Coal workers' pneumoconiosis is not a single disease process but a composite of multiple disorders, each of which may vary in incidence and severity from one patient to another. In a study of 77 miners of bituminous coal, roentgenographic categories for pneumoconiosis were found to correlate well with quantitative, postmortem anatomic measurements of (1) the volume of pulmonary dust macules and nodules, and (2) the silica (silicon dioxide) and collagen content of dust macules and nodules. Unfortunately, there was poor roentgenographic recognition of emphysema and chronic cor pulmonale, the two disorders which appear to be most closely correlated with dyspnea. A number of miners with no roentgenographic evidence of pneumoconiosis had emphysema, cor pulmonale, and dyspnea in addition to dust macules with silica and collagen.
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Richard L. Naeye (1972) studied this question.