“…When these criteria are met, the extrapolation to a similar effect, i.e., increased pulmonary infections occurring in man, becomes reasonable providing the microorganism present is capable of multiplying and invading that host and that the actual dose of the inhaled pollutant reaching these defenses is sufficient to cause an adverse effect. Evidence exists that a number of trace metals which alter either biochemical, physiological, morphological or functional mechanisms of the macrophage also cause a significant increase in susceptibility to infection. Examples of some of the particles that have been shown to cause an enhancement of bacterial pulmonary infection include: Ni2 I, Cd2 +, Zn2 +, Pb2 +, H2SO4 and coal fly ash (35,37,55,62,74,117,132,219,222,225). It is important to note that in many of these studies, dose-response data indicated that an effect could be produced with concentrations similar to those seen in the working environ-ment.…”