Spirometry is used in the workplace as part of the medical surveillance of employees who may have been exposed to potentially hazardous respiratory work conditions in order to detect early illness and assess the effectiveness of preventative measures. Many doctors, however, are unfamiliar with workplace medical monitoring or how to evaluate longitudinal spirometry over time. A recent American Thoracic Society technical standards study addressed difficulties surrounding spirometry in the workplace, particularly the interpretation of longitudinal lung function. Important factors to consider while evaluating long-term lung function are discussed. Recent research on the effects of certain occupational exposures on long-term lung function is reviewed.
Recent longitudinal investigations of exposed employees have revealed new occupational respiratory illnesses, such as flavouring-related lung disease, as well as increased our understanding of previously common exposures, such as mineral dust. Clinicians will increasingly need to be able to analyse longitudinal spirometry, including thresholds that signal further testing.