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Respiratory Disability in Coal Miners

Donald Elisburg
JAMA. 1980;244(19):2158. doi:10.1001/jama.1980.03310190013006.
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To the Editor.—  I found much in the article "Respiratory Disability in Coal Miners" to be incomplete or misleading. Unfortunately, the study, made more than two years ago by Morgan et al, overlooks certain pertinent and important considerations that are essential to reaching valid conclusions. Moreover, the sample of cases reported by Morgan and co-workers may not be representative of the universe of black lung claimants.Any valid conclusions must be based on an understanding of the criteria for establishing entitlement for benefits under the Black Lung Benefits Reform Act of 1977. These criteria involve legal as well as medical considerations. The medical considerations defined by the Act include not only massive fibrosis but also chronic obstructive pulmonary disease (COPD).For purposes of the Act, Congress adopted the definition of pneumoconiosis (black lung) as a chronic dust disease of the lung and its sequelae, including respiratory and pulmonary impairments arising


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