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The role of exercise testing in impairment evaluation
The American Review of Respiratory Disease
|January 1, 1987
Summary
Exercise testing is crucial for accurate work capacity assessment in impairment evaluations. It accurately identifies limitations, often revealing cardiovascular issues, unlike traditional resting tests.
Area of Science:
- Occupational Medicine
- Cardiopulmonary Physiology
- Diagnostic Testing
Background:
- Asbestos exposure poses significant risks to shipyard workers' health.
- Traditional impairment evaluations rely on resting tests, which may not fully capture functional capacity.
Purpose of the Study:
- To evaluate the utility of exercise testing in assessing work capacity among asbestos-exposed shipyard workers.
- To compare predicted work capacity with measured maximal oxygen uptake (VO2) during exercise.
Main Methods:
- Reviewed evaluations of 348 asbestos-exposed shipyard workers.
- Compared predicted work capacity (history, physical exam, ECG, PFTs) with measured VO2 during incremental cycle exercise testing.
Main Results:
- Predicted work capacity frequently misjudged measured VO2, with significant discrepancies in both predicted normal and reduced capacity groups.
- Cardiovascular disorders, not respiratory disease, were the primary limitation in 69% of workers with low VO2.
- Resting pulmonary function tests (VC, FEV1, DLCO) showed poor correlation with exercise performance and predictors of abnormal exercise gas exchange.
Conclusions:
- Exercise testing is essential for accurate work capacity assessment in impairment evaluations.
- Exercise testing effectively identifies the primary limiting system in individuals with reduced work capacity.
- Resting tests are insufficient for predicting exercise limitations and identifying the underlying cause.