13). Camner, et al. (BP 8) reported on clearance rates in 17
young and middle-aged ex-smokers who had stopped smoking for
3 months. These workers noted that mucociliary clearance of 6
ym. fluorinated ethylene propylene (Tefion 120) particles tagged
with Tc®™ measured at 2 hours post-inhalation had improved
at 3 months post-quitting in 11 of 17 patients. Mean retention
of particles was significantly higher prior to stopping smoking
than at 8 months (P <.05), and also was higher at 1 week post-
cessation compared to 3 months post-cessation (P =.005). In
this study, the volume of inhaled aerosol was not controlled. In
addition, coughing after inhalation of the particles was reported
to be conspicuously absent or rare, whereas in the Thomson
study (BP 67), the effect of coughing during the study was not
discussed.

 
  
  
 
 

g

“Me wma Smokers (18)
Nonsmokers (23) pHealthy
a = Ex-smokers (9)

Parcent of Initial Lung Burden
8
v

—
oo. ar =e Nonamokers (6)
40f- O09” Tots aq Smokers (17) Vries
Fo 110 «(016 «600.16 0.17 ° o12 0.38 «(048 «= 0.68 (0.32 0.37 rg exsmoners 6)
Healthy Group 0.15
nN _,

 

Not Significant
O11 0.01 0.06 0.12

Pe
F 2.86 0.70 1.34 1.66 191 1.54 1,32 0.56 .
30) Impaired Group
ane
P
i 1
°

Not Significant
1

 

J 1 J
3 4 5 6
Time After inhalation (hr)

j 1 ! 1
1 2

Ficure 13.—Mean clearance curves for smokers, ex-smokers, and nonsmokers in

the healthy group and the group with respiratory impairment. F= Snedecor’s

F; the values required for significance at the 5 percent level are 3.19 for the
healthy group and 3.35 for the impaired group.

SOURCE: Thomson, M. L., Pavia, D. (BP 67).

The question of whether the short-term effect of cigarette
smoking on enhancing mucociliary transport is specific to ciga-
rette smoke, or is due to a nonspecific reaction of the tracheo-
bronchial tree, was investigated by Camner, et al. (BP 7) who
found that inhalation of inert carbon particles by 8 normal sub-
jects (including 2 smokers) resulted in similar or enhanced

101
pulmonary clearance rates compared to the control states. These
results suggest that the increased mucociliary transport effected
by short-term exposure to cigarette smoke may be a nonspecific
reaction.

Westergaard and Olsen (BP 68) studied ciliary activity in
biopsy specimens from the larynx and carina in 20 patients and
found that there was no ciliary activity in epithelial cells from
these sites in the entire group of 16 moderate and heavy smokers,
while in 3 nonsmokers and 1 cigar smoker normal ciliary activity
was observed.

Studies in Animals

Binns and Clark (BP 1) described a new experimental model
for testing the short- and long-term effects of cigarette smoke on
pulmonary physiology. By using male cynomolgus monkeys which
were fitted with a specially designed smoking device, these au-
thors demonstrated marked increases in total pulmonary resist-
ance in animals smoking approximately 12 cigarettes per day,
for 5 days per week. These changes stabilized at about 20 weeks
of exposure and extended through the 6-month test period. The
changes in pulmonary resistance were statistically significant
(P <.001). After 6 months, no changes in tidal volume, respira-
tory rate, or dynamic compliance were noted. Histologic sections
of lungs from smoking monkeys showed clumping of pulmonary
alveolar macrophages containing pigmented granules and foamy
cytoplasm. These nonspecific cytologic changes have been observed
in other animals exposed to cigarette smoke.

Previous editions of this report (1972, 1973) have described
experimental evidence concerning the production of emphysema-
tous changes in rat and guinea pig lungs by exposure to nitrogen
dioxide (NO.), one of the gaseous components, of cigarette
smoke. Freeman, et al. (BP 18) described experiments whereby
low (10 to 15 p.p.m.), intermittent doses of NO, administered
over the normal life span of rats resulted in more severe changes
of the pulmonary parenchyma than those previously reported;
these changes included fibroblastic proliferation, epithelial hy-
pertrophy, loss of cilia in the respiratory bronchioles, fibrosis of
alveolar ducts, destruction of alveolar walls, and enlargement of
alveolar air spaces. These authors calculated a 29 percent loss of
ventilatory surface in the NO,-exposed rats, occurring in a pan-
lobular distribution. The lungs of the NO,-exposed rats had
greater residual volumes than the controls, and these rats suf-
fered from hypoxemia, hypercarbia, and acidosis, as well as a
compensatory polycythemia. Thus, by administering lower doses
of NO, intermittently, survival of these rats was prolonged (com-
pared with survival of rats receiving continuous NO,), and the

102
development of a full-blown picture of emphysema similar to that
seen in humans was produced. The relative role of NO, in the
causation of emphysema in humans is still unknown.

In another series of experiments, Giordano and Morrow (BP
91) studied mucociliary clearance rates in female rats exposed
continuously to low doses of NO, (6 p.p.-m.) over 4 period of 6
weeks. They found a significantly decreased rate of clearance in
rats exposed to NO, than in nonexposed rats (P <.02). In
those animals with a decrease in mucociliary activity, the effect
of NOz was reversible within 7 days following this long-term low
dose exposure.

Goldstein, et al. (BP 22) reported on the effects of low level
NO. exposure on bactericidal activity of the mouse lung. They
first infected mice with radioactively labelled Staphylococcus
aureus and then exposed them to different concentrations of NO,
for 4 hours. The authors then measured pulmonary radioactivity
and bacterial concentrations. They found that at concentrations
of 7, 9.2, and 14.8 p.p.m. NO, the level of radioactivity was
unchanged, but bacterial counts were greater in the NO--
exposed mice (P <.05), and they concluded that the bacterici-
dal activity of the NO,-exposed animals was significantly less
than that of control animals at these concentrations of NO.. In a
series of experiments where mice were first exposed to 1.0, 2.38,
and 6.6 p.p.m. NO: for 17 hours and then infected with the label-
led Staphylococcus aureus, pulmonary bactericidal activity was
decreased in the mice exposed to the latter two concentrations
of NO, (P <.05 and P <.01). In both sets of experiments, the
physical removal rates of bacteria by the pulmonary tree (as
measured by the degree of remaining radioactive label) was not
influenced by NO: These experiments suggest that the retarda-
tion of pulmonary bactericidal activity was due to dysfunction
of the cellular elements of the pulmonary defense mechanism
(i.e, pulmonary alveolar macrophages [PAMs]) in the NO.-
exposed mice.

Fenters, et al. (BP 15) exposed four monkeys to low dose
NO, (1 p.p.m.) for 16 months and infected these animals with
influenza virus. Three control monkeys were exposed to the virus,
but not to the NO. The NO,-exposed animals had higher hemag-
glutination-inhibition and serum neutralizing antibody responses
against the virus than the nonexposed animals. Pathologic ex-
amination of the lungs of these animals demonstrated slight to
moderate emphysema in the NO.-exposed and virus-infected
monkeys, along with thickening of the bronchial and bronchiolar
epithelium, and no such changes in. those animals only infected

with virus.

103
Dalhamn (BP 18) conducted experiments on 40 live rats,
exposing them to cigarette smoke of different chemical composi-
tions. The cigarette smoke was analyzed for “tar”, nicotine, pH,
acrolein, nitrogen oxides (NO), acetaldehyde, hydrogen cyanide
(HCN), and carbon monoxide (CO). The author found an in-
verse correlation between the number of puffs required to produce
ciliostasis of the tracheobronchial tree and the amount of acro-
lein, HCN, CO, “tar”, and nicotine found in the cigarette smoke.
The data appeared to indicate that the majority of the effect was
caused by the “tar” and acrolein content of the cigarette
smoke.

Gairola and Aleem (BP 19) studied the effect of the water
soluble and insoluble fractions of tobacco smoke on rat liver
mitochondrial function. These investigators found that both
fractions were effective in inducing a decline in energy produc-
tion by the mitochondria, but to differing degrees, thereby
suggesting some difference in their mechanisms of action on
mitochondria.

Snider, et al. (BP 59) exposed rats to 0.1 percent cadmium
chloride solution by aerosol, and were able to demonstrate cen-
trilobular emphysema in these animals after 10 days. Since
cadmium has been found in cigarette smoke, and smokers and
patients with emphysema have been shown to have elevated tis-
sue levels of cadmium at postmortem, further studies defining
the role of cadmium in the development of pulmonary. emphy-
sema in man would be useful. In Snider’s experimental pro-
tocol, animals exposed to 1 percent of CdCl, developed a severe
hemorrhagic necrotizing chemical pneumonia, and the lower dose
of CdCl, also elicited a hemorrhagic response, although no evi-
dence of such an inflammatory response was evident 10 days
post-exposure.

CYTOLOGIC AND HISTOLOGIC STUDIES

Experimental evidence indicates that cigarette smoke can im-
pair the function of pulmonary alveolar macrophages (BP 52).
Pulmonary macrophages appear to be the primary defense
against bacterial invasion of the pulmonary parenchyma and
also serve to remove particulate contaminants from inspired
air. In recent experimental work, Powell and Green (BP 53) in-
vestigated the mechanism of action of cigarette smoke on macro-
phage function. By using histochemical staining techniques, these
workers found that the filtered gas phase of cigarette smoke
(FGP) inhibited aldehyde dehydrogenase activity in rabbit pul-

104
monary alveolar macrophages (PAMs). This effect of FGP was
inhibited by prior addition of cysteine to the medium. The loss
of enzyme activity correlated with the loss of macrophage phago-
cytic function (which was also prevented by the prior addition
of cysteine). No other enzyme was inhibited by cigarette smoke
(except for G6PD in those preparations of cells which adhered
to glass). By using crystalline glyceraldehyde 3-phosphate de-
hydrogenase, the authors demonstrated that FGP inhibited ac-
tivity of this enzyme, and the degree of inhibition was directly
related to the period of incubation (most of the inhibition oc-
curring within the first five minutes). This enzyme was not
inhibited by FGP in the presence of cysteine. When enzyme
activity was assayed in cell preparations, glyceraldehyde 3-
phosphate dehydrogenase activity was reduced by FGP. This
inhibition was dose-related to FGP. FGP did not influence G6PD
or LDH activity in the pulmonary alveolar macrophages. These
experiments suggest that FGP inhibited the glycolytic pathway
within the pulmonary alveolar macrophages concurrent with the
impairment of phagocytic activity of these cells. The authors
postulated that FGP may act as a sulfhydryl agent (thereby
explaining the protective effect of cysteine) in the disruption
of the activity of glyceraldehyde 3-phosphate dehydrogenase.

York, et al. (BP 72) showed that incubation of sheep pul-
monary macrophages with tobacco extract resulted in an initial
stimulation, then inhibition of macrophage oxygen consumption.
When cigarette smoke extract was incubated with the macro-
phages, & continuous decrease in oxygen consumption was ob-
served, proportional to the incubation period and concentration
of smoke extract (figure 14). The enzymatic mechanism of the
inhibition of macrophage respiration was not examined in these
experiments.

Invertase placed in a medium of calf’s serum results in en-
hanced pinocytosis by sucrose-laden mouse peritoneal macro-
phages (monocytes). Schwartz, et al. (BP 56), utilizing this
test system, reported that nicotine inhibited invertase-induced
pinocytosis by sucrose-laden mouse peritoneal monocytes by 29
and 18 percent, depending on the concentration of nicotine added
to the medium. The contribution of this type of pinocytosis to
the bactericidal activity of these monocytes is unclear at present.

105
O: Uptake, Percent of Control

 

 
    

T t ¥ ai J c T ' v T v v t
120 F
Viability
100 fF po. = 100
‘SO amen ape,
. = -
Orme on wg, 3s
mat A ep anee, 2
so Fr —ameeg “| 80 8
> Initial Rate - 5
60 F 4 60 5
2
bo 4 é
40 70 2
3
be “4 &
>
20 PF 4+ 20
0 1 A i i i i 1 l i 1 1 l i 1 0

 

 

 

0.2 0.4 06 . 08 1.0 1.2 14

Smoke Extract, ml

Ficure 14.—Effects of aqueous cigarette smoke extract on initial oxygen uptake,

final oxygen uptake, and cell viability of pulmonary macrophages.

SOURCE: York, G. K., et al. (BP 72).

SUMMARY OF RECENT NON-NEOPLASTIC
BRONCHOPULMONARY FINDINGS

Results from epidemiologic studies on elderly populations
demonstrate an increased prevalence of respiratory symp-
toms and impairment of pulmonary function among smokers
of both sexes compared to nonsmokers.

Data from several recent studies indicate that standard pul-
monary function tests and physical work capacity are impaired
in apparently healthy smokers compared to nonsmokers.
Recent epidemiologic data suggest that smokers who retain
their cigarettes in their mouths continuously while smoking
(“droopers”) have a higher prevalence of chronic bronchitis
than those smokers who remove the cigarette from their
mouths between puffs.

A recent epidemiologic study confirms the observation that
cigarette smoke and air pollution act synergistically in the
development of symptoms of respiratory disease.

Results from several recent studies indicate that cigarette
smokers have a higher prevalence of functional abnormali-
ties of the small airways than do nonsmokers.

106
Results from a recent study suggest that although a history of
lower respiratory disease as an infant is related to the preva-
lence of cough at age 20, cigarette smoking is a far more
important factor in the development of cough in young
adulthood.

Data from a major retrospective study indicate that cigarette
smoking is related to the development of bullous disease of
the lung.

Experimental studies in animals have shown that exposure to
nitrogen dioxide, a constituent of the vapor phase of cigarette
smoke, results in emphysema-like changes in the pulmonary
parenchyma, diminished mucociliary clearance, and impair-
ment of bactericidal activity of alveolar macrophages.

Data from experimental studies have demonstrated that the
filtered gas phase of tobacco smoke may effect changes in
pulmonary alveolar macrophage metabolism through inhibition
of the glycolytic pathway ; cigarette smoke may also impair
oxygen consumption and pinocytic activity of pulmonary
alveolar macrophages.

BRONCHOPULMONARY DISEASE REFERENCES

. Binns, R., CLARK, G. C. An experimental model for the assessment of
the effects of cigarette smoke inhalation on pulmonary physiology.
Annals of Occupational Hygiene 15 (2-4) : 237-247, November 1972.
 Brooxs, A. G. F., WALLER, R. E. Peak flow measurements among visitors
to a public health exhibition. Thorax 27(5): 557-562, September 1972.
. Burst, A. S., Ross, B. B. Closing volume as a simple, sensitive test for
the detection of peripheral airway disease. Chest 63 (4, Supplement) :
298-308, April 1973.

. Buist, A. S., Ross, B. B. Predicted values for closing volumes using @
modified single breath nitrogen test. American Review of Respiratory
Disease 107 (5): 744-752, May 1973.

. Burst, A. S., VAN Fieet, D. L., Ross, B. B. A comparison of conven-
tional spirometric tests and the test of closing volume in an
emphysema screening center. American Review of Respiratory Di-
sease 107(5) : 735-743, May 1973.

. Carp, F. L, AKHTAR, A. J. Chronic respiratory disease in the elderly.
Thorax 27(6): 764-768, November 1972.

_ CAMNER, P., HELSTROM, p.-A., PHILIPSON, K. Carbon dust and mucocil-
iary transport. Archives of Environmental Health 26(6): 294-296,
June 1973.

. CAMNER, P., PHILIPSON, K., ARVIDSSON, |. Withdrawal of cigarette
smoking. A study on tracheobronchial clearance. Archives of Enviror

mental Health 26(2): 90-92, February 1973.

107
9.

10.

11.

12.

13.

14.

15.

16.

17.

18,

19.

20.

21.

22.

23.

24.

108

Cuew, P. K., Cata, M., Cuew, S. F., SupRAMANIAM, J. M. J., CHAN,
W., CHEW, C. H., Ne, Y. K., GANDEVIA, B. Asbestos workers in Singa-
pore. A clinical, functional, and radiological survey. Archives of En-
vironmental Health 26(6): 290-293, June 1973.

CuarK, T. J. H. Assessment of airway closure using the closing volume
method. Proceedings of the Royal Society of Medicine 64(12): 1245-
1246, December 1971.

CoLEMAN, A. E., BurForp, C. L., KREUZER, P. Aerobic capacity of rela
tively sedentary males. Journal of Occupational Medicine 15(8):
628-632, August 1973.

Cottey, J. R. T., Douacuas, J. W. B., Rem, D. D. Respiratory disease in
young adults: Influence of early childhood lower respiratory tract ill-
ness, social class, air pollution, and smoking. British Medical Journal
3(5878) : 195-198, July 28, 1973.

DALHAMN, T. Some factors influencing the respiratory toxicity of cig-
arette smoke, Journal of the National Cancer Institute 48(6): 1821-
1824, June 1972.

Da Siuva, A. M. T., HamosH, P. Effect of smoking a single cigarette
on the “small airways”. Journal of Applied Physiology 34(3) : 361-
365, March 1973.

FENTERS, J. D., FINDLAY, J. C., Port, C. D., EHRLICH, R., COFFIN, D. L.
Chronic exposure to nitrogen dioxide. Immunologic physiologic, and
pathologic effects in virus-challenged squirrel monkeys. Archives of
Environmental Health 27(2): 85-89, August 1973.

Fox, A. J., ToMBLESON, J. B. L., Watt, A., WILKIE, A. G. A survey of
respiratory disease in cotton operatives. Part IT. Symptoms, dust
estimations, and the effect of smoking habit. British Journal of
Industrial Medicine 30(1): 48-538, January 1973.

FRANK, S. T., WEG, J. G., HaRKLeroaD, L. E., Fitcu, R. F. Pulmonary
dysfunction in rheumatoid disease. Chest 63(1): 27-34, January 1978.

FREEMAN, G., CRANE, S. C., Furiosi, N. J., STEPHENS, R. J., EVANS,
M. J., Moore, W. D. Covert reduction in ventilatory surface in rats
during prolonged exposure to subacute nitrogen dioxide. American
Review of Respiratory Disease 106(4): 563-579, October 1972.

GAIROLA, C., ALEEM, M. I. H. Cigarette smoke: Effect of aqueous and
nonaqueous fractions on mitochondrial function. Nature 241 (5387) :
287-288, January 26, 1973.

GELB, A. F., ZAMEL, N. Simplified diagnosis of small-airway obstruction.
New England Journal of Medicine 288(8): 395-398, February 22,
1973.

GriorpaNo, A. M., Morrow, P. E. Chronic low-level nitrogen dioxide
exposure and mucociliary clearance. Archives of Environmental
Health 25(6): 448-449, December 1972.

GotpsteIn, E., EAGLE, M. C., Hozpricu, P. D. Effect of nitrogen dioxide
on pulmonary bacterial defense mechanisms. Archives of Environ-
mental Health 26(4): 202-204, April 1973.

GREEN, M., Travis, D. M. A simplified closing-volume method suitable for
field use. Lancet 2(7783) : 905-906, October 28, 1972.

Grimes, C. A., HANES, B. Influence of cigarette smoking on the spiro-
metric evaluation of employees of a large insurance company. Ameri-
can Review of Respiratory Disease 108(2): 278-282, August 1973.
Ww
=

29.

30.

31.

32.

33.

34,
35.

36.

37.

38.

HEWENAL, G.-K., Fontana, R. 5. TauxE, W. N. Radioactive xenon

pulmonary studies in the smoker. Cancer 30(5): 1858-1367, Novem-
per 1972.

YWiccins, M. W., KELLER, J. B. Seven measures of ventilatory lung func-
tion. Population values and a comparison of their ability to discrimi-
nate between persons with and without chronic respiratory symptoms
and disease, Tecumseh, Michigan. American Review of Respiratory
Disease 108(2): 258-272, August 1973.

_ HUTCHINSON, D. C. S., BARTER, C. E., Cook, P. J. L., Laws, J. W.,

MARTELLI, N. A. Hucs-Jones, P. Severe pulmonary emphyseme. A
comparison of patients with and without a antitrypsin deficiency.
Quarterly Journal of Medicine 41(163) : 301-315, July 1972.

IncRaM, R. H., IR., Scurtper, D. P. Association of a decrease in dynamic
compliance with a change in gas distribution. Journal of Applied
Physiology 23(6) : 911-916, December 1967.

Kavacic, I. Chronic nonspecific lung disease in cement workers. Archives
of Environmental Health 26(2): 78-83, February 1973.

Karacic, I. Ventilatory lung function in cement workers. Archives of
Environmental Health 26(2): g4-85, February 1973.

Kass, I., O'BRIEN, L. E., ZAMEL, N., DYKSTERHUIS, J. E. Lack of correla-
tion between clinical background and pulmonary function tests in
patients with chronic obstructive pulmonary diseases. A retrospective
study of 140 cases. American Review of Respiratory Disease 107(1):
64-69, January 1978.

Kitpurn, K. H., MERCHANT, J., LUMSDEN, J., HAMILTON, J. Chronie bron-
chitis in cotton textile workers. Evidence for addition of effect of
cigarette smoking and oceupational exposure. IN: Brzezinski, Z.,
Kopezynski, J., Sawicki, F. (Editors.) Ecology of Chronic Nonspecific
Respiratory Diseases. International Symposium, Warsaw, Poland,
September 7-8, 1971. Warsaw, Panstwowy Zaklad Sydawnictw
Lekarskich, 1972. pp 76-82.

Krumuoz, R. A., Heprick, E. C. Pulmonary function differences in
normal smoking and nonsmoking, middle-aged, white-collar workers.
American Review of Respiratory Disease 107(2): 925-230, February
1973.

LANcET. Closing volume. Lancet 2(7783) : 908-910, October 28, 1972.

LaAszLo, G., ARCHER, G. G., DARRELL, J. H., Dawson, J. M., FLETCHER,

C. M. The diagnosis and prophylaxis of pulmonary complications of

surgical operation. British Journal of Surgery 60 (2): 129-134,
February 1973.

LEBLANC, P., RUFF, F., Mitc-EMILl, J. Effects of age and pody position
on “airway closure” in man. Journal of Applied Physiology 28:
448-451, 1970.

LEPINE, C., Myre, M. L. L’emphyseme pulmonaire. Confrontations
cliniques et physiopathologiques, avec une reference speciale a l’usage
de la cigarette. (Pulmonary emphysema. Clinical and physiopatholog-
jeal comparisons with a special reference to cigarette usage.) Mede-
cine d’Afrique Noire 17(3) : 261-267, March 1970.

Linn, W. S., HACKNEY, J. D. Nitrogen and helium “closing volumes”
simultaneous measurement and reproducibility. Journal of Applied
Physiology 34(3): 396-399, March 1973.

109
39.

40.

41.

42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

110

McCarruy, D. S., Craic, D. B. Why the difference in closing volume?
(Letter). Lancet 2(7790).: 1321, December 16, 1972.

McCartuy, D. S., SPENCER, R., GREENE, R., Mitic-EMiLt, J. Measurement
of “closing volume” as a simple and sensitive test for early detection
of small airway disease. American Journal of Medicine 52(6): 747-
753, June 1972.

Macktem, P. T. Obstruction in small airways—a challenge to medicine,
American Journal of Medicine 52(6) : 721-724, June 1972.

Mackie, P. T., Map, J. Resistance of central and peripheral airways
measured by a retrograde catheter. Journal of Applied Physiology
22(3) : 395-401, 1967.

Mackiem, P. T., Proctor, D. F., Hoae, J. C. The stability of peripheral
airways. Respiration Physiology 8: 191-203, 1970.

Martsusa, K., THURBECK, W. M. Disease of the small airways in chronic
bronchitis. American Review of Respiratory Disease 107(4): 552-558,
April 1973.

Mine, J. S., WILLIAMSON, J. The relationship of respiratory function
tests to respiratory symptoms and smoking in older people. Respira-
tion 29(3): 206-218, 1972.

MILNE, J. S., WILLIAMSON, J. Respiratory symptoms and smoking habits
in older people with age and sex differences. Respiration 29(4):
359-370, 1972.

Mitrman, C. Chronic obstructive lung disease: The result of the inter-
action of genetic and environmental factors. Heart and Lung 2(2):
222-2296, March-April 1973.

MITTMAN, C., BARBELA, T., LIEBERMAN, J. Alpha-antitrypsin deficiency
as an indicator of susceptibility to pulmonary disease. Journal of
Occupational Medicine 15(1): 33-38, January 1973.

MitTMAN, C., BARBELA, T., LIEBERMAN, J. Antitrypsin deficiency and
abnormal protease inhibitor phenotypes. Archives of Environmental
Health 27(3): 201-206, September 1978.

OuznHutac, A., Donpoc, H., BADAMTSEDEN, B., CHacnasay, L. The
prevalence of chronic bronchitis under the conditions of Mongolia.
Sante Publique; Revue Internationale 15(2): 201-207, 1972.

Osman, H. A., WAHDAN, M. H., NowWEIR, M. H. Health problems result-
ing from prolonged exposure to chemical agents in rubber industry.
Journal of the Egyptian Public Health Association 47(5): 290-311,
1972.

Paterson, N. A. M., AnMaD, D., LEFCOE, N. M. Airways narrowing
in exercise in normal subjects and the effect of disodium cromoglycate.
British Journal of Diseases of the Chest 67: 197-207, July 1978.

PowELL, G. M., GREEN, G. M. Cigarette smoke—a proposed metabolic
lesion in alveolar macrophages. Biochemical Pharmacology 21(13):
1785-1798, July 1, 1972.

REINTJES, M., SWIERENGA, J., BOGAARD, J. M. Effect of smoking one cig-
arette on airway resistance. Scandinavian Journal of Respiratory
Diseases 53(3) : 129-134, 1972.

RIMINGTON, J. Chronic bronchitis: Method of cigarette smoking. British
Medical Journal 1(5856) ; 776-778, March 31, 1973.
56.

57.

58.

59.

60.

61,

62.

63.

64.

65.

66.

67.

68.

69.

70.

71,

ScuwakTz, S. L., EVANS, D. E., LUNDIN, J. E., BOND, J. C. Inhibition of
pinocytosis by nicotine. Journal of Pharmacology and Experimental
Therapeutics 183(2): 370-377, November 1972.

Scott, K. W. M. An autopsy study of bronchial mucous gland hyper-
trophy in Glasgow. American Review of Respiratory Disease 107(2):

239-245, February 1973.

SHERMAN, J., Woure, S., Hricxo, A., Mets, M. A Health Research
Group Study on Disease Among Workers in the Auto Industry.
Health Research Group, Washington, D.C. September 7, 1973. 48 pp.

Sniper, G. L., HAYES, J. A., KoRTHY, A. L, Lewis, G. P. Centrilobular
emphysema experimentally induced by cadmium chloride aerosol.
American Review of Respiratory Disease 108(1): 40-48, July 1973.

Spain, D. M., SIEGEL, H., BRADESS, V. A. Emphysema in apparently
healthy adults. Smoking, age, and sex. Journal of the American
Medical Association 224(3): 322-325, April 16, 1973.

Sreizer, F. E., Ferris, B. G., JR. Exposure to automobile exhaust. I.
Prevalence of respiratory symptoms and disease. Archives of Environ-
mental Health 26(6): 318-818, June 1973.

Speizer, F. E., Ferris, B. G., JR. Exposure to automobile exhaust. II.
Pulmonary function measurements. Archives of Environmental Health
26(6) : 319-324, June 1973.

STanescu, D. C. Age and smoking dependency of the single-breath
oxygen test in healthy subjects. Pneumonologie 147(1): 46-51, 1972.

StoLorr, I. L., Victor, S. B. Another hazard of smoking: Bullous dis-
ease of the lung. Archives of Environmental Health 25(6): 415-419,
December 1972.

Stone, D. J., SarKaR, T. K., Kettz, H. Effect of adrenergic stimulation
and inhibition on human airways. Journal of Applied Physiology
34(5) : 624-627, May 1973.

SussKinp, H., Ricarps, P., SKOLNICK, M., ATKINS, H. L. Detection of
impaired pulmonary function with a mass-spectrographic tracer tech-
nique. 24th ACEMB, International Hotel, Las Vegas, October 31-
November 4, 1971. 1 p.

Tomson, M. L., Pavia, D. Long-term tobacco smoking and mucociliary
clearance. Archives of Environmental Health 26(2) : 86-89, February
1973.

WESTERGAARD, 0., OLSEN, P. Smoking and ciliary movement in the upper
respiratory tract. Archiv fur Klinische und Experimentelle Ohren-
Nasen- und Kehlkopfheilkunde 203(3) : 179-183, 1978.

Wootcock, A. J., CoLMAN, M. H., BLackBurN, C. R. B. Chronic lung
disease in Papua New Guinea and Australian populations. Papua
New Guinea Medical Journal 16(1) : 29-35, March 1973.

Wootcock, A. J., COLMAN, M. H., BLAcKBURN, C. R. B. Factors affecting
normal values for ventilatory lung function. American Review of
Respiratory Disease 106(5) : 692-709, November 1972.

Woo.cock, A. J., VINCENT, N. J., Macktem, P, T. Frequency depen-
dence of compliance as a test for obstruction in the small airways.
Journal of Clinical Investigation 48: 1097-1106, 1969.

111
72, York, G. K., ARTH, C., STUMBO, J. A., Cross, C. E., Mustara, M. G,
Pulmonary macrophage respiration as affected by cigarette smoke
and tobacco extract. Archives of Environmental Health 27(2): 96-98,
August 1973.

93. ZaRKovic, G. Etiology of non-specific chronic respiratory illness and
cor pulmonale in Bosnia and Hercegovina. International Journal of
Epidemiology 1(2): 167-176, 1972.

BRONCHOPULMONARY DISEASE SUPPLEMENTAL
REFERENCES

‘Part I

(Articles which were reviewed but not discussed in the text, providing data
. confirming well-established relationships between smoking and bronchopul-
monary disease.)

72-1082. ANDERSON, J. A., DUNNILL, M. 5S., Ryprr, R. C. Dependence of the
incidence of emphysema on smoking history, age, and sex. Thorax
27(5) : 547-551, September 1972.

ANTHONISEN, N. R., DANSON, J., ROBERTSON, P. C., Ross, W. R. D.
Airway closure as a function of age. Respiration Physiology 8:
58-65, 1969-1970.

73-0048. Brarp, J., EMonoT, A: Enquéte sur Pétiologie due pneumothorax
spontané, dit idiopathique. (Survey on the etiology of so-called
idiopathic spontaneous pneumothorax.) Journal de Médecine de
Lyon 53: 281-284, 287-290, February 20, 1972.

73-0156. Bouptk, F., ULRicH, J., SVEC, F., BoBak, J., GOLDSMITH, J. R.
Prevalence of respiratory symptoms in three areas of Bohemia
with different air pollution. IN: Brzezinski, Z., Kopezynski, J.,
Sawicki, F. (Editors). Ecology of Chronic Nonspecific Respira-
tory Diseases, International Symposium, Warsaw, Poland, Sep-
tember 7-8, 1971. Warsaw, Panstowowy Zaklad Wydawnictw
Lekarskich, 1972. pp. 34-42. Lo

72-0984. Britix, D. Epidémiologie de la bronchite chronique données actuel-
les d’aprés les études statiques. (Epidemiology of chronic bron-
chitis current data according to static studies.) Evoluation
Medicale 15 (3-5) : 287-299, 1971.

71-0611. BRILLE, D. Fréquence de la bronchite chronique chez la femme.
Réle du tabac. (Incidence of chronic bronchitis in women. The
role of tobacco.) Revue de Tuberculose et de Pneumologie 33 (6):
194-797, 1969.

72-1083. BRINKMAN, G. L., BLocK, D. L. Chronic bronchitis in a working
population. Journal of Occupational Medicine 14(11): 825-827,
November 1972.

72-0648. BRINKMAN, G. L., BLock, D. L., CRESs, C. Effects of bronchitis

and occupation on pulmonary ventilation over an li-year period.
Journal of Occupational Medicine 14(8); 615-620, August 1972.

112
72-0979.

73-0465.

72-0360.

73-0160.

73-0037.

74-0069.

72-1108.

73-0296.

73-0643.

73-0299.

73-0807.

CUNNINGHAM, D. A., Montoys, H. J., Hiccrns, M. W., KELLER,
J. B. Smoking habits, chronic bronchitis and shortness of breath
and physical fitness. Medicine and Science in Sports 4(3): 138-
145, 1972.

DEtorr, L., PUDELSKI, J., OKLEK, K., RoZANowICcz, A., SEDLACZEK,
A. Obraz epidemiologiczny przewleklych nieswoistych chorob
pluc u mezezyzn miasta Zabrza. Wplyw palenia papierosow i
pracy zawodowej. (Epidemiological picture of chronic non-
specific pulmonary diseases in men, at Zabrze. The effect of
smoking and of professional work.) Gruzlica i Choroby Pluc
40(10) : 889-896, October 1972.

ELLEFSEN, P., Tos, M. Goblet cells in the human trachea. Quan-
titative studies of a pathological biopsy material. Archives of
Otolaryngology 95(6): 547-555, June 1972,

FELKEL, H., Kupix, A., FEUEREISL, R., GALLAS, I, REI, I. Chronic
bronchitis in manual workers employed in the open air and in a
factory hall. IN: Brzezinski, Z., Kopezynski, J., Sawicki, F.
(Editors). Ecology of Chronic Nonspecific Respiratory Diseases,
International Symposium, Warsaw, Poland, September 7-8, 1971.
Warsaw, Panstwowy Zaklad Wydawnictw Lekarskich, 1972. pp.
114-116.

Ferris, B. G., Jr., Hiccrns, I. T. T., Hiccrns, M. W., Peters, J. M.
Chronic nonspecific respiratory disease in Berlin, New Hamp-
shire 1961 to 1967. A follow-up study. American Review of
Respiratory Disease 107(1): 110-122, January 1973.

Ferris, B. G., Jr., RANADIVE, M. V., Peters, J. M., MURPHY,
R. L. H., Burcess, W. A., PENDERGRASS, H. P. Prevalence of
chronic respiratory disease. Asbestosis in ship repair workers.
Archives of Environmental Health 23(3): 220-225, September
1971.

FEUEREISL, R., KRZHIVANEK, I., REM, I., KuBIK, A., FELKEL, K.
Deistvie Kureniya na Serdechno-Legochnuyu Funkktsiyu. (Effect
of smoking on cardiopulmonary function.) Klinicheskaya Medit-
sina 50(7) : 82-84, 1972.

Fox, A. J., TOMBLESON, J. B. L., Watt, A., WILKIE, A. G. A sur-
vey of respiratory disease in cotton operatives. Part I. Symp-
toms and ventilation test results. British Journal of Industrial
Medicine 30(1) : 42-47, January 1973.

FRAPPIER-DAVIGNON, L., ST.-PIERRE, J. Gtude de l’effet combiné de
la pollution atmosphérique, de Vexposition professionnelle et
des habitudes de tabac dans les affections pulmonaires obstruc-
tives. 2. Firme d’alimentation: exposition professionnelle nulle.
(A study of the combined effects of atmospheric pollution in
occupational exposure and smoking habits on obstructive pulmon-
ary diseases. II, The food industry: No occupational exposure).
L’Union Médicale du Canada 102(7): 1542-1546, July 1978.

Gorruies, L. S., BaLcHuM, O. J. Course of chronic obstructive
pulmonary disease following first onset of respiratory failure.
Chest 63(1) : 5—8, January 1973.

Grecc, I., NuNN, A. J. Peak expiratory flow in normal subjects.
British Medical Journal 3(5874) : 282-284, August 4, 1973.

113
72-1260.

72-1089.

73-0054.

73-0475.

73-0413.

72-0760.

73-0301.

73-0478.

73-0303.

73-0166.

73-0168.

73-0041.

73-0482,

114

HAENSZEL, W., HoucEen, A. Prevalence of respiratory symptoms fy
Norway. Journal of Chronic Diseases 25(9) : 519-544, Septembey
1972. .

HUrreMaNnN, U., OswaLp, P., Lope, H., Huckaur, H. Wher deg
Einfluss langjahrigen Zigarettenrauchens auf die Lungenfunk.
tion jugendlicher Normalpersonen. (Lung function studies iy
young apparently healthy cigarette smokers versus non-smokers.)
Respiration 29 (3) : 270-287, 1972.

HirreMann, U., Scuiren, K. P. Cronisch obstruktive Lungenerk.
rankungen: Klinische Erscheinungsformen und ihre Korrela.
tion zur gestérten Atmungsfunktion. (Chronic obstructive lung
disease: Clinical symptoms and their correlation to lung func-
tion disorders.) Klinische Wochenschrift 50(20) : 944-962,
October 15, 1972.

ImMBus, H. R., Sun, M. W. Byssinosis. A study of 10,133 textile
workers. Archives of Environmental Health 26(4): 1838-191,
April 1973.

IRAVANI, J. Effects of cigarette smoke on the ciliated respiratory
epithelium of rats. Respiration 29(5/6): 480-487, 1972.

JAIN, B. L., ABRAHAM, E., Koxan, A. R. A study of ventilatory
lung functions in smokers from a tropical area. Journal of
Tropical Medicine and Hygiene 75(6): 103-108, June 1972.

JEDRYCROWSKI, W. Badania epidemiologiczne wplywu warunkow
srodowiska pracy na wystepowanie przewleklych nieswoistych
chorob ukladu oddecliowego. (Epidemiological studies concerning
the influence of working conditions on the incidence of chronic
nonspecific respiratory diseases.) Przeglad Lekarski 29(8) :
737-748, 1972.

Kreetstis, J. A. Diffusing capacity in bituminous coal miners.
Chest 63 (4) : 501-504, April 1973.

KostrEwskt, J. Chronic non-specific lung disease in Krakow. Sante
Publique; Revue Internationale 15(2): 209-216, 1972.

Kozarevic, D., RoBerTs, A., Prrc, B. Prevalence of chronic obstruc-
tive lung diseases among rural and urban populations in two
different areas of Yugoslavia. IN: Brzezinki, A., Kopezynski, J.,
Sawicki, F. (Editors.) Ecology of Chronic Nonspecifie Respira-
tory Diseases, International Symposium, Warsaw, Poland, Sep-
tember 7-8, 1971. Warsaw, Panstowowy Zaklad Wydawnictw
Lekarskich, 1972. pp. 178-184.

Kusix, A., FEUEREISL, R., GALLAS, J., KAVAN, F., FELKEL, H.,
REIL, I. Air pollution and prevalence of chronic non-specific res-
piratory disease in males aged 16 and 18 years residing in
Prague 7. IN: Brzezinski, Z., Kopezynski, J., Sawicki, F. (Edi-
tors). Ecology of Chronic Nonspecific Respiratory Diseases, In-
ternational Symposium, Warsaw, Poland, September 7-8, 1971.
Warsaw, Panstwowy Zaklad Wydawnictw Lekarskich, 1972. pp.
50-54.

Kuso, R., ONO, M. Kitsuen no koto poripu ni oyobosu eikyo ni
tsuite. (Influence of smoking on the development of laryngeal
polyps.) Jibi to Rinsho 17(2) : 122-125, 1971.

KUPERMAN, A. S., RIKER, J. B. The variable effect of smoking on
pulmonary function. Chest 63(5): 655-660, May 1973.
73-0058.

73-0038.

72-1092.

72-1284.

73-0485.

738-0486.

72-0042.

72-0772.

72-1057.

72-0775.

73-0314.

Luz, T. P., BUSTAMANTE, H. T, DE, SZKLO, M., STROZENBERG, A.
“Complexo de sintomas respiratorios” e “rinite vasomotora”.
Prevalencia em operarios da fabril juta de Parintins, Amazonas;
(Junho de 1971). (“Respiratory symptoms complex” and “vaso-
motor rhinitis.” Prevalence among the jute manufacturing plant
workers in Parintins, Amazonas; [June 1971].) Revista Bra-
siliera de Medicina 29(4): 184-187, April 1972.

McCa.uuM, R. I. Respiratory disease in foundrymen. British Jour-
nal of Industrial Medicine 29(3): 341-843, July 1972.

Martin, R. R., ANTHONISEN, N. R., ZurTer, M. Flow dependence
of the intrapulmonary distribution of inspired boluses of ™ Xe
in smokers and non-smokers. Clinical Science 43(3): 319-329,
September 1972.

Martin, R. R., Linpsay, D. L., Despas, M. D., MAcKLeM, P. T.,
ANTHONISEN, N. R. Reversible small airway obstruction associ-
ated with cigarette smoking. Chest 63(4, Supplement): 31S,
April 1973.

Matuur, K. C., Misra, S. N. Incidence of pulmonary diseases
among wool workers. Indian Journal of Chest Diseases 14(3):
172-178, July 1972.

Mercnant, J. A., LUMSDEN, J. C., KitpurNn, K. H., O’FALLON,
W. M., Usna, J. R., GERMINO, V. H., Jr., Hamitton, J. D. An
industrial study of the biological effects of cotton dust and cig-
arette smoke exposure. Journal of Occupational Medicine 15 (3):
212-221, March 1973.

MercHant, J. A., Lumspen, J. C., Kitpurn, K. H., O’FALLON,.
W. M., Uspa, J. R., Germino, V. H., IJr., Hami.ton, J. D. Dose
response studies in cotton textile workers. Journal of Occupa-
tional Medicine 15(3): 222-280, March 1973.

Rispout, J. A., DESosEL, N. L., SPECTOR, Cc. H., Torti, D. D.,
Urquiso, C., Massun, A. L. Epidemiologic surveys on air pollu-
tion. IN: Englund, H. M., Beery, W. T. (Editors). Proceedings
of The Second International Clean Air Congress, Washington,
D. C., December 6-11, 1970. New York, Academic Press, 1971.
pp. 201-209.

Rosgins, W. T. Bronchial epithelium in cigarette-smoking college
students. Journal of the American College Health Association
20(3) : 209-211, February 1972.

Saxaxura, Y., Proctor, D. F. The effect of various conditions on
tracheal mucociliary transport in dogs. Proceedings of the
Society for Experimental Biology and Medicine 140(3) : 870-879,
July 1972.

ScHLESINGER, Z., GoLDBoURT, U., MEDALIE, J. H., Riss, E., NEv-
FELD, H. N., ORON, D. Pulmonary function and respiratory dis-
ease among adult male Israelis. Variations by age and birthplace.
Israel Journal of Medical Sciences 8(7) : 957-964, July 1972.

Suctu, I., PRODAN, L., ILEA, E., CocArua, A., Cororv, M., OprEa, V.
Factori care intervin in grabirea sau prelungirea timpului de
instalare si evolutie a silicozei. (Factors promoting and hinder-
ing the time of apparition and evolution of silicosis.) Clujul
Medical 45 (2/3) : 803-307, 1972.

115
73-0651. Tse, K. S., WARREN, P., Janusz, M., McCartay, D. S., CHERNIACK,
R. M. Respiratory abnormalities in workers exposed to grain
dust. Archives of Environmental Health 27(2): 74-77, August
1973. .

72-0222. VAN GANSE, W. F., Ferris, B. G., Jr., COTES, J. E. Cigarette
smoking and pulmonary diffusing capacity (transfer factor).
American Review of Respiratory Disease 105(1): 30-41, Jan-
uary 1972.

73-0316. WALTON, M. Industrial ammonia gassing. British Journal of In-
dustrial Medicine 30(1): 78-86, January 1973.

73-0503. WiLson, R. W. Cigarette smoking, disability days and respiratory
conditions. Journal of Occupational Medicine 15(3): 286-240,
March 1973.

72-0663. Wysocki, M. Testy spirometryczne TQT i FEV %—wlasciwosci i
przydatnosc w rozpoznawaniu przewleklego zapalenia oskrzeli.
(Spirometry tests TQT and FEV—their properties and useful-
ness in diagnosis of chronic bronchitis.) Gruzlica i Chorogy Plue
40(1); 35-44, January 1972.

Part IT
(Additional articles which were reviewed but not discussed in the text.)

AtsBy, R. L., GHADIALLY, F, N. Atypical cilia in human bron-
chial mucosa. Journal of Pathology 109(1): 75-78, January 1978.

73-0047. ALBERT, R. E., LIPPMANN, M., PETERSON, H. T., JR., BERGER, J.,
SANBORN, K., BOHNING, D. Bronchial deposition and clearance
of aerosols. Archives of Internal Medicine 131(1); 115-127,
January 1973.

72-0647. ASTIN, T. W. Reversibility of airways obstruction in chronic bron-
chitis. Clinical Science 42 (6) : 725-738, 1972.

73-0157. CARILLI, A. D., Korzen, L. M., FISCHER, M. J. The chest roent-
genogram in smoking females. American Review of Respiratory
Disease 107(1) : 138-186, January 1973.

Davipson, F. F., GLAZIER, J. B., Murray, J. F, The components of
the alveolar-arterial oxygen tension difference in normal subjects
and in patients with pneumonia and obstructive lung disease.
American Journal of Medicine 52: 754-762, 1972.

73-0583. Esser, H. J.. MENNINGER, F, F., Jn., BOGDEN, A. E., Mason, M. M.
Immunological deficiency associated with cigarette smoke inhala-
tion by mice. Primary and secondary hemagglutinin response.
Archives of Environmental Health 27(2): 99-104, August 1973.

73-0128. Evans, M. J., CABRAL, L. J., STEPHENS, R. J., FREEMAN, G. Cell
division of alveolar macrophages in rat lung following exposure
to NO; American Journal of Pathology 70(2): 199-208, Feb-
ruary 1973.

73-0129. Evans, M. J., CABRAL, L. J., STEPHENS, R. J., FREEMAN, G. Re-
newal of alveolar epithelium in the rat following exposure to
NO: American Journal of Pathology 70(2): 175-198, February
1973.

73-0474. Hirst, R. N., JR., Perry, H. M., JR., CRUZ, M. G., Pierce, J. A.
Elevated cadmium concentration in emphysematous lungs. Amer-
iean Review of Respiratory Disease 108(1): 30-39, July 1973.

116
72-0614.

73-0810.

73-0254.

73-0411.

72-1046.

73-0415.

73-0476.

73-0346.

72-1240.

73-0646.

72-0590.

72-0766.

Ho, W., BenNToN, M., FURST, A. The clearance of benzo(a)pyrene
and ferric oxide from mouse lungs. Proceedings of the Western
Pharmacology Society 15: 58-60, 1972.

Hott, P. G., Keast, D. Acute effects of cigarette smoke on murine
macrophages. Archives of Environmental Health 26(6): 300-304,
June 1973.

Hott, P. G., Keast, D. Cigarette smoke inhalation: Effects on
cells of the immune series in the murine lung. Life Sciences
12(8, Part 2): 377-383, April 22, 1973.

Hout, P. G., Keast, D. The effect of tobacco smoke on protein
synthesis in macrophages. Proceedings of the Society for Experi-
mental Biology and Medicine 142 (4) : 1243-1247, 1973.

Icoioxa, M. Model experiments on absorbability of the airway
mucous membrane of SO: and NO: gases. Bulletin of the Tokyo
Medical and Dental University 19: 361-375, 1972.

Inavanl, J. Flimmeraktivitat im Respirationstrakt nach chronischer
Zigarettenrauchexposition. (Ciliary activity in the respiratory
tract after chronic exposure to cigarette smoke.) Rehabilitation,
Praventivmedizin, Physikalische Medizin, Sozialmedizin 25 (1/2):
40-42, 1972.

Jones, R., Botpuc, P., REID, L. Goblet cell glycoprotein and tra-
cheal gland hypertrophy in rat airways: The effect of tobacco
smoke with or without the anti-inflammatory agent phenyl-
methyloxadiazole. British Journal of Experimental Pathology
54(2): 229-239, April 1973.

Kanner, R. E., Kuauser, M. R., SATANABE, S., RENZETTI, A. -D.,
Jn., BicLer, A. Pathologic patterns of chronic obstructive pul-
monary disease in patients with normal and deficient levels of
alpha,-antitrypsin. American Journal of Medicine 54(6): 706—-
712, June 1973.

Kosminer, S., FELUS, E., WYSACKI, J. Ocena niektérych h wyynu-
eznikéw odpornosci humoralnej u palaczy papieroséw. (Evalua-
tion of some humoral resistance determinants in smokers.)
Polski Tygodnik Lekarski 28(2): 47-50, January 8, 1973.

Lewis, A. J., NicHotus, P. J. Effect of inhaled cigarette smoke
on content, release and breakdown of histamine in guinea-pig
lung. Life Sciences 11 (23, Part 2): 1167-1171, December 8, 1972.

Lewis, C. I, McGeapy, J. C., TONG, H. S., ScnHuttz, F. J., SPEARS,
A. W. Cigarette smoke tracers: Gas chromatographic analysis
of decachlorobiphenyl. American Review of Respiratory Disease
108(2) : 367-370, August 1973.

Lewis, C. I., McGreapy, J. C., WAGNER, J. R., Scuuttz, F. J.,
Spears, A. W. Dichlorbenzophenone as ‘a nonradioactive tracer
for cigarette smoke-gas chromatographic analysis of tracer.
American Review of Respiratory Disease 106(3): 480-484, Sep-
tember 1972.

McFapbeNn, E. R., JR., LINDEN, D. A. A reduction in maximum mid-
expiratory flow rate. A spirographic manifestation of small
airway disease. American Journal of Medicine 52(6): 725-737,
June 1972.

Mackie, P. J., Despas, P. J., LEROUX, M. Site of airway obstruc-
tion in asthma. Chest 63(4, Supplement) : 28S, April 1973.

117
73-0306.

72-1286.

73-0423.

71-1180.

7866.

78-0313.

73-0497.

73-0781.

73-0610.

73-0434,

73-0652.

118

Martin, R. R. Altered morphology and increased acid hydrolagg;

content of pulmonary macrophages from cigarette smokers 4

American Review of Respiratory Disease 107(4): 596-601, Apri 4
1973. 8

MitcHELL, C. A., ZUSKIN, B., Bovsuys, A. The effect of cigarette:
smoke and g-adrenergic antagonists on small airways. American
Review of Respiratory Disease 107(6): 1098-1099, June 1973,

Oscuerwirz, M., Epiavircn, S. A., BAKER, T. R., JARBOE, T. Differ.
ences in pulmonary functions in various racial groups. American,
Journal of Epidemiology 96(5): 319-827, November 1972. --

PARKINSON, D. R., STEPHENS, R. J. Morphological surface changes
in the terminal bronchiolar region of NO:-exposed rat lung.
Environmental Research 6(1): 37-51, March 1973. ‘

RYLANDER, R. Free lung cell studies in cigarette smoke inhalation
experiments. Scandinavian Journal of Respiratory Diseases
52(2) : 121-128, 1971.

Simonsson, B. G. Clinical and physiological studies on chronic
bronchitis. I. Clinical description of the patient material. Acta
Allergologica 20(4) : 257-300, 1965.

SrepBines, J. H., IR. Two observed associations between respira-
tory allergies and hypertension in nonsmokers. American Journal
of Epidemiology 97(1); 4-15, January 1973.

SToLoFF, I. L. Bullous lung disease in short order cooks. Journal
of Occupational Medicine 15(3): 202-203, March 1973.

TasHKIN, D. P., LEVY, S, E., THOMPSON, J. H., Simmons, D. H.,
Gorpon, B. M. Puimonary effects of chronic nicotine adminis-
tration in young and old Fischer-344 rats. Proceedings of the
Western Pharmacological Society 16: 209-214, 1973.

Tomas, W., Hort, P. G., Keast, D. Effect of cigarette smoking on
primary and secondary humoral responses of mice. Nature 243
(5404) : 240-241, May 25, 1973.

THURLBECK, W. M. Small airways disease. Human pathology 4(2):
150-152, June 1973.

VassaLLo, C. L., DoMM, B. M., Pos, R. H., DUNCOMBE, M. L,
Gee, J. B. L. NO: effects on alveolar macrophage phagocytosis
and metabolism. Archives of Environmental Health 26(5): 270-
274, May 1978.

Warr, G. A., MARTIN, R. R. Response of human pulmonary macro-
phage to migration inhibition factor. American Review of Res-
piratory Disease 108 (2) : 371-378, August 1973.