OSHA•NIOSH INFOSHEET

MaximizeYour Spirometry Screening and Surveillance Resources

Spirometry is a common type of pulmonary function test

(PFT) that measures how well a person can move air in and

out of their lungs. In occupational settings, spirometry can

be used to establish a baseline before assigning a worker to

job tasks that are physically demanding, that require use of

a respirator, or that may expose the worker to respiratory

hazards. It is also used to track lung function over time and

to evaluate workers who experience signs or symptoms of

respiratory disease.

The Need for SpirometryTesting

Spirometry testing is required for some workers

by OSHA standards. Accurate spirometry testing,

interpretation, and follow­up are critical to

effective screening and surveillance of workers

exposed to respiratory hazards. Technically poor

spirometry is of little value to the purchaser of

these services and may provide misleading

information.

TechnicianTraining

Spirometry technicians should have a valid certificate from a National Institute for Occupational

Safety and Health (NIOSH)­approved course or an

equivalent training course. For more information

go to: www.cdc.gov/niosh/topics/spirometry/training.html.

Spirometry Equipment

The spirometry equipment and software used in

such testing should be validated by independent

laboratory testing documented by the manufacturer and should comply with the most recent

American Thoracic Society/European Respiratory

Society standards. Spirometry results should be

computerized and the computer file kept by the

healthcare provider. Spirometry technicians

should check the calibration of the spirometer

before use each day and keep calibration records

as long as the related health records are retained.

The spirometry technician and the healthcare

professional are responsible for reviewing the

spirometry results, checking validation criteria,

and informing the employer of any equipment

malfunctions.

Frequency of Testing

Periodic spirometry tests must be performed in

accord with OSHA standards. For occupational

exposures to substances for which no OSHA

standard applies, periodic spirometry is usually

recommended, although such testing can be done

more or less frequently to evaluate changes in

lung function over time. Testing less frequently

than every 3 years is not recommended. The

frequency of testing should be determined by the

applicable OSHA standard or, where no standard

applies, by the specific hazard to which workers

are being exposed.

Screening and Surveillance

Periodic spirometry screening of individual workers

can detect breathing problems or significant

changes in lung function at an early stage so that

hazardous workplace exposures can be identified

and eliminated to prevent or reduce occupational

lung disease. Equally important, surveillance can

detect changes in lung function over time among

groups of workers with similar exposures and

thus help to recognize serious health effects in the

workplace at a time when individual results may

not be severe or noticeable. Employers should

consider periodically reviewing grouped data from

worksite exposure assessments with a healthcare

professional and should be alert for any significant

changes in grouped results. Reviewing grouped

data may help identify occupational exposures

and assist in reducing or eliminating any hazards

identified. Additional resources on monitoring

spirometry data over time in individuals or groups

of workers can be found at: www.cdc.gov/niosh/

topics/spirometry/spirola.html.

The healthcare professional should analyze baseline and periodic spirometry test results and explain

all results to the worker. The healthcare professional should determine when a spirometry test

result indicates that the worker needs further

medical evaluation. Finally, the healthcare professional should notify the employer if there are any

concerns about occupational exposures while

maintaining the confidentiality of worker health

information.
U.S. Department of Labor

www.osha.gov

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Checklist for Employers

Critical elements of spirometry testing that maximize

your company’s resources and should be considered

for inclusion in required contracts include:

Technicians and Clinical Healthcare Professionals

■ Technicians who perform testing should have

successfully completed a National Institute for

Occupational Safety and Health (NIOSH)­approved

course, or equivalent, within the past 5 years. A

certificate should be available for you to inspect.

■ The program should be supervised by a healthcare

professional knowledgeable about spirometry

accuracy and test validity. Documentation of the

professional’s spirometry update training should

be available.

Spirometry Equipment

■ A letter from the spirometer manufacturer indicating successful validation testing of the spirometer,

following current American Thoracic Society/

European Respiratory Society standards, should

be available for review.

■ The spirometer’s calibration is checked by the

technician each day of use. Records of daily

spirometer calibration checks should be maintained and available for review.

Interpretation of Results

■ Worker’s results are compared to normal values.

The report should specify the source of the normal

or predicted values. If the testing satisfies a regulatory requirement, then the appropriate predicted

values must be used.

■ Current worker’s results are compared to his or her

previous baseline values, if available. This is the

preferred method of evaluating change over time.

Reporting of Results

■ The healthcare professional reports the results to

the worker indicating how the worker’s results compared to the normal range and whether changes

over time require further medical evaluation.

Resources

For more information about spirometry screening,

surveillance, and training visit OSHA online at

www.osha.gov/SLTC/medicalsurveillance/index.html

and www.osha.gov/Publications/osha3162.pdf

(Screening and Surveillance: A Guide to OSHA

Standards) and NIOSH online at:

www.cdc.gov/niosh/topics/spirometry/default.html.

Other helpful references that present the American

College of Occupational and Environmental Medicine’s position on Occupational Spirometry are:

Townsend, MC. ACOEM position statement.

Spirometry in the occupational setting. American

College of Occupational and Environmental Medicine. J Occup Environ Med. 2000 Mar;42(3):228­45.

and Townsend, MC. ACOEM Position Statement

Spirometry in the Occupational Health Setting–

2010 Update at: www.acoem.org/uploadedFiles/

Policies_And_Position_Statements/ACOEM%20

Spirometry%20Statement.pdf.

OSHA Publications

OSHA has an extensive publications program.

For a listing of free items, visit OSHA’s website

at www.osha.gov/pls/publications/pubindex.list

or contact the OSHA Publications Office, U.S.

Department of Labor, 200 Constitution Avenue,

N.W., N­3101, Washington, DC 20210. Telephone

(202) 693­1888 or fax to (202) 693­2498.

Contacting OSHA

To report an emergency, file a complaint or seek

OSHA advice, assistance or products, call (800)

321­OSHA or contact your nearest OSHA regional,

area, or State Plan office; TTY: 1­877­889­5627.

Contacting NIOSH

To receive documents or more information about

occupational safety and health topics, please

contact NIOSH: 1­800­CDC­INFO (1­800­232­4636);

TYY: 1­888­232­6348; e­mail: cdcinfo@cdc.gov or

visit the NIOSH web site at www.cdc.gov/niosh.

This guidance document is not an OSHA standard or regulation but contains recommendations that are advisory

in nature and intended to assist employers in providing a safe and healthful workplace. The mention of any nongovernmental organization or link to its web site in this guidance does not constitute an endorsement by NIOSH

or OSHA of that organization, its products or services or web site.

For more complete information:

www.osha.gov

(800) 321­OSHA

www.cdc.gov/niosh

(800) 232­4636

DHHS (NIOSH) 2011­ OSHA 3415­1­11