title: [Early detection of COPD in occupational medicine in the Alpes-Maritimes].
abstract: BACKGROUND
  This study evaluated a standardized procedure aiming at early detection of COPD in a consecutive population of employees visiting occupational medicine.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service de pneumologie, hôpital Pasteur, 30, voie Romaine, BP 69, 06002 Nice cedex, France. Electronic address: francklemoigne@aol.com.
authors.forename: F
authors.initials: F
authors.lastname: Lemoigne
authors.affiliation: AMETRA 06, service de santé au travail des Alpes-Maritimes, 06560 Sophia Antipolis, France.
authors.forename: E
authors.initials: E
authors.lastname: Barré
authors.affiliation: Association du service médical de l'aromatique (ASMAROM), 06130 Grasse, France.
authors.forename: M
authors.initials: M
authors.lastname: Arsento
authors.affiliation: Centre de gestion de la fonction publique territoriale (CG-FT), 06704 Saint-Laurent-du-Var, France.
authors.forename: F
authors.initials: F
authors.lastname: Bily
authors.affiliation: Mutualité sociale agricole (MSA), 06200 Nice, France.
authors.forename: G
authors.initials: G
authors.lastname: Gibelin
authors.affiliation: Association paritaire de santé au travail BTP 06 (APST BTP 06), 06000 Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Pelser
authors.affiliation: Effi-stat, 75001 Paris, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Paillasseur
authors.affiliation: JGM Health Conseils, 95240 Cormeilles-en-Parisis, France.
authors.forename: J
authors.initials: J
authors.lastname: Garcia-Macé
authors.affiliation: Pneumologie, CHRU de Lille, 59000 Lille, France.
authors.forename: T
authors.initials: T
authors.lastname: Perez
authors.affiliation: Service de pneumologie et des soins intensifs respiratoires, hôpital Cochin, site Val-de-Grâce, AP-HP, université Paris Descartes, 75679 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Roche
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000453:epidemiology; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D009786:Occupational Health Services / Q000706:statistics & numerical data*; D011009:Pneumoconiosis / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D055815:Young Adult
keywords: BPCO; COPD; Diagnosis; Diagnostic; Médecine du travail; Occupational medicine; Spirometry; Spirométrie