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Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e3181f84577
Original Articles

Evaluation of Methods to Determine Excessive Decline of Forced Expiratory Volume in One Second in Workers Exposed to Diacetyl-Containing Flavorings

Chaisson, Neal F. MD; Kreiss, Kathleen MD; Hnizdo, Eva PhD; Hakobyan, Artak PhD; Enright, Paul L. MD

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Objective: To evaluate methods for determining excessive short-term decline in forced expiratory volume in one second (FEV1) in diacetyl-exposed workers.

Methods: We evaluated five methods of determining excessive longitudinal FEV1 decline in diacetyl-exposed workers and workers from a comparative cohort: American Thoracic Society (ATS), ACOEM an 8% limit, and a relative and absolute longitudinal limit on the basis of spirometry data variability. Relative risk and incidence of excess decline were evaluated.

Results: Incidence of excessive FEV1 decline was 1% in the comparative cohort using ATS and ACOEM criteria, 4.1% using relative limit of longitudinal decline, 4.4% with absolute longitudinal limit of decline, and 5.6% by using the 8% limit. Relative risk of abnormal FEV1 decline in diacetyl-exposed workers was elevated in all evaluated methods.

Conclusion: Alternative methods for respiratory surveillance in diacetyl-exposed workers may be preferable to ATS or ACOEM.

©2010The American College of Occupational and Environmental Medicine


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