Blood gas analysis as a determinant of occupationally related disability.

Arterial blood gas analysis is one of the criteria used by the Department of Labor to award total and permanent disability for coal workers' pneumoconiosis (Black Lung). We have observed that Black Lung claimants often undergo several blood gas analyses with widely differing results that sometimes range from complete normality to life-threatening hypoxemia in the same subject. We concluded that blood gas analysis in occupationally related disability determination is unreliable, in that quality control and instrumentation are variable; that severe hypoxemia is rare in coal workers' pneumoconiosis; and that such hypoxemia is nonspecific and correlates poorly with breathlessness.