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Published on: February 9, 2022
Impacts of Altering Spirometric Prediction Equations in Occupational Health
Mary C Townsend1, Philip Harber, Clayton T Cowl
1From the M.C. Townsend Associates, LLC, Pittsburgh, Pennsylvania (M.C.T.); Environmental and Occupational Health, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania (M.C.T.); Mel and Enid Zuckerman College of Public Health, Tucson, Arizona (P.H.); Research Faculty, Asthma and Airway Disease Research Center, School Landscape Architecture, University of Arizona, Tucson, Arizona (P.H.); Professor Emeritus, UCLA, Los Angeles, California (P.H.); Division of Public Health, Infectious Diseases, and Occupational Medicine, Rochester, Minnesota (C.T.C.); and Division of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, Minnesota (C.T.C.).
Objective:
The aim of the study was to assess implications of applying "Race-neutral" GLI-Global spirometry prediction for workers in occupational medicine (OM).
Methods:
We applied GLI-Global to 24 hypothetical male subjects (most industrial workers have been male for decades.) We examined the following: 1) four reference/prediction equations; 2) four racial groups; and 3) 80%, 100%, and 120% of race-specific predicted forced vital capacity (FVC).
Results:
The effect of changing to GLI-Global varied by group: White > Northeast (NE) Asian > Southeast (SE) Asian > Black. GLI-Global predicted values are midway between Blacks' and Whites,' and among those with lower lung function (80% predicted FVC), Blacks and SE Asians show declining %predicted values and Z-scores and increasing FVCs
Conclusions:
OM clinicians and policymakers must carefully consider the implications of changing prediction equations.
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