To the Editor.—
In his letter (234:915, 1975), Dr Phelps claims that I made certain statements in my commentary on "Respiratory Problems In Coal Miners" that are misleading and not based on fact. It is unclear to me to which of my statements he is referring.First, and contrary to what Dr Phelps implies, neither ventilatory studies nor arterial blood gas determinations assess disability; they do, however, give some indication whether pulmonary impairment is present. In this context, I have never claimed that ventilatory studies are useful in coal miners in the determination of occupationally related pulmonary impairment, except in the case of progressive massive fibrosis and possibly industrial bronchitis. Were Dr Phelps to read my commentary again, he would see that I stated that cigarette smoking was five to six times as important as dust exposure in producing airway obstruction—a statement with which he seems to be in agreement.
Morgan WKC. Respiratory Problems in Coal Miners. JAMA. 1976;235(13):1324–1325. doi:10.1001/jama.1976.03260390010005
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