Spirometry Questions and Answers

OSHA regulations require that individuals who administer spirometry tests as part of mandated health surveillance for employees exposed to cotton dust and respirable crystalline silica to have completed NIOSH-approved spirometry training courses. NIOSH regulations require this training for those administering spirometry tests to coal miners as part of their mandated health surveillance. NIOSH-approved spirometry training courses have also been widely accepted for training healthcare professionals in other occupational settings.

The purpose of the course is for participants to gain the knowledge and practical skills to collect accurate and valid spirometry results.

The NIOSH spirometry training program approves sponsors to teach practical courses enabling students to perform high quality spirometry tests. New participants start by taking an initial training course. The initial training requires a minimum of 16 hours instruction. Most of the NIOSH sponsors (groups who provide the training) offer 2-day courses. A few sponsors offer 3 days of training that includes some additional content compared to the 2-day courses.  On-line and 1-day refresher courses are also available for participants who have already successfully completed the initial training.

Initial courses adhere to a 1:6 student to practicum instructor ratio, as well as a 1:6 student to spirometer ratio.

Providing required spirometry testing to workers exposed to cotton, silica, or coal mine dust requires a current NIOSH-approved certificate. The course certificate is valid for 5 years. There is a 7-month grace period allowed after the initial training course 5-year expiration. After 5 years and 7 months, spirometry technicians must retake an initial 2- or 3-day course in order to continue testing under those regulations.

Many NIOSH-approved sponsors offer refresher spirometry training. It is highly recommended that technicians attend refresher courses well in advance of certificate expiration. For more information, go to Certificates. NIOSH-approved Refresher Courses last 1-day (minimum of 7 hours). Refresher course certificates expire 5 years, 7 months from course date.

Currently scheduled NIOSH-approved spirometry courses, including dates and locations, can be found on the course schedule page. All publically available courses are posted on the schedule as soon as NIOSH receives information from our sponsors.  Some sponsors offer on-site training.

There are NIOSH-approved live, instructor-led virtual courses. Currently, two sponsors teach virtual refresher courses. One sponsor teaches a virtual initial course: please contact Sponsor 101. In addition, two online refresher courses are also available.

The cost of registration varies, depending upon the type of course, the sponsor, and geographical location. By clicking on the sponsor name in the course schedule, you will be linked to that sponsor’s contact information.  Some sponsors, but not all, have on-line registration and other information about the course.  If the sponsor does not offer on-line information, you must contact them via telephone, fax, or e-mail.

See “How to Become a Course Sponsor”.

See “How to Become a Course Technical Director”.

There are three faculty positions for the NIOSH spirometry training program:

1. Course Director
2. Course Lecturer
3. Practicum Instructor

Requirements for faculty members are listed here. There are two ways to become a faculty member:

1. Your institution can apply for NIOSH spirometry training program sponsorship. See “How to become a course sponsor”.

OR

1. A professional can be approved through an existing sponsor. 

Under the second option, the existing sponsor must agree to submit the request to NIOSH for faculty approval.  A list of current sponsors

Currently, the Occupational Safety and Health Administration (OSHA) requires NIOSH spirometry training for technicians who test workers exposed to certain cotton dusts. In addition to the Cotton Dust Standard, other regulations also currently require NIOSH-approved spirometry training: NIOSH’s Specifications for Medical Examinations of Coal Miners and OSHA’s Respirable Crystalline Silica Standards for general industry and maritime and construction. Staff administering spirometry tests under these regulations must have a current NIOSH spirometry training certificate.

Some individual companies require staff administering spirometry tests to have a NIOSH-approved certificate. This is not related to any regulatory requirement.  Although NIOSH is aware of this practice, we do not maintain a list of companies that include this requirement as part of their management practice. Contact the individual companies that send workers to your occupational health clinic.

NIOSH does not obtain personal information about participants due to privacy issues. Contact the sponsor from whom you took the course. The sponsor will ask for your name, course date and location. There may be a nominal fee for duplicating the certificate.

NIOSH does not offer advanced training in spirometry testing. However, two NIOSH-approved sponsors offer physicians’ training for spirometry. Information about their training can be found at:

1. Web-Based Spirometry Training for Physicians
2. Interpretation of Spirometry: Beyond the Numbers

State medical boards determine specific requirements for performing clinical testing in their states. Some state medical board requirements cover only diagnostic testing, such as in hospitals or clinics, while others may also cover occupational disease surveillance in private companies. Contact your state medical board for further information.

The National Board for Respiratory Care external icon(NBRC) provides respiratory therapists with certification for performing pulmonary function testing, including spirometry and other more complex tests. Certification candidates must meet minimum education and clinical experience requirements before they can take an examination.

Companies that hire occupational medicine staff usually state the minimum training requirements in their job announcements. These requirements should be carefully considered before expending resources to apply for a position.

NIOSH approves sponsors to provide spirometry training courses. Participants successfully completing the courses receive their certificates from course sponsors. See “What is the purpose of the course certificate?”