Occupational and environmental respiratory disease. Harber P, Schenker MB, Balmes JR, eds. St. Louis, MO: Mosby, 1995 Jul; :39-54
The methods used in the physiologic measurement of respiratory function were discussed in this chapter, with particular attention devoted to spirometry.1The instrumentation, volume spirometers, flow spirometers, equipment specifications, procedures, and measurements associated with spirometry were discussed. Measurements included the assessment of expiratory airflow or expired air volume through the quantification of forced vital capacity (FVC), initial forced expiratory volume (FEV1), FEV1/FVC ratio and forced expiratory flow. Factors contributing to variations in lung function included patient height, age, sex, race and smoking habits. Good spirometric techniques discussed included testing quality control and test interpretation. The cross sectional versus longitudinal analysis of trends was described. Common clinical uses for spirometry included routine screening, diagnostic study, bronchodilator study, preshift and postshift testing, and small airway disease measurement. The inclusion of spirometry testing in employer health programs required certified technicians, the establishment of regular equipment maintenance programs and adequate means for data storage. The use of peak flow measurements for the evaluation and management of respiratory conditions was discussed. Other methods for the assessment of pulmonary function included the measurement of absolute lung volumes, gas dilution techniques, body plethysmography, and radiographic techniques. Gas transfer studies can also be implemented and included measurements of diffusion capacity, oximetry, and arterial blood gases as well as cardiopulmonary exercise testing and specialized1measurements.