Occupational airway diseases were reviewed with consideration of relevant definitions, disease prevalence, etiological agents and mechanisms, diagnostic measures, and prescribed therapies. Two syndromes, byssinosis and soy dust asthma, were described in detail. Airway disease syndromes associated with occupational exposure included industrial bronchitis, reactive airway dysfunction syndrome, bronchiolitis obliterans, and occupational asthma. The role of sensitization was said to be central to these diagnoses. Disease prevalence was attributed to the dustiness of industries and agents such as gases, fumes, large molecular weight substances, and low molecular weight substances. Host characteristics related to disease progression included atopy, cigarette smoking, airway hyperreactivity, preexisting lung disease, and genetic factors. Diagnosis was said to depend upon demonstration and characterization of the disease and establishment of its work related nature. Aside from obtaining a patient's medical history and conducting a physical examination, diagnostic testing also included chest x-rays, pulmonary function studies, skin tests, serum precipitins, nonspecific airway reactivity, specific inhalation challenge testing, bronchoalveolar lavage, and workplace studies. Therapeutic efforts by management were related to industry size, disease prevalence, federal regulations, mandated medical surveillance, job security, screening of new workers, smoking control, improved ventilation, medical therapy, and use of respirators and protective devices. The author concludes that occupational airway diseases account for a significant proportion of airway diseases but their relation to job circumstances is often unrecognized. Thorough clinical understanding and routine inquiry into potential work or environmental exposures was emphasized.