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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
Issue of Publication
Journal of Occupational and Environmental Medicine