Spirometry In The Occupational Setting

Publication Date: April 2, 2014
Last Updated: March 14, 2022


Technicians should undergo initial practical training and refresher courses to maintain their skills. Technicians should also receive on-going feedback about the quality of tests that they perform, and how to correct problems in test performance.

Standing or sitting test posture can be used, but the same posture should be used when possible on repeat testing, and this should be documented. The rationale is that posture-related changes in FEV1 and FVC, although small, may significantly impact spirometry interpretation.

Racial or ethnic differences in lung function exist. It is preferable to use specific reference equations (such as NHANES III) that have been developed from studies of certain populations when they are available. When such reference equations are not available, however, the use of correction factors is an appropriate interim solution. As an example, a correction factor of 0.88 may be applied to white subject reference values for FEV1 and FVC when evaluating Asian populations within North America.

Spirometry measurements should be evaluated relative to workers’ baseline or prior tests, in addition to comparing to population normal ranges. This is particularly important when baseline measurements exceed predicted values. FEV1 decline over time should be evaluated using one or more of the approaches described, and interpreted in the context of worker exposures, symptoms, and other clinical information.

Recommendation Grading



Spirometry In The Occupational Setting

Authoring Organization

Publication Month/Year

April 2, 2014

Last Updated Month/Year

June 26, 2023

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings


Intended Users

Nurse, nurse practitioner, physician, physician assistant


Assessment and screening


Spirometry, Workplace inhalation

Supplemental Methodology Resources

Technical Standards