Coalworkers' pneumoconiosis: correlation between opacity profusion and number and type of dust lesions with special reference to opacity type.

Abstract

The relation between the profusion and predominant type of small rounded opacities on chest radiographs taken within four years of death and the postmortem counts of dust lesions in four classes (macules, "pinhead" fibrotic nodules, nodules 1-3 mm, and nodules greater than 3-9 mm in diameter) has been examined for 71 coalworkers without progressive massive fibrosis. The radiographs were categorised by four readers independently, according to the ILO classification. For subjects considered by each reader to present predominantly p type opacities, increasing opacity profusion was exclusively and significantly associated with an increase in the number of pinhead fibrotic nodules. Numbers of nodules measuring 1-3 mm and greater than 3-9 mm in diameter both showed significant linear associations with opacity profusion category in subjects presenting predominantly q opacities, the closer association being observed with the smaller lesions. These observations held true for all readers. Opacities of type r were rarely considered to be the predominant type. For the reader who recorded the maximum number of such cases, opacity profusion was not significantly related to the numbers of dust lesions in any of the lesion classes. Nevertheless, the closest association was observed with nodules measuring greater than 3-9 mm in diameter. An overall significant linear association between total lung dust content and opacity profusion was found to be due mainly to subjects presenting predominantly p type opacities and to a lesser extent to those with predominantly q opacities.