Study objectives: To evaluate the efficacy of mass
spirometry use for the detection of airflow obstruction in a high-risk
Design: Free spirometry was offered to
smokers who were > 39 years of age with a smoking history of > 10
pack-years. Action was preceded by the dissemination of information on
the causes and symptoms of COPD in the local mass media.
Setting: Pulmonary outpatient clinics in 12 large cities of
Participants: Eleven thousand twenty-seven
subjects with the following characteristics were screened: mean
(± SD) age, 51.8 ± 12.5 years; men, 57%; current or ex-smokers,
80%; and mean smoking history, 26.1 ± 16.8 pack-years.
Interventions: Smoking history, simple spirometry (FVC and
FEV1), and an antismoking advice.
Spirometric signs of airway obstruction were found in 24.3% of the
subjects who were screened. Of those subjects, mild obstruction was
found in 9.5%, moderate obstruction was found in 9.6%, and severe
obstruction was found in 5.2%. In smokers aged ≥ 40 years who had a
smoking history of > 10 pack-years, airway obstruction was found in
30.6%. Airway obstruction was present in 8.3% of smokers < 40 years
of age who had a smoking history of < 10 pack-years. Of the 2,200
subjects who had never smoked in their lives, airway obstruction was
found in 14.4%.
Conclusions: Mass spirometry
in high-risk groups is an effective and easy method for the early
detection of COPD.