OSHA, NIOSH encourage early detection of respiratory problems

Workers exposed to hazardous airborne contaminants may be at risk for lung cancer and other respiratory problems. OSHA and the National Institute for Occupational Safety and Health are encouraging early testing and identification of respiratory problems.

The use of spirometry testing, a common pulmonary function test that measures how well a person moves air in and out of the lungs, can help detect significant changes in a worker's lung function at an early stage.

Workers who inhale some types of dusts, gases, or other air contaminants can experience lung damage over time.

OSHA already requires spirometry testing for some workers. Accurate spirometry testing, interpretation, and follow-up are critical to effective screening and surveillance of workers exposed to respiratory hazards, the agency says. Technically poor spirometry is of little value to the purchaser of these services and may provide misleading information.

Spirometry testing may be performed on workers who are required to perform job tasks that are physically demanding, require wearing a respirator, or cause exposure to certain possible breathing hazards. Workers who show signs of breathing problems may also be tested.

Periodic spirometry is usually recommended for other workers although such testing can be done more or less frequently to evaluate changes in lung function over time. Testing less frequently than every three years is not recommended.

The guidance explains to employers what spirometry is, when it is needed, and critical elements that employers can use to evaluate the quality of the spirometry services provided to their workers.

It also lists the critical elements of spirometry as:

Technicians and clinical health care professionals. Those administering the tests should have successfully completed a NIOSH-approved course or equivalent within the past five years and have a certificate. The program should be supervised by a health care professional knowledgeable about spirometry accuracy and test validity with documentation of training.Equipment. A letter from the manufacturer should indicate successful validation testing of the spirometer in accordance with American Thoracic Society/European Respiratory Society standards. The calibration should be checked by the technician each day of use.Interpretation of results. A worker's results should be compared to normal values. The report should specify the source of the predicted values. Also, the worker's results should be compared to his previous baseline values, if available. Reporting of results. The health care professional should report the results to the worker, indicating how they compare to the normal results and whether changes require further medical evaluation.

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