apparition: large scaled screening in a population of retired coal miners of the northern coal fields of France. Proceedings of the VIIth: International Pneumoconioses Conference Part II. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH); 1988:979\u201384. 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