Abstract
A study oftheaetiology, prevalence, andprogressionofrespiratory disability amongthemen employed intwolarge integrated steel worksin SouthWalesisbeing undertaken fromtheDepartmentofSocial andOccupational Medicine, Welsh National School ofMedicine, withthefinancial support oftheNuffield Foundation. Epidemiological studies haverepeatedly underlined theimportance ofthree environmental factors intheaetiology ofchronic bronchitis-urban atmospheric pollution, atmospheric pollution at place ofwork, andcigarette smoking-all ofwhich areinareal sense controllable. Itisnotpossible, of course, todetermine inanyparticular patient with chronic bronchitis precisely howmuchofhisillness is attributable toa particular environmental factor (M.R.C., 1966), andthis lies attherootofthe controversy whether persons withchronic bronchitis should become eligible forbenefit under theNational Insurance (Industrial Injuries) Act.Itispossible, however, toestimate theproportionate contributions ofoccupation, place ofdomicile, andsmoking habits totheprevalence ofchronic bronchitis indefined populations, andthis isthemainpurpose ofthestudy inSouth Wales-to assess therelative importance of thethree majorenvironmental influences inthe aetiology ofchronic bronchitis amongthemen employed inthetwosteel works. An integrated steelworks isparticularly suitable forastudy ofthis type because thegreater part ofits very large working population isdistributed between a numberof clearly-defined departments withwidely differing working environments. Thetwoworkswe have studied aretheEbbwValeworksofRichard Thomas andBaldwins Limited (population about9,500), andtheMargamandAbbeyworksoftheSteel
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