title: [Pilot data from the Spirale project -- follow-up of occupational respiratory exposures].
abstract: BACKGROUND
  The medical follow-up of individuals who have had occupational exposures to potential respiratory hazards is little known and under-utilised. The Spirale program aims to deliver this intervention effectively to all potential beneficiaries.
  
  
  METHODS
  Spirale was introduced in two stages; i) identification of occupational exposures to asbestos or wood dust through a postal questionnaire; ii) for those initially identified, confirmation of exposure through attendance at a health centre for examination and further medical follow-up as necessary.
  
  
  RESULTS
  In 2007, Spirale contacted 50,662 men born between 1942 and 1943, living in 13 departments in France. The initial response rate was 24%, rising to 50% after reminders. Seventy-two percent of people were identified as possibly having been exposed; 50% to asbestos, 3% to wood dust and 19% reporting a mixed exposure. Among the 8641 people located, 3843 (44.5%) benefited from an evaluation of their exposure. In total, 73.4% of people had their exposure to asbestos confirmed and in 1751 (64.2%) this was at a level to justify follow-up.
  
  
  CONCLUSIONS
  TheSpirale program largely achieved its objective of location and initiation of medical monitoring of people who have been exposed through their work to respiratory carcinogens. It should now be implemented throughout the country.
authors.affiliation: Inserm U1018, Epidemiology of Occupational and Social Determinants of Health Centre for Research in Epidemiology and Population Health, 94800 Villejuif, France. matthieu.carton@inserm.fr
authors.forename: M
authors.initials: M
authors.lastname: Carton
authors.forename: S
authors.initials: S
authors.lastname: Bonnaud
authors.forename: M
authors.initials: M
authors.lastname: Nachtigal
authors.forename: A
authors.initials: A
authors.lastname: Serrano
authors.forename: C
authors.initials: C
authors.lastname: Carole
authors.forename: S
authors.initials: S
authors.lastname: Bonenfant
authors.forename: D
authors.initials: D
authors.lastname: Coste
authors.forename: P
authors.initials: P
authors.lastname: Lepinay
authors.forename: B
authors.initials: B
authors.lastname: Varsat
authors.forename: B
authors.initials: B
authors.lastname: Wadoux
authors.forename: M
authors.initials: M
authors.lastname: Zins
authors.forename: M
authors.initials: M
authors.lastname: Goldberg
mesh_terms: D000465:Algorithms; D001195:Asbestosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003627:Data Interpretation, Statistical; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D018579:Patient Selection; D010865:Pilot Projects; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy