Early detection of chronic pulmonary disease

There is little question that the early detection of chronic pulmonary disease is essential for reducing morbidity and mortality. In many instances, pulmonary disease is caused by, or intensified by, environmental hazards; once established to the level of clinical expression, it is often not reversible by current therapies. Thus, early detection and removal of affected individuals from the hazards (or vice versa) constitute the only effective means for control of many pulmonary diseases. "Chronic pulmonary disease" is not a single entity but encompasses a variety of processes which may differ considerably in their clinical and physiologic manifestations. Accordingly, the methods that are applied for early detection range from simple questions to sophisticated, complex, physiologic tests. It would seem, therefore, that the success of programs for early detection require a full understanding of the characteristics of available tests, clear definition of specific goals, and a skillful estimation as to the type of pulmonary disease that is under suspicion.