Pulmonary Disability and Impairment - Can't Work? Won't Work?

Our plain-English summary of Pulmonary Disability and Impairment - Can't Work? Won't Work?, by W.K.C. Morgan (1962).

The study

• Author: W.K.C. Morgan
• Published: Basics of RD, Volume 10 No5. May 1962 Published by the American Thoracic Society.
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article was a review, not a study of people. The author, W.K.C. Morgan, described how doctors assess lung impairment and disability in disability applicants, including those with occupational lung diseases such as asbestosis, silicosis and coal workers' pneumoconiosis. The chest X-ray was described as an unreliable way to measure impairment. Spirometry (the FVC, the FEV1 and the ratio between them) was described as the most useful measure of obstructive impairment. Blood gas analysis was described as mainly unhelpful and nonspecific. Lung volumes and tests of small airway function were not recommended. Exercise testing was described as of limited use for pulmonary disability. The author argued that expressing lung function as a percentage of the value predicted for age, height and sex discriminates against older applicants. The author concluded that, in nearly every instance, provided due consideration is given to the factors the review describes, appropriate lung function tests can predict whether a person can do a certain job, if the energy that job requires is known. The scanned text is badly damaged, and its tables and figure cannot be reliably read in full.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of methods for assessing pulmonary impairment and disability
• Who was studied: No study population. The article discusses people referred for disability evaluation in general.
• Exposure: Not an exposure study. It discusses occupational lung diseases in general (pneumoconioses including coal workers' pneumoconiosis and silicosis, and asbestosis as an example) and the oxygen demands of various jobs.
• Main results:
  • The author described the chest radiograph as an unreliable method of quantifying pulmonary impairment.
  • The author described the FVC, the FEV1 and the FEV1/FVC ratio as the most useful measures for assessing disabling obstructive impairment.
  • The author described blood gas analysis as mainly unhelpful and nonspecific.
  • The author wrote that lung volumes correlate poorly with shortness of breath and respiratory disability, and did not recommend them for disability assessment.
  • The author wrote that tests of small airway function have no place in disability assessment because they are inaccurate.
  • The author described exercise testing as important for overall disability but of limited use for pulmonary disability.
  • The author argued that expressing lung function as a percentage of the predicted value for age, height and sex discriminates against older applicants.
• The authors' conclusion: The author concluded that, in nearly every instance and with due consideration of the factors discussed in the review, appropriate lung function tests can predict whether a person is capable of carrying out a certain job, provided the energy expenditure that job requires is known.

Topics

Medical terms in this study, explained in our Lexicon: Occupational Lung Disease, Silicosis, Pneumoconiosis, Chest X-Ray, Spirometry, FEV1.

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