Section 2 -

Environmentally induced Pulmonary Disease in Papua New Guinea Robin A. Cooke Mayne Medical School and Queensland Health Pathology Services Brisbane , Australia

In the 1960's Cor pulmonale was found to be the commonest cause of heart disease in Papua New Guinea. This was caused by chronic obstructive airways disease. Smoking was not common amongst these people. In the Highlands where people lived at altitudes of 5,000 feet or more, the people wore very little clothing and retired to their grass huts in the evenings where they had fires burning to keep them warm during the chilly nights. The huts were not well ventilated and the atmosphere was very smoky. The people who lived in coastal areas were exposed to a tropical climate and did not need to live in houses in which there was a dense smoky atmosphere. Epidemiological studies showed no difference in incidence of chronic obstructive airways disease between these two groups of people. Lungs removed at post mortem examinations were examined by inflation at a standard pressure and were then sliced at standard thicknesses. Lungs from Highlanders and Lowlanders were examined and the results confirmed that the incidence of Emphysema was similar in both groups. The pathological appearances did not differ from those seen in emphysema in Britain or Australia . No cause was found for the Chronic Obstructive Airways Disease encountered in Papua New Guinea. During the 1950's and 60's there was an active programme of chest Xrays done on people throughout the country. This was particularly aimed at the diagnosis of pulmonary tuberculosis. Virtually no lung cancer was encountered. Progressively as the people began to smoke western style cigarettes, cases of lung cancer began to appear.