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Evaluating pulmonary impairment: appropriate use of pulmonary function and exercise tests
1Department of Pulmonary Disease, Cleveland Clinic Foundation, Ohio 44195.
Cleveland Clinic Journal of Medicine
|March 1, 1991
Summary
Pulmonary function tests like spirometry can detect occupational lung disease. Cardiopulmonary exercise testing offers valuable insights when results are unclear, aiding in assessing respiratory impairment severity.
Area of Science:
- Occupational medicine
- Pulmonology
- Clinical physiology
Background:
- Occupational lung diseases often cause pulmonary impairment.
- Standard pulmonary function tests (PFTs) are crucial for diagnosis.
- Spirometry and diffusing capacity are common PFTs.
Purpose of the Study:
- To highlight the role of PFTs in occupational lung disease.
- To emphasize the utility of cardiopulmonary exercise testing (CPET).
- To discuss guidelines for grading respiratory impairment.
Main Methods:
- Utilizing spirometric values: forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1).
- Measuring single breath-diffusing capacity.
- Employing cardiopulmonary exercise testing for equivocal PFT results.
Main Results:
- Spirometry and diffusing capacity can detect and quantify pulmonary impairment.
- CPET provides essential ancillary data when PFTs are inconclusive.
- Published guidelines exist for impairment severity grading.
Conclusions:
- Standard PFTs are effective for initial assessment of occupational lung disease.
- CPET is a valuable tool for complex cases.
- Standardized guidelines facilitate accurate impairment assessment.