Overview and Summary

The workshop participants concluded the following. (1) COPD mortality is increasing. (2) The increase in COPD cannot be explained solely by changing diagnostic and coding practices. (3) Much of the increase in COPD mortality is associated with the temporal trends in cigarette smoking. (4) Factors other than smoking, such as occupational and other environmental exposure, contribute to the development of COPD. (5) COPD is a heterogeneous group of disorders with the common finding of obstructive airways disease. Those patients with an underlying increase in airways responsiveness may have a more favorable prognosis. (6) Ventilatory function testing, regardless of the presence and nature of the COPD, is a strong predictor of mortality. (7) As opportunities for the intervention in the series of COPD disorders develop, greater efforts will be required to train and encourage health care providers in the use of physiological and biochemical markers of disease.