title: Health surveillance for occupational respiratory disease.
abstract: BACKGROUND
  Occupational lung diseases remain common, and health surveillance is one approach used to assist identification of early cases.
  
  
  OBJECTIVE
  To identify areas of good practice within respiratory health surveillance and to formulate recommendations for practice.
  
  
  METHODS
  Published literature was searched since 1990 using a semi-systematic methodology.
  
  
  RESULTS
  A total of 561 documents were identified on Medline and Embase combined. Other search engines did not identify relevant documents that had not already been identified by these two main searches. Seventy-nine of these were assessed further and 36 documents were included for the full analysis.
  
  
  CONCLUSIONS
  Respiratory health surveillance remains a disparate process, even within disease type. A standard validated questionnaire and associated guidance should be developed. Lung function testing was common and generally supported by the evidence. Cross-sectional interpretation of lung function in younger workers needs careful assessment in order to best identify early cases of disease. More informed interpretation of the forced expiratory volume in 1 s/forced vital capacity ratio, for example by using a lower limit of normal for each worker, and of longitudinal lung function information is advised. Immunological tests appear useful in small groups of workers exposed to common occupational allergens. Education, training and improved occupational health policies are likely to improve uptake of health surveillance, to ensure that those who fail health surveillance at any point are handled appropriately.
authors.affiliation: Centre for Workplace Health, Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire SK17 9JN, UK.
authors.forename: L
authors.initials: L
authors.lastname: Lewis
authors.forename: D
authors.initials: D
authors.lastname: Fishwick
mesh_terms: D000395:Air Pollutants, Occupational; D003362:Cost-Benefit Analysis; D042241:Early Diagnosis; D005260:Female; D005541:Forced Expiratory Volume; D006291:Health Policy; D006801:Humans; D008171:Lung Diseases / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D009784:Occupational Diseases / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D016273:Occupational Exposure / Q000191:economics / Q000517:prevention & control* / Q000706:statistics & numerical data; D016272:Occupational Health / Q000191:economics / Q000592:standards*; D062486:Public Health Surveillance; D006113:United Kingdom / Q000453:epidemiology; D014797:Vital Capacity
chemical_list: D000395:Air Pollutants, Occupational
keywords: Lung function; monitoring; respiratory health; respiratory symptoms; surveillance