Spirometry in the Occupational Setting

Spirometry Longitudinal Data Analysis (SPIROLA) Software

SPIROLA software is an easy-to-use visual and quantitative tool intended to assist the health care provider in monitoring and interpreting computerized longitudinal spirometry data for individuals as well as for a group. Listed below are some of the features SPIROLA provides.

1. Evaluation of longitudinal spirometry data in individuals:
   1. Display of forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and percent predicted values (Figure) plotted against age, for each individual in the database. Display of multiple charts together with an individual's report (Figure). (Cross-sectional and longitudinal limits shown on the chart can be selected by the user.)
   2. Comparison of the most recent spirometry test results to population reference values derived from standard or user-specified reference equations (FEV₁, FVC, and FEV₁/FVC).
   3. Evaluation of changes in FEV₁ over time. For the first 8 years of an individual’s follow-up, SPIROLA uses the limit of longitudinal decline (LLD) to determine whether or not the individual’s decline in FEV₁ may be excessive (Figure).  After 8 years of follow-up, the age at which the individual may be expected to develop moderate-severe lung function impairment is taken into consideration in the evaluation (Figure). Results of the cross-sectional and longitudinal evaluation are provided in an individual’s report.
   4. Screening for individuals with abnormal findings (Figure). This function automatically identifies individuals who may experience excessive decline in FEV₁ or whose most recent test is below LLN, for further evaluation. The selection criteria, based on both cross-sectional and longitudinal evaluation, can be modified by the user.
   5. Tagging individuals for further evaluation, such as: spirometry quality control, retesting, and occupational safety evaluation or intervention (Figure).
   6. Planning, recoding and evaluating an intervention plan. The intervention module enables the user to ascertain in a standardized way questionnaire data from an individual on respiratory symptoms and occupational and non-occupational risk factors, and workplace exposure evaluation data.  Based on the information, the intervention plan can be designed and its effect evaluated for an individual and a group (Figure).
2. Monitoring of longitudinal spirometry data precision and spirometry test quality.
   1. Monitoring the precision of longitudinal spirometry data for a group of program participants (Figure). This function helps in assuring that data precision remains acceptable over time, and provides an appropriate basis upon which to calculate a limit of longitudinal decline (LLD) for use as a criterion to evaluate longitudinal decline.
   2. Monitoring the percentage of spirometry tests that do not meet the 2005 ATS/ERS criteria for acceptability and repeatability, overall and by a technician (Figure). This function helps to assure acceptable data quality and precision by each spirometry technician (Figure).

SPIROLA software is easy to install and test-run with a demonstration database (names in the database are fictional) included with the software. See the User Manual for details on installation, software functions, and instructions for data input. Please send us your questions or comments on SPIROLA.

User manual for SPIROLA V 2.0 (2 MB, 34 pages) (includes detailed installation instructions)

SPIROLA Software Download:   (Last updated April 28, 2009. See disclaimers and note below.)

• SPIROLA V 1.0 (1.5 MB, last updated June 30, 2008)
• SPIROLA V 2.0 (2.8 MB, last updated April 28, 2009)
  DHHS/NIOSH Publication No. 2009-101c
  V 2.0 uses the same database format as V1.0, but includes new features, such as:
  
  1. Improved data analysis and data presentation
  2. Intervention module to facilitate recording and evaluating intervention strategies

Utility Software Download:   (Last updated April 28, 2009. See disclaimers and note below.)

• SPIROLA EasyWare Sync V 1.0 (814 KB, last updated April 28, 2009)

Disclaimer (1): This software is provided to assist health care practitioners in their management of occupational medical monitoring programs using spirometry. The software is only intended to assist the user in assembling the information required to make medical decisions, but cannot be substituted for competent and informed professional judgment. NIOSH does not warrant the reliability or accuracy of the software, graphic screens, or text. Software users need to be aware of all applicable federal, state and local laws and regulations that may impact utilization of this software.

Disclaimer (2): This information is distributed solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. It has not been formally disseminated by the National Institute for Occupational Safety and Health. It does not represent and should not be construed to represent any agency determination or policy.

Note: We appreciate that users provide us with feedback on the latest version of SPIROLA to help us to improve the software.