Occupation 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.