(Jf6). e. Finnish 1-14 .,.., 31.6 (108) commun*l 15-24, . . . ..4O.S (191) region, >25 .,.... 42.4 (86) 40-64 yearn Femah of age. NS . . . . . ..I 4.6 (709) EX . . . ..13.3 (30) 1-14 . . ...10.4 (77) 16-24 .*,.,. 43.0 (6) >26 .,....# *. (1) TABLE AP.--Smoking and chronic obstructive pulmonary disease s~?~ipto?t~s `-percEnt prevalence (cont.) (Numben I" Qarcntbu.~ reQreaent total number of individuals in ~articulnr smokinn p.rOUD) SM = Smokers. NS = Nonsmokers. EX z Er-amokera. Author, y-2.r. Numm:ri"d Brcnthlrss"ess CO""W. Cough SQUh" prcductic.n or dyepnes Cheat Illnessw Other Commcntd refcrcnce QoQularloa Goldsmith 3,381 wtive Respiretory et al., or retired cotiditiona 1862, longahoremcn. NS U.S.A. hI"d6;;;;;h$:y (74" (9s'. smokcn 43.0 (1,298) Co&lea 1,342 male and Covgh and chronic phlcotn Current et al., 242 female NS . . . ..ll.Z (747) NS 14.7 NS . . . . 4.0 smoking 1966, Detroit poet l-14 , ..12.7 (266) (not LiK.) 1-14 .28.2(Q26 . . . 36.4 (170) (P25 . .a4.i(D26 . . . . . 26.8(Q26 . . . . . .42.4 FC7WJlC8 NS . . 4. .:-.. . 16.6 `ix . .24.8 l-14 . . . . ,* .2G.O IS-24 ,,,..... 26.2 >25 . ., .31.8 FOdC8 NS . 6.9 NS ., ,, . . 29.2 EX **.... . ..13.3 EX . . >. .33.3 l-14 . . . . . .10.4 1-14 * ,,..... 14.3 Molcl NS . . . . 6.7 EX . *. . . 16.3 1-14 , . . I 38.0 16-24 ,...41.4 >26 ,,... 40.0 FCTdU NS . . . 4.6 EX .,, . . 13.3 x-14 . 10.4 16-24 >?6 I . . .67.0 lb-26 >= . . ...67.0 Author, YCBT. Number and BreathlnsnpJs count-Y, type of Cough Sputum production or dyopneu Chest illnesses, Other Conlmvntd reference populntion Wynder 316 male New York Cily et al.. patirntr in NS I.., .14.0 (44) 19G6 Nrw York City Pipe. cigar 33.0 (64) U S.A. and 316 male Cigrrcttcs: (PSB). patient3 in l-10 . ..46.0 (44) California. 10-2.0 . .46.0 (88) >20 . ...67.0 (86) Catifornia NS .~ . . . . 22.0 (69) Pipe, cigar 30.0 (32) Cigarettes: l-10 .46.0 (64) lo-20 . ..74.0 (91) >20 . . ..`?4.0 (69; --.- FIPOID 1.066 randomlv Clinical aipna ot TABLE A2.-.%tokinn and chronic obstructive pulmonary disease syltlpto,t~s'-percent prevalence (cont.) (Numbcra in parentheses represent t&l number of individuals in particulbr smoking group) SM = Smokera. NS = Nonemokem. EX = Ex-amokera. Cough Sputum production Dreatblwsness or dyapnea Chest Illne4ace 0ti-M Commenti DCllWlI 6,ais IIW& POI(rrl PCWld Poltd Dyepnca a &I., and 7.29 1 NS ..a ,. ,. 7.0 (908) 13.1 IQ.8 rcurcscntcd 1967. fernah POStAl Pipe, clgsr 12.4 (628) 11.4 24.8 by Grade 11 U.S.A. snd ban&It Clgarettrs OIIIY. (88). worken. only . a. .27.0(2.687) 28.9 31.7 Transit Transit Tromit NS . . . 6.4(1,012) 9.6 11.7 Pipe, cigar 10.6 (766) 14.1 14.2 cigucttea onlr , . . .23.6(8,`746) 23.7 21.9 Efggins 926 white NS .I,,... 16.4 (162) NS . . . . . . . . . . . 31.1 NS , . . , , ,. 6.0 et al., de A- l-f ..a . . ..47.2 (61s) SM , ,a ., ., .4&Z snl . ., ,* . ,* ..10.7 1968. dents of EX s.,,.,. 19.9 (144) EX . . ,... 28.6 EX . . . . . . . ..16.8 U.S.A. hlatlon (116). county, West Virginia. 26-69 ycsn of age. Holland 8,788 mrlc Nolcr Fcmolcs N&I FVdC# snd and female NS . ,, . . , 8.8(1,000) 9.2(3,137) 2.4 2.1 Elliott, lChOOl SM . . . . . . . 6.3(1.038) 6.9 (664) 6.1 8.3 1968. ebildrcn. EX . , . . . . . 2.9 (1,782) 4.3(1.161) 3.9 4.2 England 5 *.,./ . . . . . . . . . . . . ..# . . . . ..9.`3(142) 18.3 Commenls Austrnlin. niminnton 41,723 mnic prcvnlrncc 01 di,WgC chronic bronchilia RlO20 , 20.6 FC,lltll~# NS .,.... 3.4(12,361) EX ,..... 38 (D69) PiDc . . 00 Cigarcttcs (8.986) 1- 9 ,.. 6.1 lo-19 . 10.6 >20 * I. 18 6 Chronic bronchilir rt al., G&54 yesra NS . . . 1.0 (88) 1IEl. of nac rnndomly EX , . . . * 3.0 (67) Swcdcn snmplcd irom l-14 grnms/ (231). Pu~~uIc.tloI\ day ., 6.0 (04) uf Guhborg. >16 ,.,., 17.0 (GO -. TAULE AZ.--Smoki?lg and chronic obstructive p~tlnmm~ discasc sutttptol,ls'-pcrcolt preuahce (co7lt.J (Numben in parentheses represent total number of individual* in wrticular amokinn `?rouP) SM = Smokers. NS = NonsmLkcrs. EX = Ex-smokers. Author, YCBT, Number and Drcnthlcssneas countw, type of Cough Sputum production or dyspnca Chest illnesses 00.X? Commcnta rctrrcnce DoPulation Pcrnistent couph otldphlcgm Mnlcr nclc rtuc Aoc Age ss-IS is-55 65-05 M-48 NS It... 7(?27) G("OU1 ll(171l 1 (01) ES . . . . . I(3031 11(3GBl 16(33G) 18(14Y) 20 . . ..27(1481 26(1X) 42(121) 26 (12) Fcmalcr NS .I.,. 31600) 4(G37) K(O26) 6 (211 EX 311271 al1281 1 (041 1 1411 <20 . . . o;mz; 13(472) 16(3OC) 11 (CGi 20 . . . . ..lC(1281 27(122) 31 (711 14 (7) izo . ...23 (22) 26 (301 43 (7) . . (11 LCfCW 310 male Agc.rlondardizcd roka Excluded from rnd Phuriciens of chronic rer~~irot~rv examokcra Wonnacott. in London dircaae nt~' thvac 1970. and Ontario, NS . . ...**. t. 1.0 (881 clgurctk Cnrda 26-74 yerAT EX ..*,,. .*.. 6.0 (61) amokcn who (151). of am. SM .,,....,.. 34.0 (101) now Bmoke Plpr, clgsr , .12.0 (aa) pipn or clnrn. ' Data collected by either dlrcct lnteylw, puntionnnirs. rcvicw of medical records and/or medical cxamlnation. TABLE A23 .-S9rloltirlg and chro~~ic f~bslr~rlcliuc lI~tltilu7ictrU tlisvclsc s~~tl~~Lo~~is'-~l~l'cc,lt prmlcncc LNumbcra In parrnthcszu rcprrscnt tutol n~~rnbcr of individunb in pal-ticunr smoking group) Shl = Smnkcra. NS = Nurlsnwkrw EX = Ex-emokcrs. Author, YCLLT. countty. Nutm$:,;nd Cough Bronchitis Commcnta rcfcrcnce popuation Ccdcrlol 9.319 twin Obacrved/ Obscrvcd Explnnotion of nnsl~nes for All ex.snrokcrs ir~cludcd et .I., paira czjectcd IIupcrmorbidilu cxllcclcd Ilyyermorhidity rc3pirotory eymplorn with smnkcrn. 136G, rcairtcrcd Croup A: C(IICII ratio COlCd ralio VNV8lCliCC: MZ--monorYKotlc Swcdcn in Swcdcn hlnlcr . . . . ...393/151.9 2.c 157/60,8 3.1 Croup A analyale-using each pPlr8 (46). 01 12,RRB FC?YIL?les . . . ..lW 49.4 2.8 a/11.2 3.8 flr~tbom twin an one proup DZ-dizynolic ueira availuble. Grau~ II Shl/NS: In sn unmntchcd relat!onshlp Author concludes thnt hlZ Males , , 14.6/1.1 1.9 G.C/ 1.1 6.0 (274) to each urcondborn twin. ~llnee hypcrmorbldltv Females . . l&6/7.6 1.8 3.0/ 2.3 1.33(264) Group I.3 annlysis-uuiop each for amsklnr pcraista DZ Mnlcs , . . 12.3/6.6 2.26 4.6/ 1.8 2.5,1(733) twin set BJ matched pair. in bmukinil-ill~rur,lrlnl Females , , . 14.6/6.? 2.67 LB/ 1.6 3.0 (663) AU compnrisons in Groups A hlZ popuIe:ion. o and B circ bctwwn smoking CBIURI rcIntio~~~tI/~ ot discordnnt pain. smokmn nnd brnnrho- DuhOt,lltY B,"lDt"",l IS luyD"rtLYl. Cederlol 4,379 twin Prevalence of reapiralceu symptoms No cx.amukcrs lnciuilcd et al.. pairs (all Group A: in Croup II an0ly~11-1. 1969. U.S. veterarls) NS . . ., ,, ,. 4.3 4.3 1.G Group A--as above. The nutliurr conclude U.S.A. in U.S. l-10 . . . . . . . . 6.4 6.4 2.7 Grouv B--n3 above. that the dntn indiente 145). National 11-30 . . . . . . . . . . . . . . 16.3 18.3 8.0 *strong probability Academy of >31 . . . . . . . .27.1 27.1 16.6 of rh cnu~al connection Sciences Twin Pipe, cigar . . 7.1 7.1 2.1 with amokinK. Even RegistrV (of Group B: NS sn1 NS snr thcsc a)`m,~t,rm~. 9,000 avial. hlZ . . . . . . . . . . . . . . . . . . . . 2.6 6.4 1.6 4.6 able), howcvcr. acem to be DZ . . . . . . . . . . ..., .,., ,..,, ,., 2.0 9.8 1.6 9.1 influvrrccd by gcnctic factors. ' Dab collccted'b~ either direct interview. questionnaire, review of medical records and/or mcdicnl examination. N (Numbers in parcnthcscs rrprcuunt total number of individuals in ynrticulrr amokinx R~QUD) NS = Nonsmokers. Shl = Smokers. EX = Ex-amokere. EFR FEV vc bliaccllancour Commcnb rorcrcncc pop"lution -_.. - Chivcl-s. 463 m.lc Ilcight-in-inchca tblrn" EFII 1069. rmlhyrcs Cigcuettes/dny: 64" 66" 680' 70" I" lltcm Ennland of olknline &rJ . . . . . . . . . . . . *. t97(28) 91 (35) 108 (91) lOl(21) par minute. (51). industry 6-20 ..~....,.......... R9(60) RR (75) 101 (112) 1w (76) RCgrl3Ul"" plnnt. >7.0 ,..... ,.. .,, ,,, 63 (6) RR.6 (9) 92.6 (9) llS(lZ) annl,als of dn~n rcvralvd L 8iPiiincsnr r* h,tionahiv bclwc-z" smuking and dc crceviny function. Hlgglnl 773 male3 26-64 65-64 cxprcsanl Et al., Invarious NS 146 (66) 101 (29) FE"o.75 DEB n>c~n indlrcct 1969, occupstionl EX 143 (31) 89 (62) MUC. England (25-34 and 1-14 grnms (116). 66-64 YeFall .140(193) 87(167) of age). >I6 Drnml ,183 (89) m(ia6) - WilSO" 28 male RV/TLC et al., residenta of NS . . . . 6.69 (14, NS . . . ,. . . 21.1 1960 nnllsa, Sbf ,..,I `4.44 (IO SM . . . . . . . `27.01 U.S.A. TCXBS. 1?32). former rural dwL4en; mntched for body aurrare. all.?. and height. TOLD A3.--Smoking and vmlilatcq function (cont.) (Numberr In parentheeca reprcscnt total number of individunls In gnrticulnr omoking group) NS :: Nonsmokers. Shl = Smokas. EX = Ex-enwkera. EFR FEV vc blleceunneoua Comment.4 Ashford 4.014 mnle et LI., coal workera Age: FNESVl .o snr lD61. at 3 Scottish co . ..2.88 (42) 2.21(297) Dnta rcprcjent reaulb nfter correction fur dtti"E hCiKht. SM lncludcs ylpc smoker. Datr on cx.amokcr not Included. FEV,,O found r,ipnlllcs"t: lower for Shl tbsn NS. Fletcher a63 male Mean peak EFR and London NS . . . . . ,.. 670 (SO) Tinker. CT!l"PPti l-14 prune 637(166) 1961, employees. >I6 grams 628(116) Ensland EX ,....,.. 666 (61) (85). Franklin 213 male llcavy smoker and factow FEV1.0 FEVo".;: y.;; LOWdl. workcra FIenVY 2.670 3,dll 2.71; Light . . 3.703 (69) rcyrcecnta 8" ListIt `2.489 amount wusl lOGI. 40-60 ycrlrs `2,666 `2.284 mnvy .~3,678(100 to or "lure U.S.A. of nw. thsn 30 pack (87). YEIIII. 240 . , I 307.63 (67) 2.90 blsrlt. 73 healthy 1962. medical per- DLC# Smukcn ,luRnrrl U.S.A. aanne with. NS . , . . ., , . a3.10(30) a* `hurt y'n"kinc (IS!). out signifi. SLI <6 yce.n .`28.40 (8) >zo ciKurcllcu/ eant we 6-lOyears . ..JZB.ZO(lO) dny for varying diflcrence >I0 YEB,S .`24.00(26) pcriuds. between smokers and nonmoken. TABLE A3.-Smoking and vmtilatory /unction (cont.) (Numberr In DatentheSer tepre~enl total number of individuals in particular smoking group) NS = Nonrmokrre. SM = Smokers, EX = Ex-smokers. AilthOr. YC@.i-. C0"thll-Y. MBC ,efCtenCe PWUltItiOtl EFR FEV vc Mfacelkneou8 Comment4 Revotakle 1,130 male et al., and 1.813 FE"I.O Data prcacntrd M&l Fmah 1862, female in tcrma of NS U.S.A. relidtnti In . . ...0.98 (66) 0X18(255) ratio of (IPI). Cigsrettes/dny: Framinp- obaervcd to ham par- l-10 .0.97 (90) 0.99 (92) 9rcdlcted 10-29 ticipating .0.91(163) O.OS(167) valuca. >30 in the pro- ..0.90 (81) 0.01 (22) spective study. KrumboL 18 physicians MEFR et al.. 24-37 yee.ra NS . en . . . . 660 (9) hftan DL lB64. or *ge. U.S.A. Shl ..,.., ,. `690 (9) NS SN Rat . . . . . . . . . 36 `81 (ILO). Excrclre: 2mlnuta ..60 `41 4 minutes ..60 148 8 mlnuks zwi 20 medical port exrrclae 39 `86 *t PI.. MNEFR ntudcnbor NS . . . 187 (lo) Authors found 1964. graduate 4.84 6.17 Sbl aa.1193 (10) a signitlcont diRercncc U.S.A. uhysicisns. `6.09 `6.63 bctwecn Shf and (P&l). NS for RV/TLC. complinnce. nnd non- CO&b, 1.342 male et al.. and 242 1966. female 9oat U.S.A. oNice (5-J). emDloYecs elastic realslance. FEV,.O Timed VC' Age: NS >25 o'oldau NS >tS/dau FEVI,/VC NS >fS/daU ID-44 `2.08(186) 2.86 (60) 3.89 3.86 `0.17 0.14 46-49 `2.96(170) 2x4 (42) 3.92 3.83 2 0.74 0.70 60-64 `2.X(116) 2.62 (22) 9.71 3.74 `0.74 0.70 2.44 (18) 3.64 8.61 `0.14 0.68 h) >roueste Of *gc. 65-59 `2.64 (64) k.i G&64 l2.36 (63) 2.30 (8) 3.30 3.33 `0.12 0.70 TADLD A3.Stnokitlg and vmlilator~ funcliotr (cont.) (Numben In percnthcacn rcprcacnr total number of lndividu8ls In patilcul~r lmDkln# E~OUPI NS = Nonsmokcre. SM = Smokcra. EX = Ex-amokera. Author, YCU, LO"lltlT. NuttAi-;nd MLIC EFR FEV vc Ml,cell*nmu Commrnta Xrumholr 20 mrls Pulmonwy cmnpftime'a Mean body surfnce et d., medlcd NS , ., ,,,, ,, .0.241(10) .rca for 2 ~1'0uUfl 1961, ltuden(a or SM , ,.., . . .~0.177(10) ~08 not hnifl- U.S.A. graduate Compliancr/FRC eanlly d,Rcrrnt. (14:). Dhyalclms. NS ,,,...,.,. 0.064 Smokcls arc those SM . ,* ,. .*. .`0.042 wit11 rc~unl to or g,ratr,' Ihhn 5 pack ycor history. RankIn 126 malea NS ,., 118.1 (68) et al.. nlthout a SM , ..`111.7 (67) FEV1.0 DL DL/ NS Includea pipe NS .,..,,.,. . ..106.6 NS . . ..Sl.l d"eo,ar .",I CiYLII. arnl)krrs 1066, P-t SM . #, *. . . *. * .`102.7 SM . .`26.9 volume snd ox-smoke~a ot U.S.A. hlatarq ~l'26 20-69 years . . . . . . . . a.ao(m) of .p?. w" w rrfrrcnec pOpil&Nl Sluia- 633 white 35-44 G-54 >SS Fh"J.O 1 cignrrtlc z CRWWr mnlc NS S63(106) 627(101) 444(H) ss-44 45-54 >Gs 1 gin",. . . . . . . . . and fflctorv Grams/day: 3.70 3.22 2.76 1 D""PC lobocco = Sichcl. workers l-14 . . . . . . 657 (2C) 619 (17) 410 (7) 3.c4 3.31 2.24 2c grrtms. 19&P. over 36 15-24 . . 632 (94) 446 (36) 401(13) 3.66 2.94 2.28 1 cigar = 2 10 6 South ycrsrs of >?5 t52a (66) t494 (31) t380(10) 3.54 3.05 12.12 grnms. AirkCl .ge. t Derivnl BIUIIPI (tw). found sunifi- ranlly dillcrcnt frurn 0. SlBlM_CU 87 male bus FE"1.o Nifrogcn gradient et 81.. drivers: Younper OIdcr YouQ?er Old&-7 Younger Older 1968. 27 anrd NS ,.I.. 4.470(14) 3.310(40) 6,126 4,?90 1.63 2.49 Rumania 20-26. 60 Shl . . . ..`4.5OOl131 `3,200(20) '6.285 '4,290 Il.47 83.77 BYIll"lQmB. DenWl 6.281 male FEV, n FEV exprcaacd 111 et &I., 1969, U.S.A. (69). postal and 7,213 mole transit workers in New York City. A." POSlOl 1Slritc 3.29 (666) 3.11t2.340) 3.14 (1.292) 3.06 (1.038) Tronait ll'hitc 3.39 (620) 3.11(2,941) 3.16(1,929) Non-white 3.05 (2041 2.04 (768) 2.96 (699) 2.93 (161) Na-vhilc 3.08 (298) 2.99(1.041) 3.00 (691) 226 gramaldey ,. ,. . . , . . . . 3.0?(1,011) 2.96 (149) (Numbers in parentheses rcprcscnt totul number of individunh in Dnrticular smoking group) NS = Nunsmukrrs. Shl = Smukcrr. EX - Ex-smokcru. EFR FEV vc Miscellanwu Commcntr PEFR vc 1963 vnlum only. NS . . . . . . . . . . . . . . . . . . . . . . . 1. 626(88) FEVl,O 3.17 4.83 EX . , . . 631tb7) 3.69 4.77 1-14 grams/day .,., . . .., 621(90 3.62 4.83 >I6 grams/day ., ,I. .., ,. 492(GO 3.31 4.66 -- NBIFR NblFR hua Lccn NS , . . 4.09 (88) ;;;I.0 ~lnnllnrdlrcd for Cignrrtte ogc nnd hciuht. amokers. 3.64(101) 3.11 EX , 3.99 (61) 3.38 Pipe, cigar 4.17 (33) 3.17 TAELE AS.--Smoking and vent&tory function (cont.) (Numbs-8 In psrenthcaea rcprcacnt total number of lndivldurb In pw-tlcular amoklnr WJuD) NS = Nonsmokers. Shl = Smokers. EX = En.smokem. AUbX, Year, countl-y, FEV Miacellsneoua Commcnta rtfcrcncs Lundmnn. 87 hlZ and FEV, n N. wanhout nndicnt hlZ = monorygotle. 62 DZ twin prim aelectcd from Swedlrh Twln.Pair Rerl1tty. Slgnlftcant dlffercnccs between smoklnp discordant twin DltIl found for: 1. G~OUD A MZ males and fern&e. 2. Group n DZ malea, 8. Gmuu ADZ nudes. Slgnlficant diFferencea between smoking dls- cordant twin pain found far: Grouu B DZ malee. DZ = dirygotlc. The author concludea that the danwe of ventllrtlon II mcssured by N, w&shout was correlated with cigarette conaumptlon. Tbr FEY,,, WBI aignlficrntly lower for amokera and tbcre wns a ecrrelstiuti with clgsrette consumutlon. Explan&tlon of rnalysea for rnplratow wnptam prevalencr: Grouu A nnrlvsls-u~lnn each Aratborn twin " ona PIO"P In .n unmatched relstlcnshlp to each wcondborn twin. Group B w~alyala-wing ekfb twin set u mstcb*d unlr. All comp~rlson~ In Grour, A rnd B are bctwetn nnoklw-dlscor dant DllrI. ' Not lignlflcnnt Cdlflerence OI trend), : DtO ye~n of age) (59). (lime md xxi- sxs ruociated with decrcued PEFR v~lua. Mb uposum~. Fiireins 300 mak miner. Miners showed incrra~ed prevalence of symptoms and de and and 300 mak creased MBC value which remained even after standard- c"cbrwne. nonminer 3-4 iration for smoking habits. 1961. yea13 of .KF. Torrl dust cxmure wm not dirvcthr correlated with these Engbnd hndiwx. (115). Wiva of miners showed similsr symr)tom nod tert changes u compmrd with -iv- of nonminen. Brinkmm 1.317 mxlt_ 4-s Incrcucd ailicl exposure wu lssociati with r+n increased md ye.?5 of LKe prcv&nce of chrnnic broacbith. cata. ritb v.rious Higbrrt prcrsknce of chronic bronchitis -xx noted in the 1962. ailiu tXpon"rC non-expowd -up: and this group wsx noti to have U.S.A. hhtorier. tie hirhea number of smoken and bisbest consumption. OX). Hyatt 267 male min,m Increued history of undewround work xvxs a%.oci~Led Witi cl d.. md tx-minen o n incrtued bmnchopulmonrv s~~tom prevd~~ce and 1964. 45-55 yc.n decreu& p"lmonSry function rahwx USA. of .OC. The impairment of pubn"n8r~ function Luociated with (**a,. undergground work wss se~rr~(c from effect of smokimx: but rmokinp md under-und work did show *dditioF &ecu. ElW"Od 2.628 mde and Preparing room worken who umoifested hmiami -P- CL *I.. fern& flu tarns *kc. .h"aed an incrPrwd prevnknce of chronic 1965. worken ""CT 35 bronchitis inderxndent of ape "I- smoking When ComP*d IrcLod Jean of .pe. with non-prepm-ing mom workers. (77). Fern... worken manifested s signib`cant wi=ti"" b tarrn byuiaosia wm~tozzu and amoking while mrk work- m did not. Sluis-Cmmcr a27 minet-3 md Those smokcn cxpoad to nold mine duJt mnnifatcd more ct al.. nonminen over s~mptomr of COPD ' Thea did noa-durt exp~cd smoken. 1961. 3s yarJ of .OC. rbik prcvmknce of swptoms. uooog nonsmoker% VU Suth .\fric. *imil*r for the two k7rouLm. 1 WY). TABLE A7.-Epidemiological studies concerning the relationship of occupational exposure and smokzng to chronic obstructive bronchop?cl,nonary dzsease (cont.) *=I=. Number and country. t-e of Result5 reference pCJIXJla50ll -__ Sluis-Cremer 827 miners and The dose rclationxhiv of c~g~rettp. and COPD' JY~P~O~U et *I.. 1967. nonminers over we.3 much more noticeable among those cxpoaed to dulL South Africa 35 years of *gc. Thr authors strnxed the syn-istIc rctiana of cisarrtte (?09). (cont.) smoking and dust exvo~urc. BOUhUYS et J.. 1969. U.S.A. (99). 455 male cotton Those exposed to dust manifested a significantly greater textile workers prevslence of byssinosilr sym~tom'~ than nonexvcsed. (214 exposed to Smoker, msntie?ted a significantly greater vrevrlmce of dust in carding byssinosia symptoms than nnnamoken. and spinnina No aignificsnt dlffcrencn in Monday morning FEV' vnlues rooms. 241 not were observed between smoker, and nonsmoken. expo3ed~. Prevalence of bysxinosis symptoms did not show any re- lstionxhip to length of employment. Bouhuys et al.. 1969. U.S.A. (38). Chester et al.. 1969. U.S.A. (49). 216 male hemp workers and 247 workers in other industries in same region. 2069 years of age. 139 male chlorine Chlorine-exposed group manifested no difference in symp- plant workers (55 with history of severe ex- pasure,. Hemp workers (especially the older ona) were noted to have different smoking hnbitn from control group-fewer heavy smokers. more light smokers. more ex-smokers due to doctor`, orders. Aged 20-49 -a. No difference in FEV, 0' values between controls and hemp &kern in cay smok- ing catel3ory. b. No di!Terence in FEV,., valum between men in different smokmg catpgorier. Ap-ed SC+69 -3. Hemp workers manifested decreased FEV,.O values in .II smoking gmuvs except for heaviest smokers. Ex-smok- ers had lowest FEVIsO values. b. Those smoking moot had lower FEV, o values 1c1 compared with Light and non- smokers. The authors conclude that: There appesn to be no synersism between smoking and hemv exposure as to effect on FEV, o although the selection D~OCCSS whereby those with sy'mptoms have L zreater tendency to stop smoking may obscure such a relationship. tams and D decreased MBC value when compared with non-exposed IJroup. Smoken in ehlorine-exvowd group had significantly de- creased MBC and FEY values at) compared with non- smokers in non-exposed group. Greenberg 121 workers in et al.. washing powder Ser.sitized group manifested lower FEV,.dFVC' valua IS comvnred with nonsensitized group even after smok- 1910. factory (48 found inp habits were controlled for. England to be sensitized (911. to $Iraduct. 73 "CA). __- Tokuhat. 801 male miners Incrensed mine cx~)osurc WRS associated with residual vol- et al.. umr and FEV abnormalities even after adjustments for 1970. .sge and smoking. U.S.A. A systematic ervosurc-impairment relationship ~a9 noted (218). only -"ml: smokers while relatively few nonxmoken showed COPD impairment. Smokrnn minen manifested more X-ray mIteration and COPD JymDtoms than nonxmakers. regardle=., of n~m- be= of Ye*- of underground exposure. 245 TaLE AIQ.-Ezpe~~ltn~ concerning the egect of the chronic inhdation of x0x upon ihe irachcobronchial tree and pulmonary parenchma of animals freeman SpragucD~sl~Y 25 D.p.m.; and rnt% (n, after 37-41 drya-moderate brDcrtrODhY md byper- Hsydon. plrsrr of bmnchisl and bronchiolar rpirhelium. 1964 (h) dter 146-157 &P-(I) Advanced ~YDC~~WD~Y md U.S.A. hyperphaim of broochis and (90). bronchiolrr epltbeIium. (2) Increucd lunp vohlmr. (3) Proliferation of coonectlve tlrsue. Rwdon et .I.. 1965 U.S.A. (107). 12.5 p.p.m. to d.z.th: (a) Hypct-tmphy and occasion=1 metapluls of bmnchial and hronchiolsr epithelium. (b) Incrtuc in number of sctivcly aecrrtlnrr roblct CCUX. Haydon et rl.. 1967 U.S.A. (106). Albino rabbita. Fr*Ul*ll SprarucDawlcr 0.8 mp.m.-2 p.p.m. for entire lifespan: et .I., rats. (a) Alveolar distention. 1968. (b) Reduction in number of da. U.5.k (cl Epithelial inactivity ("dormancy"). (91). FWCUIan et *l.. 1968. U.S.A. (89). Bhir et .I.. 1969. U.S.A. (3X). SvagucDawleu rata. Female Swiss Albino mice. 18 D.P.m. (a) 5 days-terminal bronchiolar epithclial bm?lertrophy. (b) 4 weeks-(l) Widcapread bmnchiolar epitbelial by- vs-trophr. (2) Non-necratizing emphysema. 0.5 P.D."L: (PI 6 hours/day for 3 months--pneumonitis. (b) 24 boun/day for 3 months-(l) &3Diratiw hmnchi- okr obstruction. (2) Alveolar expmsion and bronchi&r infiammstion con- sistent with early focal emphywna. Klcincrmm. Male Smi.n Golden 100 D.p.I'n. for 5% houra: 1970. hamsten. (a) thymidinc autoradiography-intense burst of pmlii- U.S.A. eration of cpithelium retUrninE to normal in 4 days (IJO). (more lxraistent distdy). (h) electron micro,copt( 1) Decrcsaed number of ICJ- CrdmY cella + mcrrto~ granules. (2) Increased number of brso- aomd structures. (3) No chmge in number of ciliated cella. 246 AUthOr. year. country. system reference and Shreeve, 1937. U.S.A. (160. Rakictcn et al.. 1942. 1J.S.A. (188). Calf trachea. In ritro: (al rabbit and rat tmcharl rings. (b) human naJal lllUCO"S membrane Method 1 I. Nicotine in 1. Caliary sctivlty dcpreued only upon er- Locke-Ringers pmurc to 100 mg. percent mlution. solution. 11. Ciliaw activity depressed after 15-20 min- II. Cisarette smoke ute exweure depending on concentration In ecdution. of smoke in soiution. Kordik In oitro: X&tine in Locke's Nicotine at ID--J g./cc had no eflecct on ciliary CL .I.. Rabbit solution. activity. 1952. trachea England (137). Hilding. In vitro: Cigarette smoke All tracbes, showed depressed or absent riliary 1956. Cow trachea (direct mtivity. U.S.A. exposure,. (120). Krueger In viva: Cisarertc smoke. Cigarette smoke decreased ciliarv activity by and Rabbit approximately 200 beata,minute. Smith. trachea 1958, U.S.A. ,199,. Dalhamn. 1~ vim: Cigarette smoke. 1: `I/IO ahowed retsstion of ciliaw activity 1959. I. Rat after one explmure. Sweden trachea II. 6/10 showed cessation of ciliary activitg (59). In vitro: after one expol"r.5 II. Rabbit III. 6/7 ahowed cation of ciliary activity trachea after one cigarme exposure. III. Humsn ciliated Dl"CO3a Fslk In vitro: Cigarette smoke. Decreased ciliam activiW noted on expaaure to et al.. Rat and rabbit cigarette smoke: 1959 tracheal (a) Repetitive exp~nure -ELU associated with U.S.A. epithelium. persistence of response user longer periods (80). of time. (b) "Tar"-rich clgarette WZY more inhibitory than "tar"-poor. cc) Filtered smoke was I- inhibitory than Wlfillcred. BIllleWCr. In vitro: Cigarette unoke Ciliary activity =su fully inhibited within 628 1960. Human in solutioa. minum of erpmure depending upon concen- U.S.A. bronchial tration of smoke in solution. (15). .nd tracheal epitbclium obtained durinr r*e.tbnla. 247 TABLE X13.-Ezp~rimmts concerning the effect of czgnrette smoke UT its co~stitzlenfs upon diary function (cont.) Krnder et rL. 1963. U.S.A. (896,. In riror Cinarrttc smoke: Unfiltered ci~~rctte smokwili~tasia bp Znd- Frab a.ter and ita fractions 5th poty mussel in solution. Acid fpbenolic) fraction solution-immedialc diata-3 ciliastlrrh. epitbelium I%%& extr*ct fraction solution--oo cililataris. Neutral fraction solution-no ciliaatasia. 1 percent phenol solutica+-immediate ciliuta- sin. D~lhunn In &-or Cig.rrtte smoke. Unfiltered eigarctte?r--ciliasstsala in 3/6 csta and cst trscbc8. after 5 cigarettes. Rylandcr. Filtered cigarettes--no ci1ieata.G after 8 ciga- 1964. rett`?_ (6 cata). SWed?fJ Controls-no cili.utasis (6 cab). (61). Balleoacr In rib-o: Nicotine in solution. Initlsl stimulation of activitT fallowed by de- ct *I.. axl3.a cline mnd complete ciliuWi8 sfter 12-24 1965. uij.ted hours of erwnure. U.S.A. mched (26). e>it0rhm obtazned d-ring. .2atbesiL Dalhamn In tirar Cigarette smoke. The longer the time interval between expo- and Cst trxter sure-s, the more puffs were required (0 ca~ae Rylandcr. ciliastasis. 1965. swwde?3 (61,. Wvnder In rim: Various compounds Formic. acetic. proDionic. benzaic acids alI et sL. FrcGl rua:R` in soluhxL more ciliatoxic than phenol. 1965, masel Oxalic acid Ins ciliatoxic than phenol. U.SA. cihted Formrldebvde. acrolein more ciliatoxic than (35). cpitbelium phenol. CBTSOIJ In R'COT Cigareltr smoke. Perccv2 dccnruc in ciiiary activity et .L.. c*r traclla Control . . . . . . . . . . . . . . . . . . . . . . . 0 1966. Unfiltered smoke . . . __ __ _... . . . . . . . . . 63 U.S.A. C4lulose aceLate filter . . _. . ._ . . . . . . . 46 (44). C.rbon cellulose ncetste filLcr . . . . . . . -. . . so D&was. In rite: Cigrrette smoke. Mean number of puffs requirrd to v&uca -- 1966. Cat rrubcl. CiIiadLG Swdm No filter . . . . . . _. . . . . . . . :. . . . 91 (60). Chnrcoal filter ._ __ _ _. _. . . . . . . . . . . . 170 Commcrrial cellulose acetate tilLer . . . . . 194 Chsrcoal and acet.tc filter . . . . . . . . . . . . 612 Cambridpc filter . . . . . . . . . . boo Ken&r III G-9: Cianrettc smoke Rabbit trachea-Total smoke condemw& of 2 and Rabbit mnd componenta cigareiten, gas phase condensate of 7 ci&%- B.ttisu. trdlcs. in Tyrode's rctte caused similar ciliastasis. 1966. cat t.chea. Yolution. Other sDeeiar--All found scnaitive to ciliaatrtic U.S.A. don trde., components of cigarette smoke. Bulk of a~- (135). monkc7 tivitg noted in gal phase (HCH. fommkk- tncba bud=-. rcrokia). I-St machcr 248 TABLE A13.--Erpen'msnts concerning the rdcct oj kgarette smoke or its comtitucnts upon diary junction (cont.) Author. ye-r. CD"3h-S. SIStem Methcd ' IkS"lb reference Kaminski In virlo: Whole md filtered Wet chamber adsrotion aignificantlrr reduced et II.. c*t trP.chea. cigarette smoke tbc cilirstaric activity of whole smoke. but 1968. er$cm?d or uler- did not affect the ciliastatic activity of smoke U.S.A. posed to "Wet previously filtered by Cambridge or cbuwal (ISJ). chamber" made filters. to stimulate oral mucoma and saliva Klrhl In viw: CiRarette amokc SimiBcant ciliastasis. reveaible. md ConmOD dissolved in BulmMb* mollusk sea water. 1968. ciiirtcd U.S.A. cpithclinm. (IN). B.ttiata and Ken&r, 1970, U.S.A. (ra). Bdtlsta md ILenskr. 1970. U.S.A. (19). In vitro: Cigrrette smoke The autban observed that: Chicken or HCN in (1) The more diluted smoke required more trxhed TYrode's puRa to cau3c ciliastasis. cpitbelium. solution. . (2) Activated rbarcoal filtered smoke wu less eiiia3tatic than ceilulose acetnte filtered smoke and ~LYO contained less HCN and acmkio. (3) HCN alone Wm ciliastatic but recovery WLS mare rapid than after cigarette smoke alone. They conclude that the ~a, phase components are more related to ciliastaeis (as particnlste matter is not aignificantb decrearred by char- coal filtration while HCN and acmlein nre). In o&m: Ciearette smoke. The authors ab,crved th.t: Hen tracha. (1) Whole smoke acuteb depressed ciliuy activity in 44 puffs. 249 Dalhamn In vim: Unfilteredcigarette Acrmor number of puda required to arrest and Cat trachea. and c,ge.r smoke. diary nctivity Rylander. Cigsrette smoke . ._. __. 73 (p