ARCHIVESHISTORIQUES
DELACOMMISSION
COLLECTION RELIEEDES
DOCUMENTS "COM"
COM(76)240
Vol.1976/0080

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COMMISSION OFTHEEUROPEAN COMMUNITIES
COM(76)240 final .
Brussels ,26th May1976 .
MEMORANDUM
Presentation ofathird medical research programme onChronic
Respiratory Diseases .
COM(76)240final .
>-

MEMORANDUM
Presentation ofathird medical research programme on
Chronic Respiratory Diseases
I. Introduction
II. Current position
-results oftheresearch programme '.Chranic Respiratory Diseases II'
authorized bythe Cemmission on October 1970
opinion of'the 'advisory Committees •:
-action
III .Newresearch programme 'Chronic Respiratory Diseases III'
-content and objectives oftheprogramme
■-implementation
-financial aspects
-conclusions
Annex 1:content oftheprogramme -Doc .Nc3902/1/7^
Annex 2:list ofinstitutes -Doc .Ne1209 /75

I.Introduction
Pursuant toArticle 55.§2eftheTreaty establishing theECSC ,
afresh initiative isproposed topromote research intheindustrial
medical sphere .
Theprinciples guiding theCommissi®n 'spolicy andmethods are
described inthepublicati®n *Eigh Authority policy for thepromotion
ofstudy andresearch ®nindustrial health ,medicine andsafety *(1).
2.5millions u.a.were allocated for thepreceding research
programme 'Chronic Respiratory Diseases II'which was authorized by
the Commission «n13October 1970 .F«ll*wing theaccession ofthe
United Kingdom ,Ireland and Denmark andbyaCommission decision of
21December 1973 »afurther million u.a .were made available for the
projects .63research projects were financed inthis manner between
#1971 and 197^. -
Whereas thefirst research programme (1955 )wasmainly proposed
byprofessional research institutes whose interests were geared largely
tobasic research ,recent years have shown anincreasing general
trend towards clinical andpractical studies .Occupational lung dis­
eases inparticular (pneumoconiosis fr^m varying causes andalso
thechronic non-specific respiratory syndrome )have undergone in­
tensive study intheform effunction tests onlungs ,heart and cir­
culation .F®rthis ,research workers intheMember States needed
standardized questionnaires and ,toobtain comparable results ,
harmonized metheds ofstudy .
(1)Office forOfficial Publications oftheEuropean Communities ,
Luxembourg ,I966

-3-
One oftheaims oftherecent programme ©nchronic bronchitis
caused bypulmonary emphysema was todetermine theconnection between
these diseases andoccupational noxne ,especially dusts ,theprogramme
itself comprising thefollowing aspects
1.Basic research onpneumoconiosis
2.Epidemiological research
3.Physiopathology andstandardization
k.Prévention andtherapy
5.Rehabilitation .
This programme has nowreached successful completion .Detailed
scientific results were presented tointerested professional circles
and tolabour andmanagement atatwo-day conference inLuxembourg oil
2and J>July I975 .
The newprogramme 'Chronic Respiratory Diseases III *isbased »n
these results and includes further epidemiological research ,diagnestic
studies for the early recognition ofbronchopulmenary diseases and the
development oftherapeutic andrehabilitation measures .Furthermore ,-
new drugs -are tobedeveloped far .theprevention ortreatment of
pneumoconiosis (animal experiments .)(seeAnnex 1),
Thenew programme isinaccc-rdance with the 'social action
programme' (1)submitted bytheCommission totheCouncil on25October
1973 ,oneobjective ofwhich isan'improvement ofliving andworking
conditions' .Italso provides specific suppsrt f©r the 'programme _
(l)Council Decision of21January 197^concerning a'social action
programme' ,Official Journal ©ftheEuropean Communities C13of
12February 197^-

ofaction ontheenvironnent' (1).
II.Current position
Summary oftheresults oftheresearch programme 'Chronic Respiratory
Diseases II' adopted bythe Commission »n13October 1970
Basic research onpneumoconi»sis
The aim ofbasic research was togain further knov /lecge permitting
more specific preventive ,diagnostic and therapeutic measures tobe
taken...
Basic research projects onpneumoconiosis areanextension ofthe
work undertaken inthepreceding programme .Theimportance ofthese
results wasillustrated bythegreat interest inandresponse tothe
symposium held inFlorence in1968 (2).Thelatest results were presented
atthesymposium 'held inJuly 1975 an^have been published (Farch 1976 ).
Epidemiology .
Thedrafting b-f "astandard ECSC questionnaire (3)enabled 16insti­
tutes intheCommunity countries toimplement identical procedures in
determining theeffects cfworkplace orenvironmental pollution on
chronic bronchitis .Ingeneral ,comparisons were made between subjects
(1)Declaration ofthe .Counc.il oftheEuropean Communities and ofthe
representatives oftheGovernments oftheMember States' meeting is
theCouncil onthe'Programme efaction oftheEuropean Communities
ontheenvironment' ,Official Journal cftheEuropean Communities
C112 of20December 1973 »
(2)'Basic research onpneumoconiosis (Fierence 16to18October I96-;)»
Commission oftheEuropean .Communities (ECSC )Industrial Health and
Me.dicine Series No10,,Luxembourg ,1970 *
(3)'Commentary ontheECSC questionnaire fc.rstudies ofchronic bronchitis
andemphysema ofthelung *,Commission iftheEuropean Communities ,
Industrial Health andMedicine Series Ik,Luxembourg 1972 ,P

-5-
from thecoal andsteel industries andnon-industrial subjects .The
sample sisses of500 to6000pesple used inindividual research pro­
jects made forsatisfactory statistics .
Field surveys have produced interesting results ,especially as
regards theaetiological significance ofthevarious biological para­
meters considered intheseparate projects .They also shswed ,however ,
that the EC8C questionnaire will have t«bem«re detailed for future
research programmes .Inparticular ,the current definition ®fthe
clinical symptoms ®fthe chronic non-specific respiratory syndrome
hasproved tobeunsuitable forepidemiological retrespective screening .
Thoresearch workers have already submitted anddiscussed therequisite
amendments tothis definition .These problems have tobesolved if
comparability ofthesubjects under study ist*beguaranteed .There
would also seem tobeaneed t©settle any outstanding terminology
difficulties and include mere modern study methods ,suitably standardized ,
(l)(2)intheresearch projects .
Asfar asthe etiopat'h«5geny ofchronic bronchitis isconcerned ,a
final Opinion would seem tobe -somewhat premature ,despite thefact that
theresults already obtained sh*w that dust exposure and smoking habits
are determining factors .
(1)'Aide-memoire ofepiregraphic practice f»rexamining ventilatory
function' ,Camirissim oftheEuropean Communities ,Industrial Health
andMedicine Series K»11.second edition ,Luxembourg 1973 *
(2)'Aide-memoire pour lapratique desépreuves d'exercices enmedecine
dutravail 1,Commission «ftheEuropean Communities ,Industrial Health
andMedicine Series No12,Luxembourg 1971 *

~6,-V
Physxopp.tholory and standardization
' * v .«
Valuable results were also ebtained inthis sphere ,which is
equally useful forboth hospitals andgeneral practitioners .Awide
"range ofspecific pulmonary function tests were carried out ona
large number of.subjects .Comparisons were' made with themeasurements
taken onhealthy subjects ofdifferent age andsex ,thus producing
.valuable information for thestandardization ofergometry and spiro -
graphy .
Finally ,theresults produced bytheworking parties concerned
with cardiac diseases show that heart and circulation dynamics depend
considerably onbronchopulmonary function .There arestill many points
tobeclarified onthis subject andthese must betackled inthenew
research ,programme with aview topreventing early disablement .
m . • ••
mPrévention and therapy ' ■
i Inthepreceding programme twodifferent types ofproject onpre-
'vention andtherapy were subsidized ,namely :
•tests onanimals toprevent experimental pneumoc jniosis using polyvinyl
pyridine Noxide (FVNO ),and
–tests onhuman subjects forthetreatment ofchronic brorc^iitis inits
various stages .
Theresults ofwhat atfirst .seemed t&beapromising project ,i.e.
FVNO prevention ofmixed-dust silicosis ,were questioned byvarious
research workers ;inparticular ,thesecondary damage caused bythe
•drug means -that ,itcannot .ye.t beused unhesitatingly .on .humans .
t..*' 1'-. < * s
Following clarification cf'the effect ofairborne irritants on
brsnchial obstruction ,certain research teams carried outstudies

-7-
onbronchodilatory drugs .Thepharmacodynamic features established
fermedicines best suited tovarious groups made itpossible todevelop
preparations with longer-lasting effects but with#ut toxic side-
effects .Immunologic aiethcds designed tecontrol branchial infection
bystimulation ofbranchial resistance torespiratory infections
were tested .Some ©fthehypotheses were confirmed . -
Aninteresting experiment would appear tobepulmonary lavage
forchronic bronchitis .This therapy ,however ,isonly tobeapplied
topatients who are seriously ill .Certain technical problems
still have tobeovercame . .
Réhabilitation
Inthegeneral context oftherehabilitation ofhandicapped
persons measures forpatients suffering from bronchopulmonary diseases ,
and inparticular the chronic non-specific respiratory syndrome ,
are ofconsiderable importance since these patients form asizeable
social andmedical group *National social insurance statistics
show toWhat ahigh dogree these diseases areresponsible forthe
increase inearly disablement ,theeconomic andsocial cost ofwhich
isconsiderable *
Thesuccess achieved with thephysical andfunctional rehabi­
litation ofpatients suffering from heart diseases augurs well
forpatients suffering from chronic bronchitis . ;

Aprogramme forrespiratory rehabilitation accompanied bya
corresponding questionnaire has been developed byexperts interested
inthese aspects .Itisbased mainly onclinical data obtained from
the ECSC questionnaire .Social and econsmic aspects aswell as
attempts tometivate thepatients are further' parameters tobeadded
tothelist ofpositive results .1Thetraining programme hitherto
adopted still has tobemodified ifthe effect onrespiratory function
istobefurther increased .General physical fitness ,however ,is
improved from both objective andsubjective angles .
Inthe future further techniques should besought and new
methods ofrehabilitation developed &nthebasis oftheknowledge
acquired *
Opinion ofthe advisory cenmittees onthe continuity of
the ,research programmes ■
Inthe last fewmonths the.'' Cemmission ofthe European Communities
hassubmitted theresults tothefollowing .committees responsible for
theECSC social research projects onrespiratory diseases : . ,
V
1.Producers' and Workers' Committee onIndustrial Safety andMedicine .
2.Committee ofGovernment Experts »nIndustrial Medicine andReha­
bilitation . - .
3«Research Committee onChronic Respiratcry Diseases .
Allthree committees have taken great interest intheresults
achieved thus farandmade the following comments :

-9-
Agreement onallquestions connected with bronchopulmonary
diseases inECSC industries :the effect ofdust atthe work­
place ,which has tobeanalysed ingreater detail ,smoke andfume ,
chemical gases ,general airpollution andcertain infections go
together with individual life styles tocause thechronic respi­
ratory non-specific syndrcme . . •
Thedisease itself (inview ofthegreat number ®fworkers suffering
from orthreatened byit)continues tepose maj&r andurgent problems
inthe form ofthesociological and ecsn3inic consequences early
disablement can have .
Seen from thestandpoint oflabour andmanagement ,future research
projects must continue t*begeared topractical needs ,i.e.
prevention ,therapy and rehabilitation .
The research programme should beextended beyond work onthese
diseases and their occurrence inthe ECSC industries toinclude
other industries .Additional measures ofageneral nature must be
taken for air pollution inparticular ,agood opening being
offered bythe Commissisn 'senvironmental action programme .
The Committee thought that theprogramme completed had produced
positive results although not allpossibilities had been fully
exploited .Certain 'aspects need tabecompleted andfurther work
done onproblems already .embarked upcn .They therefore stressed
that itwasurgently necessary t®carry out afurther four-year
research programme onchronic respiratory insufficiency .

-10-
Action
Current research inthefield ofchranic respiratory diseases is
pursued inaccordance with theconcrete suggestions ,needs and
priorities indicated bytheadvisory committees when they draw up
research programmes ,andittakes account ofthetypes ofaction
currently possible . , /
I *-
TheCommission calls onthfccooperation ofresearch institutes
•rcentres intheCommunity which rover thespheres corresponding
totheobjectives setbytheCommissian .Thefinancial aidwhich it
grants entitles ittorequire that thework should beorientated
t«wards thepriorities established bytheCemmissian after consulting
labour andmanagement .Theinstitutes cooperate closely with the
Commission 'sdepartments throughout theprogramme .
This has the effect ofconsiderably developing international
cooperation inthe scientific field and constitutes real stimulation
ofnational bodies ,both private and public .
Thepreparation ofanewresearch programme wasbegun inJuly
1975 andhasnowbeen campleted ..Theadvisory ooiamifctees took part
inthework andapproved this prograrnme .
III .New research programme 'Chronic Respiratory Diseases ITT '
Thenewresearch programme concentrates «nthree aspects :
1.pneumoconiosis .•
2.other occupational bronchopulmonary diseases
3.treatment andrehabilitation ofbronchopulmonary patients .

Thesubjects aresummarized inAnnex 1according tothemethods
ofresearch thought apprepriate .
1.Pneumoconiosis
Intheresearch onpneumoconiosis ,b®th asregards prevention
and treatment ,experiments will beconfined toanimals .These in­
volve experiments ontheanthropoid apewith aview toclarifying
further the effect ofPVNO onmixed-dust ^pneumoconiosis -and to
studying the effects ofsoluble aluminium salts .
The aim ofthe tests onhuman subjects istodevelop tests for
the -assessment ofindividual reactions toexposure tovarious types
ofdust .This isofparticular importance forpre-employment medical
examinations .Further standardization and coordination ofradiologi­
caltests forpneumoconiosis would also appear tobenecessary .Des­
pite theinternational classification «fthe ILOsubjective factors
still combine toproduce varying interpretations .
.Aspart cfthe study of'lesions associated with pneumoconiosis ,
afurther promising field cfresearch isoffered bythepathological
andanatomical study ofpulmonary emphysema and' the development of
extensive X-ray shadows jbased «nthekn®wledge already acquired .
Toexamine the development and epidemi«l«gy cfpneumoconiosis ,
statistical studies onthe life expectancy of .perso-ns suffering from
thedisease ar'e 'tobe-encouraged .These studies must beconsidered
in'close connection with theresearch carried «ut©ntheradiological
and clinical development andmanifestation »fpneumocsniosis asa
function ofthecomposition ofthe dust and thelength ofexposure to
Itishsped inparticular that them*st recent studies will allow the
clinical data tobecorrelated with the results ofX-rays onthebasis
cfthe technical documents collected for ever ten years .

12
2.Other occupational bronchopulmonary diseases
Further epidemiological studies areneeded «nother occupational
bronchopulmonary diseases .There areplans formore detailed aetiological
studies ofthevarious types ofairpollutants ,both particulate and
.gaseous .Tothis end ,-further prognostic studies extending over
several years are absolutely essential .
Eewever ,implementation ofsuch studies with aview torecognition o
early forms ,requires intensive standardization ®fthevarious methods
ofanalysing lung functions (analysis cfrespiratory curves for
helium ,oxygen andcarbon dioxide ,alveolo-arterie.l gradients ,CO
transfer factor ,mechanical aspects efventilation andparameters
ofbronchial hyperreactivity ).Newmeasurement methods must therefore
bedevised .For these occupational bronchopulmonary diseases ,itwas
proposed that ..individual proneness toinfection andindividual sensiti -
m
,«vity should bedetermined ,asinthecase ofpneumoconiosis *This
calls foridentification .efaggressive factors ,particularly newgaseous
pollutants ,determination oftheir effects ontherespiratory system
1and development ©fmethods -offunction measurement .
3.Treatment andrehabilitation ofbronohopulmon&ry^patients
Theaccent intreatment must beonthedevelopment ofmedicines
'for useintheearly stages .However functional rehabilitation and
assessment there«f must bedeveloped further after standardization ofthe
latest tests .Tothis end ,physical tolerance levels atthework­
place must bestudied before andafter treatment .Forthis reason early
diagnosis ofthecardiovasciilar complications ofchronic emphysema was
added tothe list ofresearch' subjects .

Implementation
Tnenewresearch programme will becarried outbyresearch ..centres
andinstitutes invited directly bytheCommission «ftheEuropean
Communities .Theaccession oftheUnited Kingdom ,Denmark andIreland
will certainly provide further invaluable aid ,enaccount ofthe
experience acquired bythehighly specialized national institutes in
these countries .
Alist ofresearch ,centres and institutes which could 'becalled ,
upon t#take part intheprogramme was compiled with thehelp ofthe
three abeve-mentioned committees (seeAnnex 2).
Representatives from these centres and institutes must begiven
theopportunity ofexamining jointly theindividual projects planned
*
and thebreakdown ofthework t®becarried out under theprogramme .
Research projects submitted totheCommission will beexamined by
theResearch Committee and theappropriate advisory -committees ,
whowill give their opinions ,criticisms andsuggestions which the
Commission will take int® account toensure satisfactory implementation
ofall aspects oftheprogramme *.
Thefinal decisisn oneach research project andfinancing will
betaken bytheCommission oftheEuropean Communities .Research
projects finally approved will begoverned bytheusual type of
• . .... jc^ntract .
(1)Producers' and Workers' Committee onIndustrial Safety andKedicme .
Committee ofGovernment Experts rnIndustrial Medicine andRe­
habilitation . " ,-■■■■

-1k-
Theresults will becirculated inaccordance with theabove -
mentioned criteria :
-distribution ofpublished articles ,inthefcrm ofoffprints ,to
those participating inprojects ;
-preparation ofabiennial progress report ,under theterms ofthe
agreements tobeconcluded ;
-summary oftheresults atthe endoftheprogramme intheform
ofconference andpublication ofthepapers presented .
Depending ontheprogress made ineach research subjoct ,working
party andinformation meetings should beheld throughput the .programme .
Anup-to-date distribution list for documentation and informa­
tion must bedrawn upwith thehelp oftheDirectorates-General
concerned . . <
I
l'' V :
Financial aspects
Estimation ofthefunds required for this four-year programme
isbased *nthefollcwing considerations :
a)Theproposed pr©gramme isacontinuation oftheprevious programme ,
farwhich atotal «f3»5million units ofaccount wasprovided
(seepage 2).
b)Thescope andscale efresearch into occupational safety and
1 , ;
health ,improvement *fworking conditions andrehabilitation
will certainly increase inall sectors .
c)'Rising research costs andtheenlargement oftheComuunity
necessitate strict selection and restriction ofthe number of
subjects ,soastoconcentrate efforts towards therealization
ofcertain practical aims within theframework ofthis research
programme .

-15-
d)TheCommission hasinformation onthenumber ofresearch workers ,
equipment andresearch capacity oftheresearch institutes and
centres invited totake part intheprogramme .
e)Thefunds tobeprovided must also cover administrative costs
throughout theprogramme ,particularly those f«r :
-coordination ofscientific cooperation ;
-official trips byexperts andresearch workers ;
-publication andcirculation efreports ;
-bibliographical documentation ,etc .
Taking all these facters into account ,thetotal budget for
thefour-year research programme is5million european units of
account .Asinprevious years ,Community aidwill f'jrm only apart
ofthe total funds required forcarrying out thevarious research
projects .
Conclusions
?orthereasons outlined above ,there isanurgent need for the
release cfmore funds for medical and social research .The aim ofthe
newprogramme istwofold :t»permit continuation rfstudies which
have undisputed value and totackle newpreblems with new research
methods and objectives .
Itmay beexpected that theprogramme will produce aconsiderable
amount ofnewknowledge and that the research capacities ofthenew
Member States will contribute very substantially totherealization
ofthis expectation .

ZÏ-jU.
APPENDIXI
PROGRAMME ON
"CHRONICRESPIRATORY DISEASEStlF'
(1976)
I.PNEUMOCONIOSIS
A.Researchontheanthropoid ape
Prophylactic ortherapeuticeffectsofaluminiumsaltsorP204
onmixed-dustpneumoconiosis
B.Testsonhumansubjects
1.AssessmentofIndividualreactionstodustexposure
2.Coordination andstandardization ofradiologicaltestsfor
pneumoconiosis
3.Pathogenesis ofextensivefibrosis
4.Pathological andanatomicalstudyofpulmonaryemphysema
5.Epidemiology anddevelopment
a)Lifeexpectancyofpersonssufferingfrompneumoconiosis 1
b)Radiological andclinicalmanifestation anddevelopmentof
pneumoconiosis asafunctionofexposuretodustandthe
composition ofthedust
II.OTHEROCCUPATIONAL BRONCHIAL ANDLUNGDISEASES
A.Earlyforms
1.Analysisoflungfunctionandstandardization ofmethods

-2-
m
ma)Analysis ofexpiratory curves forHe,0^,COgetc.
b)Alveolo-arterial gradients
c)Mechanical aspects ofventilation (including flow-volume
.diagram )
d)COtransfer factor
e)Parameters ofbronchial hyperreactivity
f)Newmethods
2.Identification ofaggressive factors andoftheir effects on
therespiratory system '
3.Factors influencing individual proneness toinfection .
B.Epidemiological studies
1.Significance ofvarious types ofairpollutants (particulate
andgaseous )
2.Prognostic studies
III .TREATMENT AND REHABILITAT !ON "
1.Useofmedicine intreating theearly stages
2.Standardization ofthe exercise tests
3.Research into admissible physical loads attheworkplace
4.Eaxly diagnosis ofcardiovascular beat
5.Methods offunctional rehabilitation andtheir relative merits in
theearly stages .

ANNEXEII
MLAGEII
APPEKDIXII
Provisorische Liste
Provisionai List
Liste Provi soire
FCASCEUITGSIE'ST ITUTE
PROGRAMM"CHRONISCHE ERLCROTFKUK'AM DERATEIIWEGE .HF'
RESEARCHINSTITUTES
PROGRAMS "CHRONICRESPIRATORR DISEASESIIP'
INSTITUTS DERECHERCHE
PROGRAMME ;,A2FECTIOÎTS RESPIRATOIRES CHRŒTIQUESIH"

Medizinische Klinikund.Poliklinik
derBerufsgenocsenschaftlicfcen
Krankenanstalten "Bergmannsheil 71
Prof.FRITZ?
Bochun
Pathologisches Institutder
Bergbau-Beruf sgenossenschaft
Prof.K053SW
Bochum
Silikoseforschungsinstitut
derBergbau-Beruf sgenossenschaft
Prof.ULMER
Bochum
Universitätsinstitut fürLufthygiane
undSilikoseforschung
Prof.SCHLIPKOETER
Düsseldorf
Universitâtsinstitutfur
HygieneundArbeitsmedizin
KlinikumEssen
Prof.KTjOSTF.RTCD^'rnm .">■
Essen ...-
Universitätsinstitut für
Arbeits–undSozialcedizin
Prof.VALEPTBT
Umversitäteinstitutfür
angewandtePhysiologie
Prof.WITZLKB
Kiel
Krankenhaus Bethanien
fürdieGrafschaft Moers
Prof.WORTH
Moers

,.,,n<n Knai/pschaf tskrankenhausML T)r.BRINiC.™ '.
Hecklinghausen
Universitatsinstitut fur
Arbeit smedizin
Prof .DRASCHS
Searlariicken

Groupementscientifique pourlediagnostic
etletraitementdescardiopathies
HôpitalSt.Pierre
Prof.DEUOLDT-,
Bruxelles
DienstvoorHygiëneënSocialeGeneeskunde
Rijksuniversiteit Gent
Prof.-VUÏLSTEEK
Gent
MedischInstituut"SintaBarbara"
Prof.KINETTE
Lanaken
Academisch Ziekenhuis "St.Rafaël:f
Prof,vandeWOESTIJNE
Leuven
CliniqueUniversitaire St.Pierre
Prof.LA7ENHE
Louvain

DjaEL'-RK Arbejdstilsynet
Statensinstitutforarbejdshygiejne
Dr.B.SALTET
Hellerap

f-0-
FRAÏÏC5 Centre d'Etudes des Pneumoconioses
Hôpital deCrébange
,Dr.D'ICHOUX ..
Créhange
Institut Pasteur
Prof . .VOISIff
Lille
Institut deRecherches Pneumo logique s
Dr.LAVAL
Marseille
Unité deRecherches sur la
Physiopathologie Respiratoire
Centre deRecherches HTS T.;K1
LZF?~
CFRCH JUI
Dr.Dïï,L."!ÎTOï
Paris
Centre Hospitalier etUniversitaire
Prof .30LLBTELLI
Toulouse
■Unité 14
Hôpital deBrahois
Prof .SADOUL
Vanào euvre-le s-Nancy

-6-
GRANT!''E^TAGEn InstituteofOccupational Medicine
Dr.BUHNS
Edinburgh
DepartmentofRespirâtorjDiseaees
UniversityofEdinburgh
CityHospital
Prof.J.CROFTOÏÏ
Fdinburgh
InstituteofOccupâtionalMedicine
Dr.DAVIS
Edinburgh
InstituteofOccupational Medicine
Mr.JAC0BSI2T
Fdinburgh
InstituteofOccupa+ional Medicine
Dr.IÏUIÏI
Edinburgh
SchoolofHygieneandTropicalMedicine
PhysiologyUnit
Lr„C.liAVES
Lonaon
UstionaiGoalBoard
Dr.ìiCLUiTOGIÙ
Lordon
Post-gri^duate MedicalSchool
Esmmersiaith Hospital
Dr.11.PRIDE
London
InstituteofDiseasesoftheChest
BromptonHospital
Prof.-.I&xgaretITXar^-l'ffiRWICK
Lonicn
IleaicalRtee^rchCouncil
PnotaoccniociK Unit
LlandoughHospital
Dr.J.GILSOIT
Penarth,Gl?m.
\ynf-

IRLAIÎDE

IstitutodiMedicinadelLavoro
dell'UniversitàdiCagliari
Prof.CASULA
IstitutodiMedicinadelLavoro
dell'Università diGenova
Prof.ZANNUTI
Genova
ClinicadelLavoro"LuigiDevoto"
Prof.VIGLIANI
Milano
IstitutodiMedicinadelLavoro
dell'UniversitàdiPadova
Prof.CREPET
Padova
IstitutodiMedicinadelLavoro
dell'UniversitàdiPavia
Prof.MAUGERI
Pavia

AlgemeenProvinciaal-,Stads-
enAcademischZiekenhuis
Prof.0R3E
Groningen
Rijksuniversiteit Groningen
Dr.VANDERL3NDE
Groningen
Dept.ofFhysiology
Universiteit Nijmwegen
Dr.R.A.BINKHORST
Ni.imwegen
Laboratoire defonctionpulmonaire
Leiden