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a MRC
Environmental Epidemiology Unit, University of Southampton, Southampton
SO16 6YD, UK, b Department of Occupational and
Environmental Medicine, Imperial School of Medicine at National Heart
and Lung Institute, London SW3 6NP, UK
Correspondence to: Professor D Coggon.
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Introduction |
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The potential of coal mine dust to cause disabling pneumoconiosis has long been recognised, but research now suggests that pneumoconiosis is not the only respiratory hazard of coal mining. Over the last 30 years evidence has accumulated that miners also experience an excess of chronic obstructive pulmonary disease (COPD), and this has led the British Government to classify chronic bronchitis and emphysema in coal miners as an occupational disease for which industrial injuries benefit can be paid. In Germany, too, COPD in miners is now compensated as an occupational disease. However, some scientists have expressed doubts as to whether coal mine dust can cause clinically important loss of lung function in the absence of complicated pneumoconiosis.1 In view of this continuing controversy, it is helpful to review the evidence as it now stands.
The epidemiological investigations that bear on the relation between
coal mining and COPD are of four main types:
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