Physiological/pathological correlations in coal workers' pneumoconiosis.

There is remarkably little information about the direct relationship of physiological abnormality in coal workers' pneumoconiosis with structural changes in the lung and there are major difficulties in attempting such a correlation. The general population, including coal workers, has a regrettably high prevalence of pulmonary functional abnormalities attributable to chronic bronchitis or to emphysema occurring either separately or together. The pathological basis for the functional impairment in chronic bronchitis and possible functional sequelae to the anatomical changes of emphysema are not clearly understood, making it extremely difficult to identify separately the functional effects associated with coal workers' pneumoconiosis. Any study of coal workers' pneumoconiosis must take into account the background population. The published investigations relating the functional abnormalities and pathological changes in the lung in coal workers' pneumoconiosis are reviewed. The relationship of functional change to emphysema, chronic bronchitis, cor pulmonale and the specific lesions of coal workers' pneumoconiosis are dealt with. There is great need for further work in this field, both in the form of simple studies of pathological changes in miners' lungs as well as more complex attempts to correlate such pathological surveys with physiological abnormalities in life.