National Guideline Clearinghouse | Official American Thoracic Society technical standards: spirometry in the occupational setting.

National Guideline Clearinghouse | Official American Thoracic Society technical standards: spirometry in the occupational setting.

American Thoracic Society

• Official American Thoracic Society technical standards: spirometry in the occupational setting.

Guideline Title Official American Thoracic Society technical standards: spirometry in the occupational setting. Bibliographic Source(s) Redlich CA, Tarlo SM, Hankinson JL, Townsend MC, Eschenbacher WL, Von Essen SG, Sigsgaard T, Weissman DN, American Thoracic Society Committee on Spirometry in the Occupational Setting. Official American Thoracic Society technical standards: spirometry in the occupational setting. Am J Respir Crit Care Med. 2014 Apr 15;189(8):984-94. [100 references] PubMed  Guideline Status This is the current release of the guideline. This guideline meets NGC's 2013 (revised) inclusion criteria.

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Official American Thoracic Society technical standards: spirometry in the occupational setting. - PubMed - NCBI

Am J Respir Crit Care Med. 2014 Apr 15;189(8):983-93. doi: 10.1164/rccm.201402-0337ST.

Official American Thoracic Society technical standards: spirometry in the occupational setting.

Redlich CA, Tarlo SM, Hankinson JL, Townsend MC, Eschenbacher WL, Von Essen SG, Sigsgaard T, Weissman DN; American Thoracic Society Committee on Spirometry in the Occupational Setting.

Abstract

PURPOSE:

This document addresses aspects of the performance and interpretation of spirometry that are particularly important in the workplace, where inhalation exposures can affect lung function and cause or exacerbate lung diseases, such as asthma, chronic obstructive pulmonary disease, or fibrosis.

METHODS:

Issues that previous American Thoracic Society spirometry statements did not adequately address with respect to the workplace were identified for systematic review. Medline 1950-2012 and Embase 1980-2012 were searched for evidence related to the following: training for spirometry technicians; testing posture; appropriate reference values to use for Asians in North America; and interpretative strategies for analyzing longitudinal change in lung function. The evidence was reviewed and technical recommendations were developed.

RESULTS:

Spirometry performed in the work setting should be part of a comprehensive workplace respiratory health program. Effective technician training and feedback can improve the quality of spirometry testing. Posture-related changes in FEV1 and FVC, although small, may impact interpretation, so testing posture should be kept consistent and documented on repeat testing. Until North American Asian-specific equations are developed, applying a correction factor of 0.88 to white reference values is considered reasonable when testing Asian American individuals in North America. Current spirometry should be compared with previous tests. Excessive loss in FEV1 over time should be evaluated using either a percentage decline (15% plus loss expected due to aging) or one of the other approaches discussed, taking into consideration testing variability, worker exposures, symptoms, and other clinical information.

CONCLUSIONS:

Important aspects of workplace spirometry are discussed and recommendations are provided for the performance and interpretation of workplace spirometry.

Comment in

• Reply: Spirometry in the occupational setting. [Am J Respir Crit Care Med. 2014]
• Spirometry in the occupational setting. [Am J Respir Crit Care Med. 2014]

PMID:

 

24735032

 

[PubMed - indexed for MEDLINE]