Quality of spirometry in the workplace

TLDR: In this article, the authors evaluate whether quality spirometry meeting ATS/ERS criteria can be carried out in the workplace and evaluate the levels of repeatability of spirometry using the ATS andERS criteria.

Abstract: Background Spirometry is a useful and accurate measure of airflow obstruction that is commonly used for health surveillance in an occupational setting. If done incorrectly it can be misleading and result in early signs of lung disease in workers being missed. Aim To evaluate whether quality spirometry meeting ATS/ERS criteria can be carried out in the workplace. Methods Spirometry was carried out as part of a research study investigating the relationship between workplace exposures and ill health in the brick, stone and foundry industries. Levels of repeatability were analysed using the ATS/ERS criteria. The criteria states that where the difference between the two greatest values of the forced vital capacity (FVC) and between the forced expiratory volume in 1 second (FEV1) should not exceed 150mL. Three acceptable curves were selected for each worker and the FEV1 and FVC repeatability analysed. Results 302 workers have participated in the study to date with spirometry data available for 295 (98%) workers. Three (1%) workers’ data did not meet the ATS/ERS criteria for both FEV1 and FVC measurements. Ten (3.4%) workers data did not meet the criteria for FEV1 and variation in curves was between 160mL and 270mL. 22 (7.5%) workers data did not meet the criteria for FVC and variation in curves was between 160mL and 350mL. In total, technically acceptable spirometry data was obtained from 260 workers (88%). Conclusions These provisional data illustrate that high quality, technically acceptable spirometry (which meets the ATS/ERS criteria) can be achieved within a working environment. It highlights that some workers were not able to perform reproducible spirometry despite coaching from a healthcare professional using a rigorous operating procedure.