NCWASNational Coal Workers' Autopsy Study
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15,22-24) The lung sections submitted to the NCWAS program are not optimal for the evaluation of emphysema, which is best evaluated on whole lung sections.
The NCWAS is a voluntary program and the number of participants during the period studied was small relative to the total number of decedents who had CWP listed as a cause of death on death certificates.
The difference in pneumoconiosis prevalence between smoking and nonsmoking coal miners could also be explained by a participation bias in the NCWAS.