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The value of periodic spirometry for early recognition of long-term excessive lung function decline in individuals
1Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, W Va 26505, USA. ehnizdo@cdc.gov
Objective:
To establish the value of workplace spirometry monitoring methods for early recognition of long-term excessive lung function decline in individuals.
Methods:
Sensitivity, specificity, and positive likelihood ratio were calculated to determine the predictive value of the linear regression slope and limits of longitudinal decline for early prediction of long-term excessive forced expiratory volume in 1 second (FEV1) decline (> 90 mL/yr established over 9 to 11 years) in ongoing spirometry monitoring programs (firefighters and construction workers) and a historical program (paper-pulp mill workers). The longitudinal limits account for the expected FEV1 within-person variability.
Results:
The longitudinal limits achieved clinical "usefulness" (positive likelihood ratio 10 or higher) from the fourth to fifth year of follow-up, whereas the linear regression slope was less useful. The usefulness depended on data precision and measurement frequency.
Conclusion:
The limits of longitudinal decline are more useful for early recognition of long-term excessive FEV1 decline than the linear regression slope.
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