How Frequently Should Workplace Spirometry Screening Be Performed? Optimization via Analytic Models

Details

• Personal Author:
  Bansal S ; Harber P ; Levine J
• Description:
  Background: Our objective was to determine how to select the optimal frequency of workplace spirometry screening using diacetyl-exposed workers as an example. Methods: A Markov model was constructed to assess the likelihood of progressing from healthy status to early or advanced disease, starting from four different exposure levels, and performing longitudinal or cross-sectional interpretation of spirometry results over time. Projected outcomes at 10 years were evaluated to inform the optimal frequency of workplace spirometry testing. Results: The optimal screening interval depends on the population risk and is highly sensitive to the real-life impact (utility) associated with false-positive results (eg, related to the availability of alternative work). Screening interval is particularly important for high-risk individuals with rapid transition from early to advanced disease, where the 10-year prevalence of advanced disease would be reduced from 5.3 to 2.5% using a 6-month interval rather than a 12-month interval. Longitudinal test interpretation, based on observing trends within each person over time, is marginally preferable to traditional cross-sectional spirometry interpretation. Conclusions: There is no single best screening interval. For high-risk populations, annual testing may be too infrequent. [Description provided by NIOSH]
• Subjects:
  Lung Diseases Occupational Exposure Occupational Health Respiratory Function Tests Respiratory Tract Diseases Safety
• Keywords:
  Lung Disease Medical Screening Occupational Exposure Screening Methods Screening Programs Spirometry
• ISSN:
  0012-3692
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  136
• Issue:
  4
• NIOSHTIC Number:
  nn:20058491
• Citation:
  Chest 2009 Oct; 136(4):1086-1094
• Contact Point Address:
  Philip Harber, MD, MPH, FCCP, UCLA Occupational Medicine, 10880 Wilshire Blvd, No. 1800, Los Angeles, CA 90024
• Email:
  pharber@mednet.ucla.edu
• CAS Registry Number:
  Butanedione (CAS RN 431-03-8)
• Federal Fiscal Year:
  2010
• Performing Organization:
  University of California Los Angeles
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Chest
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7ab6b7f056f1d9ddb8e29e41a35822c2458404e531e68497f84ed45db6f9b46df6bd393b6697f25acb3e7231114cf68c06b5fcbdc2a573a3be30e4fcd64ec051
• Download URL:
  https://stacks.cdc.gov/view/cdc/221578/cdc_221578_DS1.pdf
• File Type:
  [PDF - 191.15 KB ]