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

J Occup Environ Med. 2011 Sep 10. Hnizdo E, Hakobyan A, Fleming JL, Beeckman-Wagner LA. 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.

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.

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