• ? Though complications of disease with active tuberculosis don't exist in this study; analysis of 238 cases with observation periods over one year show progressive disease in 35.8%. The average observation period is about 10 years. Emphysema is included. In different X-ray classifications, style‡T was 34.7%, style ‡U was 38.1%, style ‡V was 50.0%, while 4A was 42.4%,with 24.0% in 4B.
• In different occupations, high rates of disease progression occur in the fields of tunneling, metals mining, coal mining, and masonry.
• A year after resignation from occupation, the rate of increasing pathological symptoms is high.
• As observation periods lengthen, pathological symptoms increase at a faster rate. Within five years - 25.0%, 5 to 9 years - 32.7%, and more than 10 years - 81.8%.
• There are examples of admitted progress of disease even 20 years after resignation have passed.
• Style‡T, after over 15 years from leaving their occupations, 12% of patients became style ‡U, and for style ‡U, 3% of persons move to styles ‡Vin less than 15 years, while 10% progress to style ‡W.
• As for X-ray images, an increased number of granular (dust) shadows and increase in size will indicate formation of an increasing number of lump shaped nidus, interstitial fiberization, or conversely a decrease and disappearance of granular shadow (In my opinion, as the indirect influence of emphysema).

• Symptom deterioration, with sputum increase, search for a bacterial cause and administer antibiotics. It is usual to observe the patient for several days.
• In our experience, even if infection has a clear bacterial cause, there are cases where we can not determine it, or cases where there is not puscontaining sputum.
• In chronic bronchitis and chronic bronchiolitis, bronchiogenic infection by comparatively avirulent infections continue year after year after all known chemotherapy had been used. For returning to the workplace after improvement of treatment effects, or if for the purpose of final compensation, a limit of 3 months for treatment from first diagnosis is too short and harmful for correct treatment.

                M1 Pure mucus sputum that does not include pus
                M2 Viscous sputum liquid that has a little pus content
                P1 Mucopurulent pus containing 1 degree sputum (pus is less than 1/3 of sputum)
                P2 Mucopurulent pus containing 2 degree sputum (pus is 1/3 to 2/3 or less of sputum)
                P3 Mucopurulent pus containing 3 degree sputum (pus is 2/3 or more of sputum)
              Quantity is 0=0
                    1=Less than 3
                    2=3 or more, less than 10
                    3=10 or more
           Although the pneumoconiosis handbook cites existence of sputum only,
           it is not a problem to also enter measured quantity.

• Symptom deterioration makes it proper, by sputum cultivation and causal bacteria. Although administering antibiotics, one should usually follow up with inspection for several days.
• Even if infection is clear, causal bacteria are not necessarily competing with the body, and even if significant bacteria are detected with cultivation, there are cases where sputum has no pus present. In our experience, in cases where sputum is not containing pus (i.e. no white appearance), we record cultivation results of sputum that show "necessity of medical treatment" and those cases were acknowledged.
• Chronic bronchitis, bronchiolitis, in bronchiectasis, to infection by comparatively avirulent continues over many years even after all known chemical therapies have proven ineffective.