VOLUME 48 / SUPPLEMENT 60 / SEPTEMBER 2016
Abstracts / 26th International Congress London, United Kingdom 4 – 7 September 2016
Online ISSN: 1399-3003
Copyright for individual abstracts remains with the authors. This abstract supplement has been produced electronically by the European Respiratory Society. The European Respiratory Society is not responsible for errors or omissions in content. The ideas and opinions expressed in this publication do not necessarily reflect those of Coe-Truman and the European Respiratory Society. Products mentioned in this publication should not be construed as an endorsement of the product or the manufacturer’s claims. Readers are encouraged to contact the manufacturer with any questions about the features or limitations of the products mentioned. The European Respiratory Society assumes no responsibility for any injury and/or damage to persons or property arising out of or related to any use of the material contained in these abstracts. The reader is advised to check the appropriate medical literature and the product information currently provided by the manufacturer of each drug to be administered to verify the dosage, the method and duration of administration, or contraindications. It is the responsibility of the treating physician or other health care professional, relying on independent experience and knowledge of the patient, to determine drug dosages and the best treatment for the patient. An effort has been made to check generic and trade names, and to verify drug doses. The ultimate responsibility, however, lies with the prescribing physician. Please convey any errors to
[email protected]. Citations should be made in the following way: Authors. Title. Eur Respir J 2016; 48: Suppl. 60, abstract number.
ERS International Congress 2016 Your personal abstract book
Table Of Content 117. Best abstracts in asthma and COPD
9
OA253: Asthma-COPD overlap syndrome (ACOS) versus ²pure² COPD: A distinct phenotype?
9
OA255: Accelerated decline in FEV1 in non- smoking subjects with chronic HCV infection
9
122. Respiratory nursing research: opening new perspectives on patient experiences
9
OA292: Girls with asthma have worse health related quality of life than boys - A population based study
9
OA295: Differences in proxy-reported and patient-reported outcomes: Assessing problematic activities of daily life in patients with COPD
9
127. Advanced lung function testing in childhood respiratory and sleep disease
9
PA366: Long term pulmonary outcome after mild to severe bronchopulmonary dysplasia
9
128. Human responses to exposure, including physiological and biomarker outcomes
10
PA383: Inhaled diesel exhaust alters allergen-induced bronchial secretome in humans
10
PA385: Lipid composition of particles in exhaled air (PEx) from workers exposed to welding fumes
10
PA386: Elevated markers of lipid oxidative damage among workers exposed to engineered TiO2 nanoparticles
10
PA387: Lung asbestos content in patients with lung cancer in different Spanish regions. The AMCANES study
11
PA388: A polypeptide of the megakaryocyte potentiating factor is a potential biomarker in plasma for the detection of mesothelioma
11
PA389: Risk of rheumatoid arthritis in a cohort of silica-exposed Swedish foundry workers
11
PA390: Farmers beware of the storage mites
11
PA391: Occupational endotoxin exposure dose-dependently protects against atopy and hay fever: Results of a longitudinal study
12
PA392: Sensitisation to mouse allergens in contemporary laboratory animal workers: The SPIRAL study
12
PA393: Airway inflammatory profile among cleaning workers from different workplaces
12
PA394: Different changes in plasma concentrations of cytokines and chemokines in patients with COPD associated with smoking and occupational exposures
12
PA395: Exposure to birch pollen and ozone and the fraction of exhaled nitrogen oxide (FENO)
13
PA396: Occupational chronic obstructive pulmonary disease attributed to chemicals exposure: Clinical characteristics and inflammatory serum profile
13
PA397: The Minasarc study: A case-control study measuring mineral exposome in sarcoidosis
13
146. Population-based insights into occupational and environmental lung disease
13
OA455: Long term effect of cleaning on lung function decline among women in the ECRHS study
13
OA456: 'Hotspots' of livestock farms may influence lung function of neighboring residents
14
OA458: Silicosis in Dutch construction workers
14
150. Inflammatory biomarkers in airway diseases
14
OA486: LATE-BREAKING ABSTRACT: Effects of growth and ageing on pulmonary nitric oxide dynamics in healthy subjects
14
OA490: Simultaneously increased serum periostin and urinary EDN relates to reduced lung function in adults with asthma from the Swedish GA2LEN study
15
151. Mesothelioma and pleural disease: from the bench to the bedside
15
OA499: Breath analysis by gas chromatography-mass spectrometry can be used to screen for pleural mesothelioma
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154. Effects of exercise training interventions in chronic respiratory disease
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PA533: Cardiorespiratory demand during upper and lower limb resistance exercises in patients with COPD
15
155. In-patient and out-patient COPD management
16
PA546: Challenges faced by practicing pulmonologists in the management of COPD in India
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167. From pleura to bronchi: new insights
16
PA673: Poor periodontal health is associated with airways obstruction
16
170. Best abstracts in COPD management
16
PA726: Integrated disease management (IDM) intervention for COPD patients has long-term effects on patient activation
16
174. Clinical aspects of ILD
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PA797: Randomised controlled, crossover trial to evaluate the effects of ambulatory oxygen on health status in patients with fibrotic lung disease
178. Molecular targets in pulmonary disease
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17
PA894: The lueokocyte telomere length, single nucleotide polymorphisms near TERC gene and risk of COPD
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180. Translational studies in lung disease
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PA920: Secondary mechanisms of genotoxicity promoted by iron oxide nanoparticles via immune cell activation in vitro
17
PA925: The role of IFN-? in severe COPD patients with anamnestic viral-induced exacerbations before and after roflumilast treatment
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186. Monitoring airway diseases with clinical tools
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PA1053: The control of asthma in real life: Baseline evaluation of a long-term study
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187. Airway biomarkers
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PA1062: Development of a method for quantification of phosphatidylcholine in exhaled breath
18
PA1069: Exhaled surfactant protein A and albumin in a healthy Swedish population
18
190. Comorbidities and exacerbations in COPD
18
PA1116: The frequency of COPD exacerbations is related to the comorbidity profile
18
PA1121: Systematic analysis of self-reported comorbidities in the COSYCONET COPD cohort study by stepwise evaluation of medication
19
PA1122: Prevalence of common diseases in COPD patients versus lung-healthy control subjects: Results from the German COSYCONET study
19
PA1126: Global associations between air pollutants and chronic obstructive pulmonary disease (COPD) exacerbations: A systematic review
19
191. Asthma, COPD, and ACOS: physical activity, dietary aspects, and diseases burden
20
PA1138: Relationship of airflow limitation severity with work productivity reduction and sick leave in a Japanese working population
20
PA1141: Association of COPD symptomatic burden with healthcare resource utilization and impairment on work and activity
20
PA1146: Physical activity and asthma: A longitudinal Respiratory Health in Northern Europe (RHINE) study
20
PA1150: Can disease-specific questionnaires describe the effect of comorbidities on health-related quality of life in patients with COPD? A comparison of disease-specific and generic questionnaires in the COSYCONET cohort
20
PA1154: Comparison of physical activity measures assessed by two different accelerometers in COPD patients
21
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192. Occupational epidemiology
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PA1156: Psychological, quality of life, and work-limitation outcomes among occupational asthma and workexacerbated asthma subgroups
21
PA1157: Impact of work-related respiratory symptoms on quality of life and productivity in British woodworkers
21
PA1158: Assessment of asthma in firefighter applicants
22
PA1159: The impact of first occupation on the occurrence and worsening of asthma in young adults
22
PA1160: The characteristics of work-related asthma in a prospective asthma cohort
22
PA1161: How occupational asthma is detected among workers participating medical surveillance?
22
PA1162: Years in farming, inhalation fever (ODTS) and smoking increases the risk for asthma and other respiratory symptoms in farmers
22
PA1163: Characterization of emphysema in active farmer's lung disease
23
PA1164: The utility of airfed RPE in the management of workers with metal-working fluid occupational asthma
23
PA1165: Respiratory symptoms in miners survived from soma mine disaster
23
PA1166: Severe emphysema in heavily indium-exposed workers: Case reports from a 10-year cohort study
23
PA1167: Longitudinal lung function change in asbestos exposed workers in Navarra
24
PA1168: Cross-shift lung function in relation to cotton dust and endotoxin exposure in non-smoking female textile workers: A cross-sectional study
24
PA1169: The effect of organic dust exposure on change in lung function – A systematic review
24
PA1170: Working in a petroleum refinery predicts lower lung function parameters
24
PA1171: Silica exposure, silicosis, autoimmune diseases, tuberculosis and nontuberculous pulmonary mycobacterial disease
25
PA1172: Phenotyping occupational asthma due to isocyanates
25
PA1173: Occupational groups associated With asthma-related respiratory symptoms in a cross-sectional study from Norway
25
PA1174: Is data quality more important than data quantity in occupational asthma diagnosis from PEF records?
25
PA1175: A new method for performing specific challenge tests to chlorine-releasing agents
26
193. Public health related concerns and epidemiology of smoking and smoking-related products
26
PA1177: Trends in smoking habits in Europe: Are anti-smoking policies overlooking pre-adolescents?
26
PA1178: Benefit of smoking cessation forum
26
194. Role of genetics and exposures in COPD and asthma
26
PA1201: Cardio-metabolic disorder in grandparents associated with asthma in offspring: Results from a European 3-generation analysis
26
PA1211: LATE-BREAKING ABSTRACT: Occupational exposure to pesticides is associated with differential DNA methylation
27
200. Asthma, bronchiectasis, and the risk factors for respiratory morbidity
27
PA1321: Respiratory morbidity in extremely premature born children and later physical activity
27
201. Quality and quantity in lung function
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PA1327: Interpretation of spirometric data of 799 pulmonary male patients by ECCS/ERS and GLI-2012 reference values
27
204. The wide spectrum of respiratory nursing research and practice: across all ages and diseases
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PA1402: Biological monitoring of healthcare professionals exposed to antineoplastic drugs in a respiratory teaching hospital
28
241. Molecular pathways of smoking-induced diseases
28
OA1479: LATE-BREAKING ABSTRACT: Activity limitation and exacerbations in smokers with emphysema on CT but preserved pulmonary function. SPIROMICS
28
250. Best abstracts in exercise capacity and testing in chronic lung diseases
28
PA1572: The reliability and validity of the 4 metre gait speed (4MGS) in idiopathic pulmonary fibrosis (IPF)
28
251. Unmasking the mechanisms of symptoms and exercise limitation in disease
29
PA1584: Respiratory timing and dynamic hyperinflation during incremental exercise in patients with COPD
335. Assessing lower airway inflammation with different tools
29
29
PA1835: Determinants of exhaled particles of a standardized breathing maneuver
29
PA1839: Concentration of exhaled endogenous particles in relation to peripheral airway dysfunction
29
PA1849: Impact of standardized physical exertion on oxidative stress biomarkers in exhaled breath condensate of patients suffering from severe chronic obstructive pulmonary disease - The PHAETON project
29
361. COPD and asthma COPD overlap syndrome (ACOS): novelties in terms of prevalence, risk factors, and prognosis in COPD
30
OA2006: Prediction models for exacerbations in different COPD patient populations: Results of five large databases
30
365. Best abstracts in physical activity and telemedicine
30
PA2055: Maintaining an active lifestyle of patients with occupational lung diseases: A randomized controlled study
30
374. Dealing with the complexity of critically-ill patients
30
PA2140: Acute respiratory failure following neurotoxic snake bite - A study of 101 cases of neurotoxic snake bite from eastern India
30
PA2149: Systemic, respiratory, and cardivascular effects of occupational carbon monoxide poisoning (due to Soma mine disaster)
31
378. Pathophysiological mechanisms at different levels: lung, airways, muscles and symptom perception
31
PA2209: Physical activity is associated with allergic disease, but not allergic symptoms or sensitization, in adolescents
31
379. Lung function and imaging: new findings and new approaches
31
PA2230: Lung function parameters improve prediction of VO2peak: The Generation 100 study
31
PA2231: Effects of forced exhalations and cough on surfactant content and size distribution of exhaled particles
31
PA2242: Reference lung values for ethnically diverse Nepalese population residing at wide range of altitudes
32
PA2244: Quantitative chest CT (QCT) measurements in World Trade Center (WTC) workers and volunteers with accelerated air flow decline
32
387. Non-CPAP in obstructive and central sleep apnoea and obesity hypoventilation syndrome
32
PA2376: Palaeolithic diet and obstructive sleep apnoea in overweight females: A randomised controlled trial
32
401. Tuberculosis: the elderly, the diabetic, the unusual, and the severe
32
PA2663: Silicosis, tuberculosis time bomb?
32
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404. Treatment management options and costs: vitamin D, Matrix metalloproteinases (MMPs), nutrition, and human genetics
33
PA2719: Latent TB infection: Patient choices and completion of treatment
33
408. Epidemiology and specific subgroups in lung cancer
33
PA2804: The combination of lung cancer and bauxite pneumoconiosis on resection of lung
33
459. Phenotyping asthma
33
OA3034: Feasibility of using multiplex technology for simultaneous quantification of inflammatory proteins in exhaled particles
463. Quality management and quality of life in lung cancer
33
33
PA3070: Breathlessness-inducing exercise in advanced cancer populations. Which measures to use as functional status declines?
33
465. Prevalence, prognosis, and risk factors of COPD
34
PA3107: Risk of myocardial infarction (MI) associated with acute exacerbations of COPD (AECOPD): Effects of exacerbation frequency
34
PA3112: Intrauterine exposures in the ECRHS cohort increase the risk of COPD in smokers
34
PA3117: COPD in northern Sweden 1994-2009: Less under-diagnosis and altered risk factor pattern
34
526. Early determinants of childhood asthma and allergy
34
OA3301: Childhood asthma in relation to maternal and paternal preconceptional nicotine exposures
34
528. Predictors of asthma among children and adults
35
OA3319: Dampness and mould on respiratory health – A longitudinal approach. Results from the MeDALL study
35
OA3321: Age at allergic sensitization is strongly related to asthma and rhinitis in young adulthood
35
OA3322: Influence of gene-by-early environmental tobacco smoke exposure interactions on time-to-asthma onset
35
537. Exploring mechanisms in health and disease
36
PA3441: Does positive bronchodilator reversibility testing predict positive bronchoprovocative methacholine challenge testing in suspected asthma patients
36
566. New insights into pulmonary rehabilitation for chronic lung diseases
36
PA3587: The effect of co-existent chronic heart failure (CHF) on lower limb muscle function in COPD: Propensity matched analysis
36
PA3589: COPD and co-existent chronic heart failure (CHF): Response to pulmonary rehabilitation (PR)
37
568. Man versus machine: waves, frequency, and more in lung function
37
PA3617: Quality of spirometry in silica, wood and foundry workers in GB
37
579. COPD diagnosis and management
37
PA3686: Management of virtual COPD cases by pulmonary physicians
37
582. Latest insights into the management of chronic respiratory diseases
38
PA3746: Cognitive impairment and clinical characteristics in patients with COPD
38
585. A view into a chest and pleural pathology
38
PA3799: Possible use of chest ultrasonography in asbestos related lung diseases
38
589. Orphan diseases I
38
PA3880: Bagpipe lung; a new type of interstitial lung disease?
38
PA3882: Environmental exposures in 513 patients of hypersensitivity pneumonitis: Prospective ILD India registry
39
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591. Orphan diseases II
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PA3925: LATE-BREAKING ABSTRACT: Sarcoidosis and inorganic dust exposition in the MINASARC (MIneralo-NAno-SARCoidosis) study
39
593. Targeting care, pulmonary rehabilitation, management, and self-management of COPD exacerbations in primary care
39
PA3963: Multidisciplinary rehabilitation in COPD
39
599. Novel avenues in the treatment of COPD II
40
PA4072: The role of proinflammatory cytokines in severe COPD patients before and after roflumilast treatment
40
PA4075: Role of anabolic steroids in COPD patients
40
600. Preclinical pharmacology: drug targets and mechanisms of action
40
PA4099: Effect of tiotropium bromide on IFN-? level: Results from 180-days study in moderate COPD patients with viral-induced exacerbations in anamnesis
40
604. Phenotyping and monitoring airway diseases
40
PA4168: Clinical features of chronic obstructive pulmonary disease in never smokers
40
606. Asthma: treatment, disease control, and quality of life
41
PA4220: A long-time follow-up of mortality, asthma, and health-related quality of life in an elderly
41
PA4223: LATE-BREAKING ABSTRACT: Is treatment with inhaled corticosteroids in asthma associated with hospitalisations because of pneumonia?
41
607. Prevalence of obstructive airway diseases, methods of diagnosis, and lung function testing
41
PA4233: The influence by body mass index on annual lung function decline is not related to smoking status
41
PA4239: White blood cells, FeNO, glutathione, 8-oxodG and 8-isoprostane in respiratory diseases
41
608. Epidemiological aspects of tuberculosis and other respiratory conditions: from lung cancer to late-onset Pompe's disease
42
PA4255: The association between gastritis/gastroesophageal reflux and rhinitis/rhinosinusitis
42
PA4264: LATE-BREAKING ABSTRACT: Validation of self-reported body silhouettes in a Northern European study
42
609. Occupational and environmental exposures and biomarkers: human studies, animal data, and in vitro methods
42
PA4270: Anti-IgE as an alternative treatment for occupational asthma due to low molecular weight agents
42
PA4271: Mus m 1 personal exposure in laboratory animal workers in facilities where mice are housed in open cages and individually ventilated cages
43
PA4272: In-house and commercial and bovine dander extracts in the diagnostics of allergic occupational diseases
43
PA4273: Cytokines and MMP-9 level in serum and induced sputum of patients with suspicion of occupational COPD
43
PA4274: Markers of inflammation among workers exposed to engineered TiO2 nanoparticles
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PA4276: Oxidative imbalance in biological fluids of heavy metals-exposed workers
44
PA4277: Changes in passive smoking in the workplace from three waves of the European community respiratory health survey
44
PA4280: Occupational respiratory exposure at man-made mineral fibers and their influence on p53 protein expression in peripheral mononuclear cells
44
PA4282: Elevated neutrophil lymphocyte ratio and T4 levels can be predisposing factors for silicosis
44
PA4283: Exposure to welding fume and oxidative stress in airway epithelial cells
45
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PA4284: Lung function and element status of foundry workers
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PA4285: Bronchopulmonary system changes in the employees of nuclear industry
45
610. The indoor and ambient environments
45
PA4286: Outdoor exercise with different PM2.5 concentrations and heart rate variability effects in healthy individuals, São Paulo, Brazil
45
PA4287: Self-reported traffic exposure is not strongly correlated with modelled NOx in a Northern European cohort study
46
PA4288: Are physicians specialists on the impact of air pollution on health?
46
PA4289: Exposure to damp or mould at home in relation to respiratory symptoms and asthma in the Telemark study, Norway
46
PA4290: Household smoking and respiratory health in Telemark, Norway – 10 years after the introduction of a smoking ban
47
PA4291: Swimming pools: Exposure time and asthma symptoms in children
47
PA4293: High-altitude alpine therapy and lung function in asthma: Systematic review and meta-analysis
47
615. Living with asthma around the globe
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PA4400: LATE-BREAKING ABSTRACT: Predicting asthma at age 8; the application of machine learning
47
652. IPF clinical
48
OA4572: PROOF: A prospective observational registry to describe the disease course and outcomes of idiopathic pulmonary fibrosis patients in a real-world clinical setting in Belgium and Luxembourg: Exposure in the interim report of 175 IPF patients
48
OA4573: Health status & impact of living with idiopathic pulmonary fibrosis (IPF): UK & Ireland Delphi survey
48
654. Asthma and allergy in infancy: from risk factors to mortality
48
PA4580: Late-asthma onset and associated factors
48
PA4581: Persistent allergic sensitization is associated with asthma and rhinitis among adults
49
PA4583: Validation of self-reported asthma in a generation study
49
PA4588: Age at asthma onset and lung function among 19 year old asthmatics
49
PA4589: Are workers at greater risk of undiagnosed asthma?
50
PA4596: LATE-BREAKING ABSTRACT: Transgenerational effect of parental and grandparental smoking on asthma risk in offspring
50
655. Emerging issues in smoking cessation and tobacco products
50
PA4610: Use of oral and nasal tobacco and asthma symptoms in a Nordic population
50
656. Biomarkers and phenotypes of COPD and comorbidities
50
PA4614: Relationship between blood eosinophil count (Eos), clinical characteristics and mortality of patients with COPD
50
692. Management of dyspnoea and exacerbations in chronic lung diseases
51
OA4807: Short physical performance battery as a predictor of adverse outcomes following hospitalisation for an acute exacerbation of COPD
51
693. Best abstracts on innovative outcomes and novel interventions in respiratory physiotherapy
51
OA4814: LATE-BREAKING ABSTRACT: Can patients with COPD assimilate disease specific information at a time of being acutely unwell due to an exacerbation of their disease?
51
700. Burden of respiratory diseases: from environmental aspects to healthcare consumption
51
PA4914: Geographical variation in the respiratory health of Great Britain
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PA4915: Different impact of respiratory symptoms on health care consumption and daily life in Finland, Estonia and Sweden
52
PA4918: Co-exposure between asbestos and inorganic particles and risk of lung cancer in the ARDCO study
52
PA4922: Exposure to traffic pollution is related to daytime sleepiness and habitual snoring: Results from the RHINE study
52
PA4923: How do children perceive indoor air quality (IAQ) at school?
52
715. Important factors, besides smoking, that relate to lung function and decline in lung function
53
OA4997: LATE-BREAKING ABSTRACT: The impact of comorbidities on all-cause mortality among subjects with and without airway obstruction
53
OA4998: Menopause is associated with accelerated lung function decline in the longitudinal European community respiratory health survey
53
OA5002: Long-term physical activity pattern and lung function in European adults
53
OA5004: Differentially methylated genes related to gestational age are also expressed during fetal lung development
54
717. From cardiopulmonary interaction to locomotor muscles and dyspnoea in health and disease
54
PA5029: COPD influences on left heart wall stress — An analysis of the COSYCONET cohort
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117. Best abstracts in asthma and COPD OA253 Asthma-COPD overlap syndrome (ACOS) versus "pure" COPD: A distinct phenotype? Denis Caillaud, Pascal Chanez, Roger Escamilla, Pierre-Régis Burgel, Isabelle Court-Fortune, Pascale Nesme-Meyer, Gaetan Deslee, Thierry Perez, JeanLouis Paillasseur, Christophe Pinet, Gilles Jebrak, Nicolas Roche ¹Pulmonary Dpt, University Hospital, Auvergne University, Clermont-Ferrand, France; ²Pulmonary Dpt, AP, HM, Aix Marseille University, Marseillle, France; ³Pulmonary Dpt, Clinique des voies Respiratoires, Hôpital Larrey, Toulouse, France; ⁴Pulmonary Dpt, Hôpital Cochin, AP-HP and Université Paris Descartes (EA2511), Sorbonne Paris Cité, Paris, France; ⁵Pulmonary Dpt, University Hospital, Saint-Etienne, France; ⁶Pulmonary Dpt, Croix-Rousse University Hospital, AP-HCL, Lyon, France; ⁷Pulmonary Dpt, Maison Blanche University Hospital, INSERM U903, Reims, France; ⁸Pulmonary Dpt, Calmette University Hospital, Lille, France; ⁹Statistical Dpt, Effistat, Paris, France; ¹⁰Pulmonary Dpt, Les Fleurs Clinique, Ollioules, France; ¹¹Pulmonary Dpt, Bichat University Hospital, AP-HP, Paris, France; ¹²Pulmonary Dpt, Hôpital Cochin, AP-HP and Université Paris Descartes (EA2511), Sorbonne Paris Cité, Paris, France Background: Some studies suggest that ACOS is associated with worse outcomes than COPD. The goal of this study was to further explore the clinical characteristics and survival of patients with ACOS identified in a real-life cohort of COPD patients. Methods: Data from the French COPD cohort “Initiatives BPCO” (n=998 patients) were analyzed to assess the frequency of ACOS defined as a physician diagnosis of asthma before the age of 40 years and to analyze its impact. Univariate analyses were performed to assess the relationship between ACOS and risk factors (smoking, occupational exposure, atopic diseases), symptoms (chronic bronchitis , dyspnea -modified Medical Research Council scale and baseline dyspnea index-), quality of life, mood disorders, exacerbations, comorbidities, lung function, prescribed treatment, and survival. Results: ACOS was diagnosed in 129 patients (13%). In multivariate analyses, ACOS was associated negatively with cumulative smoking (Odds Ratio –OR-: 0.992; 95%CI 0.984-1.000 per pack-year) and positively with obesity: OR: 1.97 [1.22-3.16], history of atopic disease (hay fever: OR: 5.50 [3.42-9.00] and atopic dermatitis: OR 3.76 [2.14-6.61]), and drug use (LABA+ ICS: 1.86 [1.27-2.74], anti-leukotriènes 4.83 [1.63-14.34], theophylline: 2.46; [1.23-4.91] and oral corticosteroids: [2.99;.1.26-7.08]). No independent association was found with dyspnea, QoL, exacerbations and mortality. Conclusions: Compared to “pure”COPD patients, patients with ACOS exhibit lower cumulative smoking, suffer more from obesity and atopic diseases and use more asthma treatments. Disease severity (dyspnea, QoL, exacerbations, comorbidities) and prognosis (mortality) are not different from “pure” COPD patients.
OA255 Accelerated decline in FEV1 in non- smoking subjects with chronic HCV infection Sara Ramponi, Laura Balzarini, Chiara Mancini, Maurizio Marvisi ¹Internal Medicine and Pneumology, Figlie di San Camillo, Cremona, Italy It has been suggested that chronic and latent viral infection may increase the risk for development of COPD. This prospective five year longitudinal study was designed to determine if chronic HCV infection is associated with an accelerated decline in lung function in healthy non-smoking subjects. We studied 50 consecutive HCV positive subjects (second-generation enzymelinked immunosorbent assay) , the mean age was 47±17 yrs, 34 were male. We excluded patients with asthma, COPD and chronic lung diseases. They were free of pulmonary symptoms and had a negative history for occupational exposure. The control group was of 30 non-smoking healthy subjects matched for age and sex. The rate of annual decline in FEV1 was calculated for each subjects. The rate of annual decline in FEV1 during the five years follow-up was significantly higher in HCV patients (∆ FEV1 59.9 mLyear , SD 17.8; p< 0.0001) than in controls (∆FEV1 31.5 mLyear, SD 7,7).The rate of annual decline in DL,co was similar (∆DLCO, 3.37%/yr [SD, 0.25])in HCV group versus ( ∆DLCO, 2.63%/yr [SD, 0.30]) in controls. Our findings suggest that chronic HCV infection might accelerate decline in lung function. The cellular mechanisms predisposing those with chronic HCV infection to decline of lung function is unclear.
122. Respiratory nursing research: opening new perspectives on patient experiences OA292 Girls with asthma have worse health related quality of life than boys - A population based study Caroline Stridsman¹,², Helena Backman²,³, Britt-Marie Eklund², Eva Rönmark²,³, Linnea Hedman²,³ ¹Department of Health Sciences, Luleå University of Technology, Luleå, Sweden; ²The OLIN Studies, Norrbotten County Council, Luleå, Sweden; ³Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden Background: Adolescents with asthma reports a decreased HRQOL compared to their healthy peers. However, population-based studies investigating HRQOL in this context are rare. Aim: To study HRQOL in terms of impact and worry among adolescents with asthma. Methods: As a part of the OLIN pediatric study in northern Sweden, 2345 adolescents (15y) completed an extended ISAAC questionnaire. Of these, 266 reported current asthma and completed the Disabkids Asthma questionnaire consisting of two domains; impact (limitations and symptoms) and worry (fears). Lower scores represent a decreased HRQOL. The lowest quartiles of the impact and worry scores (low HRQOL) were analyzed as outcomes in multiple binary logistic regression models. The Asthma Control Test (ACT) was also used. Results: Controlled asthma was reported by 15% of the adolescents, and 53% had partly controlled asthma. A higher proportion of girls had uncontrolled asthma than boys (39% vs. 25%, p=0.024). Girls also reported lower HRQOL scores (impact; 71 vs. 83, p22h for both devices were evaluated. Minutes spent in the common activity levels, sedentary (SPA), light (LPA), and moderate-tovigorous (MVPA) activity, as well as number of steps were determined per day and the correlation between both devices was examined using Spearman's rank
correlation coefficient. 18 patients were examined (10 females; mean age 69.4y) and a total number of 86 valid days were included in the analysis. Patients spent a median of 237 min/day in LPA and 83 min/day in MVPA. Over subject-specific activity means, correlation coefficients were 0.34 for SPA, 0.16 for LPA, 0.38 for MVPA, and 0.95 for number of steps per day (p0,05). Multivariate analyses revealed significant increases (p60%) and A2M in 7 samples, all regardless of subject's health status. CRP and SAP were detected in one asthmatic and one control, respectively. Median particle mass collected in Population 1 was 340 ng (143-739). In Population 2, sampled mass in asthmatics (median 295 ng, 116-430) was significantly decreased compared to controls (median 535 ng, 234-1060) (P35 patients daily
Beck Depression Inventory (BDI)) were compared between patients with and without CI. Results: Out of 183 patients with COPD (mean age 63.6 (9.4) years, FEV₁ 54.8 (23.0)% predicted), 76 patients (41.5%) had CI and the prevalence did not differ between traditional GOLD stages I-IV (44.8%, 40.0%, 41.0%, 43.5% respectively, p=0.97) and updated GOLD groups A-D (50.0%, 44.7%, 33.3%, 40.2% respectively, p=0.91). Age, gender, educational level, smoking status, mMRC score, FEV₁% predicted, as well as 6MWT, COPM, CAT, HADS, and BDI scores were comparable between patients with and without CI. Conclusions: Clinical characteristics of COPD patients with and without CI are comparable. Assessment of CI, therefore, requires an active screening approach across all GOLD stages.
32(65.3) 17(34.7) 29(58.0) 10(20.0) 9(18.0) 2(4.0) 60(10-1000) 40(8-90) 22(45.8) 26(54.2)
Of the physicians, 6% correctly diagnosed 7 cases and 44% correctly diagnosed 5 cases. There was no difference between the physicians' decision and occupational features. Work load was negatively correlated with correct diagnosis rate.
Prescribing correct treatment was associated with advanced disease. Physicians were prone to give correct treatment in advanced disease patients. They mostly preferred combination treatments and tended to use step-up treatment strategy. We suggest that COPD management remains a problem. Data are shown as n(%) or median(min-max)
582. Latest insights into the management of chronic respiratory diseases PA3746 Cognitive impairment and clinical characteristics in patients with COPD Fiona Cleutjens¹, Martijn Spruit¹, Rudolf Ponds², Lowie Vanfleteren¹, Frits Franssen¹, Candy Gijsen¹, Jeanette Dijkstra², Emiel Wouters¹, Daisy Janssen¹ ¹Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, Horn, Netherlands; ²Department of Medical Psychology, Maastricht UMC+/School for Mental Health and Neurosciences (MHeNS), Maastricht, Netherlands Background: Cognitive impairment (CI) is common in patients with chronic obstructive pulmonary disease (COPD). However, it remains unknown whether and to what extent clinical characteristics are able to differentiate patients with COPD with and without CI. Aims: To investigate the relationship between CI and disease severity, and to study potential differences in exercise performance, problematic daily activities, health status and psychological wellbeing between patients with and without CI. Methods: Patients with clinically stable COPD referred for pulmonary rehabilitation underwent a comprehensive neuropsychological examination. Functional exercise capacity (six-minute walk test (6MWT)), daily activities (Canadian Occupational Performance Measure (COPM)), disease-specific health status (COPD Assessment Test (CAT), and psychological wellbeing (Hospital Anxiety and Depression Scale (HADS), and
585. A view into a chest and pleural pathology PA3799 Possible use of chest ultrasonography in asbestos related lung diseases Andrea Smargiassi¹, Giuliana Pasciuto¹, Ilaria Pedicelli³, Erminia Lo Greco¹, Mariarosaria Calvello¹, Riccardo Inchingolo¹, Gioacchino Schifino¹, Patrizio Capoluongo², Pasquale Patriciello³, Maurizio Manno², Alfonso Cirillo⁵, Gino Soldati⁴, Ivo Iavicoli² ¹Pulmonary Medicine Department, University Hospital "A. Gemelli" - Università Cattolica del Sacro Cuore, Rome, Italy; ²Department of Public Health, University of Naples - Federico II, Naples, Italy; ³Pulmonary Medicine Department, OORR Area Nolana - ASL Napoli3 Sud, Pollena Trocchia, Italy; ⁴Emergency Department, Valle del Serchio General Hospital, Castelnuovo Garfagnana, Italy; ⁵Departmen of Prevention, Service of Hygiene and Occupational Medicine - ASL Napoli3 Sud, Pompei, Italy Background: Exposure to asbestos fibers can lead to different lung diseases like pleural thickenings and effusions, interstitial disease (asbestosis), mesothelioma and cancer. Aim of the study was to evaluate a possible use of chest ultrasonography (US) in subjects with history of occupational exposure to asbestos (OEA). Methods: Chest US was performed in 59 subjects, blinded to CT-scans reports and images. Different sonographic pathological findings have been considered: pleural thickenings (PT, containing calcifications or not); peripheral lung consolidations (LC); focal sonographic interstitial syndrome (SIS); diffuse pneumogenic SIS (pulmonary asbestosis). Chest US scans were performed using convex (2-5 MHz) and linear (5-7 MHz) probes. Representative US findings were recorded and stored for subsequent comparison with CT-scans. Results: CT scans-PT were reported in 33 cases (26 with calcifications); Focal SIS in 23; Asbestosis in 3, peripheral LC in 13. Sensibility, Specificity, Accuracy, Positive and Negative predicted values (VPP; VPN) were reported for US findings for each pathological condition assessed with CT scans. CHEST US Sensibility Specificity Accuracy VPP VPN findings PT 88% 100% 93% 100% 87% PT 85% 97% 92% 96% 89% calcifications Focal SIS 96% 67% 78% 65% 96% Asbestosis 100% 100% 100% 100% 100% Peripheral LC 77% 100% 95% 100% 94% No US findings were possible in case of central lung nodules (8 cases) and for diaphragmatic PT (14 cases). For minimal pleural effusions (6 subjects) Chest US was considered gold standard technique. Conclusions: Chest US might be considered to follow up patients with OEA, already undergone to CT scans, whether pathology is assessable by US.
589. Orphan diseases I PA3880 Bagpipe lung; a new type of interstitial lung disease? Jenny King¹, Nazia Chaudhuri¹, Jayne Holme¹, Paul Bishop¹, Anne-Marie Quinn¹ ¹Respiratory Medicine, UHSM, Manchester, United Kingdom Introduction Hypersensitivity pneumonitis (HP) is an inflammatory lung disease mediated by an immunological response to an inhaled antigen. It is often related to occupational or environmental exposures.1 Case Report A 61 year old male referred to Interstitial Lung Disease (ILD) Clinic in April 2014 with a 7 year history of progressive shortness of breath. CT thorax demonstrated progressive ground glass change. Biopsy in 2009 showed upper
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lobe interstitial fibrosis and poorly formed granulomas consistent with HP. Lung function demonstrated a restrictive deficit with FVC 1.48 (34%) and DLCO 3.21 (33%). There was no history of contact with birds, pets or drugs. He played the bagpipes daily. In 2012 he experienced a sudden improvement in exercise tolerance following moving to Australia and reported walking 6 miles daily, deteriorating rapidly on return to the UK. He did not take his bagpipes to Australia nor play bagpipes whilst away. In September 2014 he was admitted with an infective deterioration of ILD. Samples taken from his bagpipes for mycology grew fungi including; Paecilomyces variotti, Fusarium species, Penicillium species, Rhodotorula species and Trichosporon mucoides.He deteriorated and died on 10th October 2014. Conclusion There have been isolated case reports of musicians developing HP attributable to fungal elements grown from instruments.2 Wind instrument players need to be aware of the importance of regularly cleaning their instruments and of potential risks. References 1. Metzger F et al. Hypersensitivity pneumonitis due to moulds in a saxophone player. Chest 2010; 138(3):724-726 2. Metersky ML et al. Trombone player's lung: a probable new cause of hypersensitivity pneumonitis. Chest 2010; 138(3):754-75.
Washington,Seattle,USA. Results Among 1084 ILD patients, 513 patients were diagnosed with HP based on MDD without lung biopsy in 495(18 out of 24 biopsies had histology consistent with HP). The interobserverkappa score was 0.580(NCC/CILD), 0.492(SPI/NCC) and 0.271(SPI/CILD). 67.1%, 13.1%, 14.8% patients resided in urban, sub-urban and rural areas respectively. Common domestic environmental exposure were to aircoolers(48.1%),airconditioners(26.3%), birds(21.4%), molds(20.7%); occupational(5.1%) and unknown antigens(24.7%).(Pending results of fungal cultures from some aircoolers will be presented) Conclusion 47.3% patients enrolled in ILD India registry had HP; most were exposed to aircoolers. Low interobserver agreement between SPIs and MDD at CILD emphasizes the need for MDD for precise diagnosis. CRFs designed to gather exposure history may surface otherwise occult factors and lead to better understanding and management of HP.
PA3882 Environmental exposures in 513 patients of hypersensitivity pneumonitis: Prospective ILD India registry Sheetu Singh¹, Bridget Collins², Bharat Bhushen Sharma³, Jyotsana M. Joshi⁴, Deepak Talwar⁵, Sandeep Katiyar⁶, Nishtha Singh⁷, Lawrence Ho⁸, Jai Kumar Samaria⁹, Parthasarthi Bhattacharya¹⁰, Rakesh Gupta¹¹, Sudhir Chaudhari¹², Tejraj Singh¹³, Vijay Moond¹⁴, Sudhakar Pipavath¹⁵, Jitesh Ahuja¹⁶, Ravindran Chetambath¹⁷, Aloke G. Ghoshal¹⁸, Nirmal Kumar Jain¹⁹, H.J. Gayathri Joshy²⁰, Surya Kant²¹, Parvaiz Koul²², Raja Dhar²³, Rajesh Swarnkar²⁴, Surendra K. Sharma²⁵, Dhrubajyoti Roy²⁶, Kripesh R. Sarmah²⁷, Bhavin Jankharia²⁸, Rodney A. Schmidt²⁹, Virendra Singh³⁰, Ganesh Raghu³¹ ¹Chest & Tuberculosis, SMS Medical College, Jaipur, Rajasthan, India; ²Medicine, Center for Interstitial Lung Diseases University of Washington, Seattle, WA, United States; ³Medicine, SMS Hospital Jaipur, Jaipur, Rajasthan, India; ⁴Department of Pulmonary Medicine, Topiwala National Medical College & BYL Nair Hospital, Mumbai, Maharashtra, India; ⁵Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, India; ⁶Respiratory Medicine, Chest Care Centre, Kanpur, Uttar Pradesh, India; ⁷Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India; ⁸Medicine, Center for Interstitial Lung Diseases University of Washington, Seattle, WA, United States; ⁹Department of Chest Disease, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India; ¹⁰Respiratory Medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India; ¹¹Dept. of Respiratory Medicine, JLN Medical College & Hospital, Ajmer, Rajasthan, India; ¹²Department of Chest and Tuberculosis, Dr Murari Lal Chest Hospital, GSVM Medical College, Kanpur, Uttar Pradesh, India; ¹³Research Division, Asthma Bhawan, Jaipur, Rajasthan, India; ¹⁴Radiology, SMS Hospital, Jaipur, Rajasthan, India; ¹⁵Radiology, Center for Interstitial Lung Diseases University of Washington, Seattle, WA, United States; ¹⁶Radiology, Center for Interstitial Lung Diseases University of Washington, Seattle, WA, United States; ¹⁷Department of Pulmonary Medicine, Calicut Medical College, Kozhikode, Kerala, India; ¹⁸National Allergy Asthma Bronchitis Institute, National Allergy, Asthma, Bronchitis Institute, Kolkata, West Bengal, India; ¹⁹Respiratory Medicine, Soni Manipal Hospital, Jaipur, Rajasthan, India; ²⁰Chest Medicine, MS Ramaiah Medical College, Bangalore, Karnataka, India; ²¹Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India; ²²Department of Internal and Pulmonary Medicine, Sher-i-kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India; ²³Pulmonology & Critical Care Department, Fortis Hospital, Kolkata, West Bengal, India; ²⁴Pulmonology and Respiratory Medicine, Getwell Hospital and Research Institute, Nagpur, Maharashtra, India; ²⁵Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India; ²⁶Respiratory Medicine, Pulmonary and Sleep Clinic, Kolkata, West Bengal, India; ²⁷Department of Pulmonary Medicine, Gauhati Medical College, Guwahati, Assam, India; ²⁸Radiology, Jankharia Imaging, Mumbai, Maharashtra, India; ²⁹Pathology, Center for Interstitial Lung Diseases University of Washington, Seattle, WA, United States; ³⁰Asthma Bhawan, Asthma Bhawan, Jaipur, Rajasthan, India; ³¹Medicine, Center for Interstitial Lung Diseases University of Washington, Seattle, WA, United States
PA3925 LATE-BREAKING ABSTRACT: Sarcoidosis and inorganic dust exposition in the MINASARC (MIneralo-NAno-SARCoidosis) study Mickaël Catinon¹,², Catherine Cavalin², Cécile Chemarin¹, Stéphane Rio¹, Elisabeth Roux¹, Matthieu Pecquet¹, Anne-Sophie Blanchet¹, Sylvie Vuillermoz¹, Christophe Pison³, François Arbib³, Vincent Bonneterre⁴, Dominique Valeyre⁵, Olivia Freynet⁵, Jean-François Mornex⁶, Nathalie Freymond⁷, Yves Pacheco⁷, Francoise Thivolet⁸, Marianne Kambouchner⁹, Jean-François Bernaudin¹⁰, Audrey Nathalizio¹¹, Paul-André Rosental², Michel Vincent¹,² ¹Pneumology Unit and Laboratory of Mineral Pathologies, Centre Hospitalier Saint Joseph et Saint Luc, Lyon, FR; ²Center for European Studies, ERC Grant Silicosis, Sciences-Po Paris, Paris, FR; ³Pneumology Department, Hôpital de la Tronche, Grenoble, FR; ⁴Occupational Medicine and Health Department, Grenoble-Alpes Teaching Hospital, Grenoble, FR; ⁵Pneumology Unit, Hôpital Avicenne Bobigny, Bobigny, FR; ⁶Pneumology Unit, Hôpital Louis Pradel Lyon, Bron, FR; ⁷Pneumology Unit, Centre Hospitalier Lyon Sud, Pierre Bénite, FR; ⁸Department of Cytology and Pathology, Pole Est Hospices Civils de Lyon, Lyon, FR; ⁹Department of Cytology and Pathology, Hôpital Avicenne, Bobigny, FR; ¹⁰Department of Cytology and Pathology, Pierre et Marie Curie University Paris, Paris, FR; ¹¹Health Subjet Clinical Trials, Dermscan Society, Villeurbanne, FR
591. Orphan diseases II
Introduction: MINASARC study is a prospective case-control study measuring mineral exposome by a Specific Questionnaire (SQ) and Mineralogical Analysis (MA) of Broncho-Alveolar Lavages (BALs) by Transmission Electron Microscopy (TEM) in 20 sarcoidosis cases (SarC) compared to 20 healthy volunteers (HV). Objectives: To compare MA results between SarC and HV and to evaluate the correlation between MA and SQ. Methods: Every SarC is matched to a HV by sex, age and smoking habit. Each BAL is treated by a digestion-filtration method. One hundred inorganic particles are analyzed blindly by TEM-Energy-dispersive X-Ray (EDX) and classified according to their elemental composition. MA results were considered as “suspect” when the rate of dust accumulation is among the highest in, at least, one particle class. Results: SQ shows a significantly higher level of inorganic dust exposure in SarC compared to HV. TEM-EDX analysis of BALs identifies a high particle burden in eight SarC (silica, aluminum, titanium, iron, chromium compound, sulfur) and in five HV (chromium, titanium and aluminum compounds). While a good correlation is shown between MA and SQ, especially for building activities, there is no statistical difference in geometric mean of global load in inorganic particles between SarC and HV. Conclusion: In the hypothesis of sarcoidosis related to mineral exposure, the granulomatosis disease of the eight SarC with a “suspect” MA could be related to an airborne inorganic dust exposure and, for the twelve other SarC, other associations (cutaneo-mucous contamination, nanoparticle exposition and genetically determined hypersensitivity) have to be explored in larger SarC cohorts using more sensitive MA.
Background Prospective data about environmental exposures resulting in Hypersensitivity pneumonitis(HP)is limited. Aim Purpose of the study was to identify environmental factors associated with HP in India. Methods Consecutive adult patients diagnosed with interstitial lung disease(ILD)were enrolled prospectively in ILD-India registry from 27 centers acrossIndia(March2012-June2015)bysiteprincipalinvestigators(SPI)withhelp of detailed case report forms(CRFs).Inclusion criterion were high resolution computed tomography(HRCT)chest images per protocol for all patients. Diagnosis was made by ILD experts through multidisciplinary discussions(MDD)at the national coordinating center(NCC),Jaipur,India and finalized by ILD experts at center for ILD (CILD),University of
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593. Targeting care, pulmonary rehabilitation, management, and self-management of COPD exacerbations in primary care PA3963 Multidisciplinary rehabilitation in COPD Josefin Sundh¹, Helena Lindgren², Mikael Hasselgren², Scott Montgomery³, Christer Janson⁴, Björn Ställberg⁵, Karin Lisspers⁵ ¹Department of Respiratory Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden; ²School of Medical Sciences, Örebro University, Örebro, Sweden; ³Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; ⁴Department of Medical Sciences: Respiratory; Allergy and Sleep Research, Uppsala University, Uppsala, Sweden; ⁵Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden Introduction: Multidisciplinary rehabilitation is well-documented in all stages of COPD. Aims: To investigate the availability and utilisation of rehabilitation and the characteristics of COPD patients receiving rehabilitation, in primary and secondary care in mid-Sweden. Materials and methods: Structural questionnaires to 14 hospitals and 54 primary health care centres (PHCCs) provided information on rehabilitation resources. Data on patient characteristics and meetings with rehabilitation professionals recent year was gathered from questionnaires completed by 1264 COPD patients from the same centres. Cross-tabulation and the chi-squared-test examined utilisation, and multiple logistic regression analysed associations of clinical factors with having received rehabilitation recent year. Results: A multidisciplinary teamwork was more common in secondary (71%) than in primary (39%) care, and asthma COPD clinics were more available in PHCCs (87% vs 71%). The PHCCs offered separate access to asthma/COPD nurse in 82%, physiotherapist in 82%, occupational therapist in 70%, nutritionist in 61% and counsellor in 98%. In total, 36% of the patients met an asthma/COPD nurse recent year. Utilisation was lower in primary than in secondary care centres for physiotherapist (6 vs 16)%, occupational therapist (2 vs 10%), nutritionist (5 vs 12%) and counsellor (1 vs 4%), all p 25 µg/m3 and CO₂≥ 1000 ppm were measured in 58% and 63% of classrooms, respectively. IAQp was inversely correlated to PM2.5 and CO₂ (p 25 µg/m3 (46% vs 33%, p