Annual General Meeting of the Irish Thoracic Society - IJMS | Irish ...

31
1
SESSION THREE ONE
ANNUAL MEETING OF THE IRISH THORACIC SOCIETY • 11 - 12 November 2005 • WESTWOOD HOUSE HOTEL, GALWAY
ANNUAL MEETING OF THE IRISH THORACIC SOCIETY • 11 - 12 November 2005 • WESTWOOD HOUSE HOTEL, GALWAY
3
SESSION
SESSION THREE ONE
Population Studies
3.16
A study to estimate the prevalence of idiopathic
pulmonary fibrosis in Ireland
3.18
The effects of the workplace ban on smoking on the lung
function of bar workers in Dublin
Prevalence estimates for IPF vary from 3 to 20 cases
per 100,000 in the general population. The aim of
this study was to estimate the prevalence of IPF
in Ireland. Information on patient admission and
discharge was obtained from the hospital inpatient
enquiry system (HIPE) and the private sector data
sets. Sixty nine acute hospitals participate in HIPE.
The period January 1999 to December 2003 was
chosen. Age, sex and hospital admissions were
estimated.
YEAR
3.17
NO. PATIENTS WITH IPF
(PUB SECTOR)
Investigation of the prevalence of undiagnosed airflow
obstruction in symptomatic subjects attending a large
physiotherapy department
Introduction
Screening patients for COPD is well documented.
However, there is little information regarding
the prevalence of undiagnosed COPD in patients
attending physiotherapy, and the benefits that
screening may have.
Method
By providing information in the waiting area, patients
(attending physiotherapy for other reasons) were
encouraged to refer themselves to a clinic held once
a week in the department.At the clinic, patients gave
a brief medical background, had their height and
body mass measured followed by spirometry using a
Micro Medical Microlab.
Results
Sixteen patients presented themselves for
spirometry at 15 clinics. – six male and 10 female,
with a mean (SD) age of 59 (11.22), mean (SD) BMI
Results
Eight hundred and thirty eight IPF cases were
identified.Seven hundred and thirty seven (62%)
were male and 456 (38%) were female.The mean
age was 67.5 years. The total number of hospital
admissions between 1999 and 2003 n = 1193.
The estimated mean prevalence per 100,000 of
the general population over the 5 year period was
calculated n = 4.2. Total deaths from IPF recorded
over the 5 year period was n = 218.
NO. PATIENTS WITH IPF
(PRIVATE SECTOR)
PREVALENCE IPF/100,000
1999 124 74 5
2000 130 64 4.9
2001 118 64 4.6
2002 86 35 3.1
2003 107 36 3.6
24.94 (5.85), and mean (SD) FEV 1
/FVC 74.54 (11.66). Of
these 16 patients, seven were diagnosed as having
obstructive airways disease (44%) and were followed
up at a COPD OPD clinic, as well as smoking cessation
facilitation. One patient (6%) was diagnosed as
having a high risk of developing COPD, and was
followed up with smoking cessation facilitation. All
seven of the patients who were smokers, were given
details of how to contact the smoking cessation
officer. Three of the smokers (43%) quit smoking as a
result of the study.
Conclusion
Screening patients in a physiotherapy department
is easily accomplished with the support of a
Respiratory Consultant and a smoking cessation
facilitator. The results suggest that screening is a
beneficial service, and potentially may help to slow
down the progression of the COPD through adequate
medical management and smoking cessation.
BN McCullagh,
JM Coyle, DT Keating,
MB Codd, JJ Egan
Heart Lung Transplant
Unit, Mater
Misercordiae Hospital,
Dublin
H Fisher, 1 N Murphy, 1
F O’Connell, 2 J Gormley 3
1. Physiotherapy Dept
and
2. Dept of Respiratory
Medicine, St James’s
Hospital, Dublin
3. School of
Physiotherapy,
Trinity College
Dublin
Background
It has long been recognised that exposure to
environmental tobacco smoke causes respiratory
and cardio-vascular disease in those exposed to it.
Bar staff are a group of workers with long hours of
exposure at work, and as such, were an ideal group to
study the effects of the government ban on smoking
in the workplace.
Methods
Bar workers were recruited through their Trade
Union, Mandate, and 81 participated in the first
phase of testing between September 2003 and
March 2004. They attended the Respiratory
Laboratory in St. James Hospital for lung function
tests and measurement of exhaled carbon monoxide.
They also completed a questionnaire relating to their
respiratory health, and smoking history. Seventy-five
(93%) returned between September 2004 and March
2005 for repeat testing and again completed the
questionnaire.
Results
Subject demographics: 75 completed phase 1 and
phase 2, all male. Nine (12%) of these had been
diagnosed as asthmatic by a physician. For analysis
two subjects were excluded due to change in
smoking status on return. Thirty-four (47%) had never
smoked. Thirt-one (42%) were ex-smokers. Eight (11%)
were current smokers.
Symptoms
No. complaining
of eye, nose and
throat symptoms
No. complaining
of respiratory
symptoms
PHASE 1 PHASE 2 CHANGE
65 (89%) 32 (44%) -51%
65 (89%) 47 (64%) -28%
Carbon Monoxide (CO) Measurement
Mean CO levels 5.9ppm 4.2ppm -29%
Lung Function Spirometry, lung volumes and
gas transfer measurement were performed at
both visits and showed changes as follows:
Never
smokers
(34)
Exsmokers
(31)
Smokers
(8)
FEV1 +2% -1% -5%
FVC +5% +3% -3%
PEF +12% +8% -2%
TLC +3% +2% +2%
DLCO +5% -1% -6%
The figures in bold and italics are statistically significant (P