Spirometry for Assessing Work Ability and Impairment: Navigating Scylla and Charybdis

Details

• Journal Article:
  American Journal of Respiratory and Critical Care Medicine
• Personal Author:
  Weissman, David N. ; Mannino, David M. ; Laney, A. Scott
• Description:
  ... What are the implications of these reports for future practice? Without knowing that a change in reference equations would better identify those able to safely engage in firefighting tasks, an important priority going forward is to avoid doing harm. Like Ulysses in the Odyssey, we must avoid unnecessarily changing outcomes of firefighting candidates' and members' evaluations to potentially exclude individuals who are physiologically capable of safely performing essential duties on one side or missing those with meaningful impairment on the other. In the specific setting of firefighter evaluation, for purposes of continuity, it would be reasonable to continue using the NHANES-III equation. For a change to GLI-Global, data such as in these reports could be used to set thresholds that maintain continuity to the degree possible in how candidates and members are categorized. Also, it is important that spirometry results near threshold values not be used as sole determinants in making work ability determinations. Extensive additional information such as candidate physical ability tests and timed run results, exercise tests, and other medical tests are already collected for firefighters. Where appropriate, additional pulmonary function tests, chest imaging, etc., can be performed. Fire department physicians can weigh the full range of relevant information, not just spirometry, in making decisions about whether to recommend work restrictions. Ultimately, protecting both workforce fairness and public safety involves moving toward transparent, evidence-based, performance-anchored standards informed by real-world data. Description provided by NIOSH
• Subjects:
  • Firefighters
  • Occupational Health
  • Respiratory System
  • Safety
• Keywords:
  • Fire fighters; Spirometry; Medical fitness evaluation; Work capability; Physiological testing; Physical fitness; Pulmonary function tests; Respiratory health
• Source:
  Am J Respir Crit Care Med 2026 Apr; :Epub ahead of print
• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Report
• Place as Subject:
  Birmingham Region OSHA ; Kentucky ; Philadelphia Region OSHA ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  7 pdf pages
• NIOSHTIC Number:
  nn:20071568
• Contact Point Address:
  David N Weissman, MD, Respiratory Health Division, 1000 Frederick Lane, Mailstop H-2900, Morgantown, WV 26508
• Email:
  dweissman@cdc.gov
• Federal Fiscal Year:
  2026
• Peer Reviewed:
  False
• Download URL:
  https://stacks.cdc.gov/view/cdc/259343/cdc_259343_DS1.pdf
• File Type:
  [PDF - 136.66 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:17d7b606eb4c443672e6556284fec54201b3ba62cdd82c9e7105a08d9ffeb8f3b33dfb7c4a2c7ef87e00bcb74f73ea139fa65bca94a8814d1f4add80a7cc9b0c