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Pulmonary Function Impairment in Pneumoconiotic Patients with Progressive Massive Fibrosis

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Author(s): Chuan-Ing Yeoh | Shieh-Ching Yang

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 25;
Issue: 02;
Start page: 72;
Date: 2002;
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Keywords: coal workers' pneumoconiosis | progressive massive fibrosis | lung function

ABSTRACT
Background: Progressive massive fibrosis (PMF) is the severe form of coal workers' pneumoconiosis(CWP). Clinical observations have suggested that the componentsof PMF are inhomogenous. There may be a significant diversity in themagnitude of pulmonary impairment for miners with PMF. This study isintended to investigate the relationship between radiological categories ofPMF and pulmonary impairment.Methods: Eighty-six coal workers with radiological evidence of PMF were enrolled.They were subdivided into 3 categories, i.e., A, B, and C according to theInternational Labour Office (ILO) classification. Maximal expiratory flowvolumecurves and diffusing capacity were measured in each subject.Results: Our data reveal that forced vital capacity (FVC) and forced expiratory volumein 1 s (FEV1) were abnormally low in all categories. However, FVCwas only mildly reduced in category A, and then rapidly decreased with theprogression of radiological category. The major pattern of impairment forminers with PMF was obstructive, but there was an increasing trend forrestrictive impairment for higher radiological categories. A normalspirogram was still observed in 6-11% of subjects in category A and even B.For diffusing capacity (DLCO), there was also a progression of impairmentwith transition from category A to categories B and C. Smoking miners hadeven lower FEV1/FVC and DLCO than did their non-smoking counterparts.Conclusions: Pulmonary impairment increased with increasing radiological category evenin PMF. Assessment of lung function should be individualized and carriedout with a combination of tests, i.e., spirometry and DLCO measurement.The loss of lung function cannot be accounted for by different smokinghabits

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