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NIOSH spirometry training guide
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NIOSH spirometry training guide
  • Description:
    DISCLAIMER -- ACKNOWLEDGMENTS -- PROJECT FACULTY AND STAFF -- NOTICE TO ALL COURSE ATTENDEES -- INTRODUCTION -- COURSE GOAL AND OBJECTIVES -- -- UNIT ONE: OVERVIEW OF PULMONARY ANATOMY AND PHYSIOLOGY -- A. The Respiratory System -- B. Mechanics of Respiration -- C. Mechanisms for Protecting the Lungs against Airborne Hazards -- D. Smoking and Occupational Lung Disease -- E. Occupational Lung Diseases -- -- UNIT TWO: OVERVIEW OF SPIROMETRY -- A. Definition of Spirometry -- B. Types of Spirometers -- C. Important Measures of Ventilatory Performance -- D. Limitations of Spirometry -- E. Accuracy and Precision -- -- UNIT THREE: THE QUALITY ASSURANCE PROGRAM -- A. Components of a good spirometry QA program -- B. Calibration checks and other equipment quality control measures -- C. Infection Control -- -- UNIT FOUR: SPIROMETRIC TECHNIQUE -- A. Prepare the Equipment -- B. Prepare the Subject -- C. Position the Subject -- D. Perform the Test -- E. Check the Acceptability and Reproducibility of the Maneuver -- F. Retest as Needed -- G. Record Keeping -- H. Sample Tracings -- -- UNIT FIVE: BASIC SPIROMETRIC CALCULATIONS -- A. Forced Vital Capacity (FVC) -- B. Calculating Excessive Variability for FVC -- C. Forced Expiratory Volume in One Second (FEV1) -- D. Calculating Excessive Variability for FEV1 -- E. Back Extrapolation -- F. Calculating Excessive Extrapolated Volume -- G. FEV1 as a Percentage of FVC (FEV1/FVC%) -- H. Forced Mid -Expiratory Flow (FEF25-75%) (OPTIONAL) -- I. Conversion to BTPS -- -- UNIT SIX: COMPARING OBSERVED TO PREDICTED NORMAL VALUES -- A. "Normal" Spirometry -- B. Spirometry Reference Studies -- C. The Lower Limit of the Normal (LLN) Range -- D. How to Determine Predicted Values Using Look-up Tables -- -- UNIT SEVEN: COMPARING CHANGES IN FOLLOW-UP SPIROGRAMS -- A. Rationale for Comparing Changes -- B. Interpreting Changes in Follow-up Spirograms -- -- UNIT EIGHT: OVERVIEW OF STANDARDS FOR SPIROMETRIC EQUIPMENT -- -- UNIT NINE: ADDITIONAL EXERCISES -- -- UNIT TEN: ADDITIONAL EXERCISES MEASURING EXTRAPOLATED VOLUME -- -- APPENDIX A: GLOSSARY OF TERMS COMMONLY USED IN SPIROMETRY -- APPENDIX B. AN OVERVIEW OF OCCUPATIONAL LUNG HAZARDS -- APPENDIX C. OVERVIEW OF OCCUPATIONAL LUNG DISEASE -- A. Some of the Pulmonary Diseases that Show Obstructive Patterns -- B. Some of the Pulmonary Diseases that Show Restrictive Patterns -- C. Some of the Pulmonary Diseases that Show Either Obstructive or Restrictive Patterns -- APPENDIX D. RESPIRATORY SURVEILLANCE PROGRAMS -- APPENDIX E. APPENDIX D OF THE OSHA COTTON DUST STANDARD -- APPENDIX F. AMERICAN THORACIC SOCIETY STANDARDS -- APPENDIX G. SPIROMETRY PROCEDURE CHECKLIST -- APPENDIX H. OUTLINE OF SPIROMETRIC CALCULATIONS -- APPENDIX I. BASIC MATHEMATIC CALCULATIONS -- APPENDIX J. METRIC CONVERSIONS -- APPENDIX K. OTHER FACTORS TO CONSIDER WHEN CALCULATING BTPS -- APPENDIX L. TABLES OF PREDICTED VALUES -- APPENDIX M. TABLES OF OBSTRUCTIVE/RESTRICTIVE PATTERNS -- REFERENCES

    BACKGROUND: The NIOSH Spirometry Training Guide is based on two earlier publications, the NIOSH Spirometry Workbook and the NIOSH Manual of Spirometry in Occupational Medicine. In the new curriculum, the material covered in the NIOSH Manual of Spirometry in Occupational Medicine has been simplified and incorporated into the content of the NIOSH Spirometry Workbook. New material has also been added, including a comparison of volume and flow spirometers and volume/time and flow/volume tracings, quality assurance procedures, occupational lung diseases and hazards, and information from the American Thoracic Society Standardization of Spirometry -1994 Update (1). The American Thoracic Society is the medical section of the American Lung Association. It has provided a leading thrust in the standardization and upgrading of spirometric instruments and practices. Its first set of standards, ATS Statement - Snowbird Workshop on Standardization of Spirometry was essentially incorporated by OSHA in the Cotton Dust Standard, which was promulgated on June 23, 1978. The Snowbird Workshop standards were revised in 1987 (2), and again in 1994, and released as the ATS Standardization of Spirometry -1994 Update (1). PURPOSE: The NIOSH Spirometry Training Guide was prepared for use as an adjunct or supplement to a NIOSH approved course on spirometry. It is not intended to serve as a self-instructional package. Learning spirometry requires observation, demonstration, and hands-on practice. INTENDED AUDIENCE: This Guide is intended for individuals who are responsible for conducting spirometry in the workplace. It will be of special interest to occupational health physicians, nurses, and other health professionals.

    NIOSHTIC No. 20025502

  • Content Notes:
    Prepared by Universities Occupational Safety and Health Educational Resource Center, Continuing Education and Outreach Program, Division of Consumer Health Education, Department of Environmental and Community Medicine, Robert Wood Johnson Medical School University of Medicine and Dentistry of New Jersey; and Center for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies Surveillance Branch.
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