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Periodic Spirometry in Occupational Setting: Improving Quality, Accuracy, and Precision

Hnizdo, Eva PhD; Hakobyan, Artak PhD; Fleming, James L. DO; Beeckman-Wagner, Lu-Ann PhD

Journal of Occupational and Environmental Medicine: October 2011 - Volume 53 - Issue 10 - p 1205–1209
doi: 10.1097/JOM.0b013e31823078b8
Original Articles

Objective: Effectiveness of periodic spirometry in medical monitoring depends on spirometry quality. We describe an intervention on spirometry quality and its impact on accuracy and precision of longitudinal measurements.

Methods: The intervention was conducted from 2005 to 2010 in a monitoring program involving approximately 2500 firefighters. Intervention supported adherence to 2005 American Thoracic Society/European Respiratory Society recommendations through monitoring of spirometry quality and longitudinal data precision, technician training, change of spirometer, and quality control.

Results: The percentage of forced vital capacity tests meeting the American Thoracic Society/European Respiratory Society criteria increased from 60% to 95% and the mean longitudinal forced expiratory volume in 1 second within-person variation decreased from 6% to 4%. The increased accuracy and precision of measurements and estimated rates of forced expiratory volume in 1 second decline were statistically significant.

Conclusion: Monitoring of quality and data precision helped to recognize the need for intervention. The intervention improved accuracy and precision of spirometry measurements and their usefulness.

From the Division of Respiratory Disease Studies (Drs Hnizdo and Beeckman-Wagner), National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV; System Research & Applications International, Inc (Dr Hakobyan), Morgantown, WVa; and Phoenix Fire Department (Dr Fleming), Phoenix, Ariz.

Address correspondence to: Eva Hnizdo, PhD, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, 1095 Willowdale Rd, Morgantown, WV 26505 (ehnizdo@cdc.gov).

This work was supported by funding through the National Institute for Occupational Safety and Health intramural program. Periodic spirometry in occupational setting: improving quality, accuracy, and precision.

† Deceased.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Mention of a specific product or company does not constitute endorsement by the Centers for Disease Control and Prevention.

©2011The American College of Occupational and Environmental Medicine