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Healthcare for obstructive lung disease in an industrial spirometry surveillance program

J Occup Environ Med. 2009 Mar;51(3):336-42. Gulati M, Slade MD, Fiellin MG, Cullen MR. Yale University School of Medicine, New Haven, Conn., USA.

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.

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