title: Healthcare for obstructive lung disease in an industrial spirometry surveillance program.
abstract: OBJECTIVE
  The efficacy of workplace spirometry surveillance programs is unclear. We examine whether aluminum industry workers with airflow obstruction (AO) received health care for obstructive lung disease.
  
  
  METHODS
  We performed a cross sectional analysis over 7 years of 6821 aluminum production workers. The primary outcome was the association between obstructive lung disease insurance claims and the presence of AO. We also examined whether the presence of claims was associated with increasing AO severity.
  
  
  RESULTS
  Although workers with AO more frequently had claims, 60% of workers with AO, most frequently those with mild and borderline obstruction, had no claim.
  
  
  CONCLUSIONS
  Workers with AO, particularly borderline and mild obstruction, frequently do not receive health care despite respiratory surveillance. Further investigation is needed to determine if workers with undiagnosed AO are symptomatic or have accelerated losses in lung function over time.
authors.affiliation: Yale University School of Medicine, New Haven, Conn., USA. mridu.gulati@yale.edu
authors.forename: Mridu
authors.initials: M
authors.lastname: Gulati
authors.forename: Martin D
authors.initials: MD
authors.lastname: Slade
authors.forename: Martha G
authors.initials: MG
authors.lastname: Fiellin
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007221:Industry; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D011159:Population Surveillance; D012720:Severity of Illness Index; D013147:Spirometry