Smoking, morbidity, and pulmonary function in a group of ex-asbestos workers: a pilot study

Thirty-three of 184 formerly exposed asbestos textile workers were interviewed to evaluate knowledge, attitudes, and practices concerning smoking and asbestos. Twenty-three subjects in this group also underwent physical examination to determine smoking-symptom/sign-pulmonary function interrelationships. Approximately half of the exworkers smoked, and the majority who had stopped did so mostly because of illness rather than because of knowledge concerning smoking-asbestos hazards. All workers welcomed the offer of smoking cessation programs. Smokers and exsmokers, but not nonsmokers, were at risk for obstructive-type impairments, but all three groups contained subjects with impairments interpretable as restrictive. The presence of shortness of breath, cough, râles, or decreased breathing sounds alone or in any combination greatly increased the odds that either obstructive- or possible restrictive- or mixed-type impairments would be found on spirometry. Mass screening techniques required about one hour of person time per examinee to assess health status, provide educational material on smoking, and counsel workers on referral arrangements. The findings suggest that smoking alerts, smoking cessation clinics, and medical follow-up are needed, feasible, and acceptable in Israel.