inhaled exposures at an individual level, and the attitudes of workers with and without COPD to these issues. Aim The aim of this work was to explore attitudes to workplaces, and to other aspects of the management of long-term respiratory problems, from individuals within a large population study with and without COPD. Methods The primary aim of this population-based study was to assess the contribution made by inhaled occupational exposures to the development of COPD. The study was based in Sheffield, historically an industrialised part of the UK. A sub sample of cases of self reported COPD (n = 66) and non cases of COPD (n = 224) were asked to rate their views to a set of 36 pre defined statements, each rated between "don't agree" and "completely agree" on a five point scale. Statements included enquiry about attitudes to chronic respiratory ill health, smoking, general health issues and the influences of the workplace on health.Results 290 individuals, all 55 years old or greater, participated, 172 (59%) of whom were male. The majority of participants generally agreed or completely agreed with most statements, although various differences emerged between those with and without COPD. For example, those with self reported COPD were more likely, as anticipated, to identify this condition as a longer term health problem, but less likely to agree that workers with possible breathing problems should talk to their employer about these or undergo regular spirometry to identify these. Conclusions This study has identified a set of attitudes and beliefs from those with and without COPD relating to chronic respiratory problems at work. Knowledge of these semi-quantitative data will assist the development of better workplace interventions to reduce the burden of this condition. Introduction and objectives Spirometry is frequently carried out as part of workplace-based respiratory surveillance programmes for the detection of both obstructive and restrictive lung diseases. However, the performance of spirometry to detect restrictive lung diseases is generally poor and especially so if the prevalence of the disease in the tested population is low such as in many working populations.Our aim was to increase the specificity and the positive predictive value (PPV) of current spirometry-based algorithms to diagnose restrictive lung diseases in the occupational health setting to reduce false positives and so the number of unnecessary and expensive referrals for lung volume measurements in hospital. Methods We re-analysed two prospective studies of 259 and 265 tertiary care hospital consecutive patients, respectively used to derive and validate the current standard spirometry-based algorithm (FVC <85% predicted and FEV1/FVC >55%) to diagnose restrictive lung diseases (Glady CA, et al. Chest 2003). We used true lung restrictive cases (TLC