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Pneumoconiosis among underground bituminous coal miners in the United States: is silicosis becoming more frequent?
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    To the Editor:

    Laney, et al. [1] provide important and compelling insight to potential causes of the unexpected occurrence of progressive massive fibrosis among underground coal miners in some areas of the U.S. Based on the occurrence of “r” opacities in these films, exposure to quartz is the likely cause. This conclusion is supported by an exposure assessment that shows elevated exposure to quartz dust in area...

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