Lemoigne F, Barré E, Arsento M, Bily F, Gibelin G, Pelser M, Paillasseur J-L, Garcia-Macé J, Perez T, Roche N
Service de pneumologie, hôpital Pasteur, 30, voie Romaine, BP 69, 06002 Nice cedex, France.
AMETRA 06, service de santé au travail des Alpes-Maritimes, 06560 Sophia Antipolis, France.
Rev Mal Respir. 2015 Jan;32(1):30-7. doi: 10.1016/j.rmr.2014.07.005. Epub 2014 Aug 7.
This study evaluated a standardized procedure aiming at early detection of COPD in a consecutive population of employees visiting occupational medicine.
A total of 2818 employees were included by 22 occupational physicians in 5 centers. Respiratory symptoms, smoking status, occupational exposures and socioprofessional categories were collected. Subjects with at least one symptom and/or risk factor underwent spirometry.
In this population aged 39±12 years, 2603 patients were free of known asthma or COPD. The presence of at least one symptom was observed in 23.6 % of employees and was significantly associated with smoking status, occupational exposure to organic dust, gas fumes and vapors, and agriculture (P<0.0001). Airflow obstruction (FEV1/FVC < 0.70) was detected in 1.7 % of 1605 employees who underwent spirometry. With the inclusion of known COPD subjects (n=22), the prevalence reached 2.38 %. COPD was significantly associated with smoking intensity. Information on subsequent diagnosis was obtained in only two cases. The quality of spirometry was inadequate in 30 % of cases. Thirty-three percent of detected COPD subjects did not report any respiratory symptoms.
The strategy used in this study (specific questionnaire plus spirometry) allowed detection of a few cases of previously undiagnosed COPD. Occupational physicians need specific training in spirometry and a better follow-up of care pathways is required to obtain diagnostic confirmation.
