Chronic occupational bronchitis and programs of medical surveillance

: Industrial bronchitis is of clinical significance when accompanied by irreversible obstruction of the airways. The controversy surrounding the role of dusty exposures in the workplace in the genesis of chronic obstructive lung disease derives from the numerous biases inherent in prevalence studies of working populations often used to study this relationship. Better study designs afforded by community based and longitudinal studies have clearly demonstrated the causal role of dusty exposures in chronic airflow obstruction. This abnormality is detected by spirometry, a technique commonly applied in surveillance programs of industrial workers. The large differences seen in these measures even among normal subjects as well as their variability from time to time do not allow the identification of affected individuals before the onset of significant irreversible disease. For this reason these tests are useful mainly for case detection while prevention must rely on better industrial hygiene.