The value of periodic spirometry for early recognition of long-term excessive lung function decline in individuals.
J Occup Environ Med 2012 Dec; 54(12):1506-1512
OBJECTIVE: To establish the value of workplace spirometry monitoring methods for early recognition of long-term excessive lung function decline in individuals. METHODS: Sensitivity, specificity, and positive likelihood ratio were calculated to determine the predictive value of the linear regression slope and limits of longitudinal decline for early prediction of long-term excessive forced expiratory volume in 1 second (FEV1) decline (> 90 mL/yr established over 9 to 11 years) in ongoing spirometry monitoring programs (firefighters and construction workers) and a historical program (paper-pulp mill workers). The longitudinal limits account for the expected FEV1 within-person variability. RESULTS: The longitudinal limits achieved clinical "usefulness" (positive likelihood ratio 10 or higher) from the fourth to fifth year of follow-up, whereas the linear regression slope was less useful. The usefulness depended on data precision and measurement frequency. CONCLUSION: The limits of longitudinal decline are more useful for early recognition of long-term excessive FEV1 decline than the linear regression slope.
Spirometry; Monitoring-systems; Lung; Lung-function; Fire-fighters; Construction-workers; Paper-milling; Humans; Men; Women; Surveillance
Eva Hnizdo, PhD, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, 1095 Willowdale Rd, Morgantown, WV 26505
Journal of Occupational and Environmental Medicine