Spirometric and hygienic criteria in recognition of occupational COPD in Poland - A retrospective analysis of medical records.
OBJECTIVES
Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment - clinical or hygienic one - is responsible for such a low rate of occupational COPD recognitions.


MATERIAL AND METHODS
The study group included 150 patients hospitalized with a suspicion of occupational COPD. Each patient underwent a clinical examination, spirometry and reversibility test using bronchodilator. Moreover, hygienic evaluation of work conditions was performed in all the considered cases.


RESULTS
In the case of the patients who fulfilled the criteria for COPD diagnosis in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) occupational origins of the disease, the disease was not recognized because 24.1% of the individuals did not meet spirometric criteria included in a definition of COPD in the Polish list of occupational diseases, while 27.8% of the individuals did not fulfill the criterion of a documented exposure to dusts and irritant gases. None of these criteria was fulfilled by 42.6% of the patients.


CONCLUSIONS
In our country, both clinical and hygienic criteria result in limitations in recognition of occupational COPD. There is the need to establish new guidelines for the recognition of COPD as a compensable disease in Poland. Int J Occup Med Environ Health 2018;31(2):139-150.
['Kleniewska|Aneta|A|', 'Walusiak-Skorupa|Jolanta|J|', 'Lipińska-Ojrzanowska|Agnieszka|A|', 'Szcześniak|Kamila|K|', 'Wiszniewska|Marta|M|']
D000328:Adult D000368:Aged D001993:Bronchodilator Agents D004391:Dust D005740:Gases D006801:Humans D008297:Male D008875:Middle Aged D009784:Occupational Diseases D016273:Occupational Exposure D011044:Poland D029424:Pulmonary Disease, Chronic Obstructive D012189:Retrospective Studies D013147:Spirometry
occupational COPD chronic obstructive pulmonary disease compensation VGDF acknowledgement of occupational disease