Radiologists differ markedly in the estimation of pneumothorax risk for a patient undergoing co-axial lung biopsy. Identifying individual patients developing pneumothorax was only possible when risk was estimated at > or =50%. Pulmonary haemorrhage was uncommon and difficult to predict accurately.

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Incidental abnormal colonic uptake of (18)FDG, determined by a PET/CT scan requires definitive colonic investigation in patients suitable for further treatment because significant colonic pathology is frequently identified. The benefit of this approach should be discussed in specialist MDT meetings and tailored to each patient; however, national guidelines for management are required.

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In the 1990s inhalation ('chasing the dragon') became the predominant method of recreational opiate (heroin and crack cocaine) consumption as it was perceived to have fewer detrimental health effects than injection. Although clinicians encounter individuals with COPD associated with opiate smoking ('heroin lung') the airway effects and symptoms resulting from opiate smoking are not established. We recruited 145 current and past opiate users from a local community drug service and recorded demographics. They completed spirometry pre and post salbutamol and questionnaires addressing drug use, symptoms and health status. Lower limit of normal was used to define airflow obstruction. Ten subjects failed to produce adequate spirometry, 26 had only injected and never smoked opiates while 6 subjects had marked bronchodilator (BD) reversibility consistent with asthma. Thirty six subjects appeared to have COPD and these were compared with 67 opiate smokers with normal post-BD spirometry and the 26 subjects who only injected opiates. The results from the 3 groups are shown in the table. The COPD group was a little older and necessarily had a lower FEV1 and post-BD airflow obstruction. There was little difference in length of drug use when the opiate smokers with COPD were compared to those without and the frequency of cough and phlegm differed little. Opiate smokers with COPD had modestly higher rates of wheeze and breathlessness; hence, higher CAT and MRC dyspnoea scores, but respiratory symptoms and use of respiratory medication were common in the non-COPD groups. Heroin and crack cocaine smoking is a risk factor for the development of irreversible airflow obstruction at a very young age. Respiratory symptoms are common in opiate smokers irrespective of the presence of COPD and not uncommon in those who have only injected opiates. In many, this is associated with a reduced health status despite normal spirometry; hence, symptoms are not a useful way to 'diagnose' COPD and spirometry is essential. P124 CHRONIC BRONCHITIS AMONG FISHERMEN IN EXPOSED TO FIREWOOD SMOKEVA Umoh; University of Uyo Teaching Hospital, Uyo, Nigeria 10. 1136/thoraxjnl-2013-204457.274 Background Biomass is heavily depended on for domestic energy use by people in developing countries. These materials are typically burnt in simple stoves and produce a lot of smoke. Exposure to this indoor air pollution has been linked to a number of respiratory disorders. This study aimed to assess some long term effects exposure to indoor air pollution among fishermen. Methods A survey was conducted in a fishing community in Nigeria among 337 fishermen exposed to indoor air pollution from burning firewood and 345 matched controls. Exposure was determined by the product of the average daily duration of time spent close to the fire and the number of years (Hour-years). A modified BMRC questionnaire was used to obtain information on respiratory symptoms and spirometry was performed on the participants. Results The frequency of chronic respiratory symptoms was signific...