Spirometry In The Occupational Setting
Publication Date: April 2, 2014
Last Updated: March 14, 2022
Recommendations
Technicians should undergo initial practical training and refresher courses to maintain their skills. Technicians should also receive on-going feedback about the quality of tests that they perform, and how to correct problems in test performance.
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Standing or sitting test posture can be used, but the same posture should be used when possible on repeat testing, and this should be documented. The rationale is that posture-related changes in FEV1 and FVC, although small, may significantly impact spirometry interpretation.
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Racial or ethnic differences in lung function exist. It is preferable to use specific reference equations (such as NHANES III) that have been developed from studies of certain populations when they are available. When such reference equations are not available, however, the use of correction factors is an appropriate interim solution. As an example, a correction factor of 0.88 may be applied to white subject reference values for FEV1 and FVC when evaluating Asian populations within North America.
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Spirometry measurements should be evaluated relative to workers’ baseline or prior tests, in addition to comparing to population normal ranges. This is particularly important when baseline measurements exceed predicted values. FEV1 decline over time should be evaluated using one or more of the approaches described, and interpreted in the context of worker exposures, symptoms, and other clinical information.
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Recommendation Grading
Overview
Title
Spirometry In The Occupational Setting
Authoring Organization
American Thoracic Society
Publication Month/Year
April 2, 2014
Last Updated Month/Year
June 26, 2023
Document Type
Consensus
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening
Keywords
Spirometry, Workplace inhalation