Occupational and chronic obstructive pulmonary disease (COPD)

INTRODUCTION There is growing interest in preventable, non-smoking causes of chronic obstructive pulmonary disease (COPD), among which are chronic exposures to respiratory irritants in the workplace. SOURCES OF DATA Reviews of occupational COPD in specific occupations and industries and in general populations; supplemented with other or more recently published material. AREAS OF AGREEMENT There is good evidence for an increased risk of COPD from certain specific exposures (coal mine dust, silica, welding fume, textile dust, agricultural dust, cadmium fume). AREAS OF CONTROVERSY Less clear is the causal role of non-specific dusts or fumes/gases in general populations where the available literature is notably uncritical. GROWING POINTS Other specific exposures, such as diesel fume; interactions between specific exposures and cigarette smoking; the development of safe working limits. AREAS TIMELY FOR DEVELOPING RESEARCH Occupations with large numbers of exposed employees, particularly in low-income countries.