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Large Community Spirometry Screening Proves Successful

Large scale, community spiromety screening for chronic obstructive pulmonary disease (COPD), can be successfully performed in non-traditional settings, according to a new study. The research, presented at CHEST 2006 // , the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP), also demonstrates that community spirometry screenings can identify a large proportion of subjects with significant impairment.

In a year-long study, co-authors Bob Cohen, MD, FCCP, John H. Stroger, Jr. Cook County Hospital and Diana Hackbarth, RN, PhD, Loyola University Chicago, and their colleagues performed a public health study in the broad, six-county Chicago metropolitan area. In partnership with the American Lung Association of Metropolitan Chicago and the American Lung Association of Illinois, researchers examined the impact of large-scale spirometry screening.

“We began screening subjects in June 2005 and continued through March of 2006,” said Dr. Cohen, “ and we were able to perform interpretable spirometry tests on subjects tested in a rather busy community setting.”

The study used modern spirometers and software to perform large scale, community, spirometry screenings for COPD. Subjects were recruited at a national pharmacy chain for a free lung test, and a total of 2,964 subjects sought free spirometry. Of these subjects, 2,920 agreed to participate in an on-the-spot health survey, and 2,250 agreed to participate in the follow-up study. Sixty percent of those who underwent free spirometry were former or current smokers.

Fourteen percent of the 2,027 subjects who had interpretable spirometry had significant COPD impairment, and 3 percent had severe or very severe impairment. In addition, 64 percent of these impaired patients reported being unaware of a previous diagnosis of COPD or asthma. In the related long-term study, researchers examined the impact of both spirometry screening and active telephone contact on smoking cessation attempts, which will also be presented at CHEST 2006.

According to Dr. Cohen, this study shows that a significant number of people in the community have undiagnosed obstructive lung disease. He suggests that public spirometry screening presents a great opportunity for public health intervention.

“Spirometry screening is an easy, painless, and noninvasive test that identifies people with obstructive lung disease, even at a stage when they may not be experiencing significant symptoms,” Dr. Cohen said. “This is especially important, because people in our sedentary society may not experience symptoms until COPD is relatively advanced.”

“Spirometry screening can help identify patients with lung impairment and may encourage patients who smoke to quit,” said Mark J. Rosen, MD, FCCP, President of the American College of Chest Physicians. “Clinicians should encourage spirometry screening in all patients who smoke and in people with respiratory symptoms with no known cause.”

“Current smokers, when confronted with decreased lung function, may be more motivated to quit, and we had a wonderful opportunity to coordinate our public health COPD initiative with our campaign to make Chicago smoke free,” said Dr. Cohen. “This program helped many persons from diverse communities in the Chicago metropolitan area by identifying, educating, and counseling.”

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