Ever Smoking is Not Associated with Performed Spirometry while Occupational Exposure and Respiratory Symptoms are

Abstract

Linnea Carlsson,1,2 Mathias Holm,2 Maria Edlund,2 Magnus Ekström,3 Kjell Torén1,4 1Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Occupational and Environmental Medicine, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; 3Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund, Sweden; 4Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South AfricaCorrespondence: Linnea Carlsson, Occupational and Environmental Medicine, Department of Medicine, Sahlgrenska University Hospital, PO Box 414, Gothenburg, SE 405 30, Sweden, Email [email protected]: Despite recommendations, assessment using spirometry or peak expiratory flow is insufficient in the clinical evaluation of suspected obstructive pulmonary disease. The aim was to investigate factors associated with performing spirometry or peak flow expiratory flow assessment.Methods: Randomly selected subjects from the general population aged 50– 65 completed a respiratory questionnaire with items about the history of previously performed spirometry or peak expiratory flow. The association between ever having had spirometry or peak expiratory flow performed was analyzed for smoking, age, sex, occupational exposures, dyspnea, wheeze, self-reported physician diagnosed asthma and COPD using multivariable logistic regression models. The results are presented as odds ratios (OR) with 95% confidence intervals (95% CIs).Results: Of the 1105 participants, 43.4% (n=479) had a history of previously performed spirometry or peak expiratory flow. Occupational exposure (OR 1.72, [95% CI] 1.30– 2.27), wheeze (OR 2.29, 1.41– 3.70), and dyspnea (OR 1.70, 1.11– 2.60) were associated with previously performed spirometry. Compared to men, women had spirometry or peak expiratory flow performed less often (OR 0.67, 0.51– 0.86). Neither current smoking (OR 0.83, 0.57– 1.20) or former smoking (OR 1.27, 0.96– 1.67) were associated with performed spirometry or peak expiratory flow.Conclusion: We found no relation between smoking status and a history of previously performed spirometry or peak expiratory flow in a population-based sample of middle-aged people. This is surprising regarding the strong guidelines which highlight the importance for spirometry surveillance on current smokers due to their increased risk of lung disease. Male sex, respiratory symptoms and occupational exposures to air pollution were associated with previously performed spirometry or peak expiratory flow. The association with occupational exposure may be an effect of pre-employment screening and workplace surveillance, and the findings indicate that females do not receive the same attention regarding spirometry or peak expiratory flow.Keywords: lung function test, spirometry and PEF, smoking, occupational exposure, respiratory symptoms, SCAPIS pilot

Keywords

• lung function test
• spirometry and pef
• smoking
• occupational exposure
• respiratory symptoms
• scapis pilot