The integration of epidemiology and fundamental biology in occupational lung disease. Thomas A. Neff Lecture.

It is both an honor and a source of sadness that I present this first Thomas A. Neff Lecture. Tom had the primary attributes ofthe academic chestphysician.he was a fine and dedicated teacher, and a caring, highly competent practi¬ tioner of his specialty. I also have it from someone who should know that he was a favorite of the fellows. At a time when specialty medicine needs more Tom Neffs, these skills and personal attributes may become in short supply. Pul¬ monary medicine will miss Tom! It is my intent to address three fundamental issues regarding environmental and occupational lung diseases, and for illustration, provide a summary of the evidence ob¬ tained from several of our studies of exposed populations. I shall suggest some approaches and hypotheses which can, perhaps, be profitably explored by the fundamental biologist in his/her quest toward a fuller understanding of the mech¬ anisms ofdisease, and all the potential health benefits which stem from such better understanding. The issues that I will address include the following: (1) the linkage between lung fibrosis and lung cancer risk.asbes¬ tos, possibly other mineral dusts; (2) the relationships and determinants ofacute inhalant-induced bronchoconstriction and chronic progressive airways obstruction.occupational asthma and byssinosis; and (3) acute severe deep lung in¬ jury and the determinants of long-term respiratory conse¬ quences.chlorine and other irritant gases and chemical vapors.