Medical screening using periodic spirometry for detection of chronic lung disease.
Occup Med: State of the Art Rev 1993 Apr; 8(2):353-361
Using spirometry based screening to detect chronic lung disease was discussed. Pulmonary function tests that are potentially useful for worksite monitoring were considered. One second forced expiratory volume (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio, which can be measured by a spirometer, were considered to be appropriate. FEV1 was considered to be the best choice as it can be safely and inexpensively measured and is reasonably sensitive for detecting lung disease. Issues that much be addressed in developing a spirometry screening program were discussed. These included ensuring that the tests are conducted in accordance with American Thoracic Society standards, implementing a central quality control program, and developing a consistent, reliable way of interpreting the data. Data interpretation involved being able to detect faulty tests and comparing the measurements with appropriate reference values. Longitudinal decrements in FEV1 that could be indicative of the onset of chronic lung disease must be distinguished from the expected normal decrements due to aging and decrements that reflect intrasubject variability. Intrasubject variability can be reduced by utilizing equipment that has a computerized quality assessment capability. Techniques for determining longitudinal decrements in FEV1 and determining if they lie inside or outside the normal limits were discussed.
NIOSH-Author; Statistical-analysis; Pulmonary-function-tests; Medical-screening; Respiratory-system-disorders; Laboratory-equipment; Occupational-medicine; Screening-methods
Occupational Medicine: State of the Art Reviews. Spirometry