Abstracts / 26th International Congress

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Ernesto Crisafulli¹, Roberta Pisi¹, Fabio Arpinelli², Marina Aiello¹, Meryem El. Majdoub¹ ...... Vicky Moore¹, Cedd Burge¹, Alastair Robertson², Sherwood Burge¹.
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

15

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

16

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

17

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

17

17

PA894: The lueokocyte telomere length, single nucleotide polymorphisms near TERC gene and risk of COPD

17

180. Translational studies in lung disease

17

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

17

186. Monitoring airway diseases with clinical tools

18

PA1053: The control of asthma in real life: Baseline evaluation of a long-term study

18

187. Airway biomarkers

18

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

21

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

27

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

39

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

43

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

45

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

47

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