The importance of small airway dysfunction in the assessment of pneumoconiosis

This study aimed to evaluate the prevalence and risk factors of small airway dysfunction (SAD) in patients with pneumoconiosis and to emphasize its role in early stage and disease monitoring. Data including demographics, ILO pneumoconiosis classification, and pulmonary function tests were analyzed. SAD was defined by at least two pulmonary function parameters-maximal mid-expiratory flow (MMEF), forced expiratory flow at 50% (FEF50), and 75% (FEF75)-below 65% of predicted values. SAD was identified in 59% of patients (n = 118). Compared to stage 1, the risk of SAD was fourfold higher in stage 2 (p = 0.037, OR = 4.119) and nearly 14-fold higher in stage 3 pneumoconiosis (p = 0.008, OR = 13.714). Progressive massive fibrosis increased SAD risk by nearly seven times (p = 0.010, OR = 6.884). These results highlight that SAD is common and may occur early in pneumoconiosis, underscoring its importance in patient monitoring protocols.