Document zQyaJM2Z5rVQdnRzR78vpeQ4B

FILE NAME: Newspaper & Magazine Articles (NMA) DATE: 1970 Dec 16 DOC#: NMA051 DOCUMENT DESCRIPTION: NYT - New International Code Aids X-Ray Study in Black Lung Disease New International Code Aids X-Ray Study in Black Lung Disease By LAWRENCE K. ALTMAN Special to The New York Times New York Times (1857-Currentfile); Dec 16, 1970; ProQuest Historical Newspapers The New YorkTimes (1851 - 2002) pg. 36 New International Code Aids X-RayStudyinBlackLungDisease By LAWRENCE K. ALTMAN Special to The New Y ak Times DENVER, Dec. 14--A group of 118 practicing physicians have just completed a two-day course here that taught them how to use a new international code to classify the abnormal white spots th at appear on chest X-rays of coal workers with black lung disease. Doctors said that the course and die code were designed to carry out provisions of a Fed eral law concerning the health of the 100,000 coal workers in 4,500 mines in 23 states. The Public Health Service, the American College of Radiology and the American College of Chest Physicians sponsored the sessions. What the doctors learned was how to classify the extent of damage that doal workers can get from inhaling coal dust so ill victims can qualify for Fed eral compensation.. Under the Federal Coal Mine Health and Safety Act that President Nixon signed a year ago, each coal worker can have a chest X-ray taken every two or three years at the expense of the mine op erator. If radiologists find evidence of sufficient black 'lung damage in the coal worker's chest X- ray, the patient has the option of transferring -- at no loss in salary -- to a new job in a less dusty area of the mine, if the X-ray changes are more advanced, the coal worker can apply for Social Security dis ability. "The aim of the law," Dr. William S. Lainhart of the Pub1 lie Health Service said in an interview, "is to arrest further progression of the black lung disease." Dr. Lainhart is an epidemiologist with the Bureau of Occupational Safety and Health in Cincinnati. Depending on the severity of the disease, coal workers can suffer from chest pain, cough, shortness of breath and easy fatigup on exercise. Their skin can turn bide or cyanotic. Ultimately, such lung damage can kilt from a type of heart failure called cor pul monale. Doctors have long known that inhalation of various dusts such as coal, quartz, asbestos, talc and gaphite can' lead to a group of lung diseases that are categorized as pneumoconioses. When biaefc coal dust is in haled b y miners o r men work ing on barges, for example, it can produce lung damage that appears opaque, or white, on ohest X-rays. Lung damage, often mimicking pneumoconio ses, can result from diseases produced, for example, by tox ic metals such as cadmium and berylium. By noting which area of the lung is damaged, radiologists can often distinguish between the various pheumoconioses. Because these diseases can produce similar . changes as seen on X-rays, radiologists can have difficulty in making a more precise diagnosis than pneumoconioses. Problem of Diagnosis Sometimes, for example, the lung covering called the pleura becomes abnormally thickened from many of these diseases. In such cases, information about the patient's occupation and exposure to dust and oth er environmental agents is helpful in establishing the spe cific diagnosis. Because of these technical difficulties, the service studied ways to standardize such chest X-ray abnormalities, Dr, Lainhart said, and decided on a classification that was made by the International Union Against Cancer (pneumoconio sis is no t a cancer). The code was published last July in a medical journal called Chest. The classification is a short hand system for recording and standardizing the various Xray changes resulting from dust inhalation. To teach the system, the service and the two medical organizations began last June to give the course in six cities to physicians caring' for coal workers. The physicians here are among the 900 doctors who are expected to have volun teered for tbe course by the time the last session is given next m onth in Pittsburgh- Earlier, physicians took the course in Washington, Charles ton, Knoxville and S t Louis. Participating doctors sit at a table facing a box illuminat ing the chest X-rays of patients with black lung or other dis eases th at mimic i t 'Course directors use a new technique, which was developed by East man Kodak Company of Roch ester, to make 100 high quality copies of the teaching films, thus facilitating the course in struction. The coded data that physisians submit on coal .workers and the X-rays will be sent to the Appalachian Laboratories for Occupation Respiratory Dis ease Center at Morgantown, W. Va. Epidemiologists there expect to use the data to un derstand, diagnose and con trol black lung and other dust inhalation diseases. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.