High-resolution computed tomography of the lungs in coal miners with a normal chest radiograph

Nowadays, there is a tendency to carry out high-resolution computed tomography (HCRT) in diagnosis of interstitial disease in former coal miners, but the validity and consequences in terms of compensation have not been validated. This study was designed to investigate HRCT outcome (visual and densitometric) and lung function in a group of ex-coal miners with a normal (ILO < or = 0/1) chest radiograph. In more than half of the coal miners HRCT assessed nodules visually, indicative of coal workers' pneumoconiosis (CWP). This finding was strengthened by densitometric data. With increment of cumulative dust exposure a trend was observed toward a higher mean coal workers' pneumoconiosis (MCWP) score and a higher mean lung density value. No relation was observed between the pulmonary function tests and the MCWP score or the mean lung density. In conclusion, visual assessment of HRCT slices is more sensitive than chest radiographs to detect CWP. Application of densitometric analysis to the individual coal miners with early disease seems limited because of the variability in lung density among normals.