PRIORITIES IN PREVENTION OF CHRONIC LUNG-DISEASES

We recorded the prevalence of respiratory symptoms as well as smoking habits, occupational and other environmental exposures, and lung function (maximum expiratory flow-volume [MEFV]) curves in 7,984 community residents (age 7 + years) and in 691 cotton textile workers (age 45 + years). Apart from a slight but significant excess among urban nonsmoking adults of usual cough, usual phlegm and dyspnea, but not of chronic bronchitis, there were no significant differences in respiratory health between residents of urban Ansonia, Connecticut, rural Lebanon, Connecticut, and rural Winnsboro, South Carolina. Lung function values, including flows on MEFV curves, did not differ significantly in nonsmokers, nor in smokers, in the three communities, after sex, race, age, height, and weight were taken into account. Smoking of cigarettes but not of pipes or cigars was associated with significant loss of lung function. Cotton textile workers had a significant excess of both symptoms and lung function loss; the effects of smoking and of cotton dust exposure were additive. Among the community residents, a history of asthma was most common in the least polluted rural town, Winnsboro. From our own data and from comparisons between our data and those of others in either more polluted or less polluted areas, we have concluded that control of air pollution outdoors is unlikely to decrease the health impact of chronic lung diseases. Prevention of cigarette smoking and of occupational exposures, on the other hand, deserves high priority as a public health problem. In particular, adequate control of exposures to dust and fumes in industry could completely prevent disabling chronic lung disease among groups of workers now at high risk, such as cotton textile workers. © 1979 Springer-Verlag.