Occupational Health Surveillance: Pulmonary Function Testing in Utility Workers

Abstract

This investigation analyzed occupational health monitoring data to characterize pulmonary function in a population currently employed as utility workers in the state of Florida. Pulmonary function tests for male workers (n=225) who required medical examinations to ensure fitness for continued respirator use were compared to National Health and Nutrition Examination Survey (NHANES) III Raw Spirometry subjects (n=4958) to determine if abnormal pulmonary function was associated with employment as a utility worker. Mean Forced Vital Capacity (FVC) and mean Forced Expiratory Volume in 1 second (FEV1) values were determined, and linear regression was used to evaluate the impact of utility worker status on pulmonary function after adjusting for confounders. Workers had a statistically significant higher total mean FEV1 value of 3.81L (95%CI 3.71–3.91), compared to the NHANES III mean value of 3.71L (95% CI 3.69-3.73). The total mean FVC value for workers 4.85L (95% CI 4.73–4.96) was also statistically significant compared to the NHANES III mean of 4.70L (95% CI 4.68-4.73). No significant differences were found between mean pulmonary function test values of utility workers and NHANES III study subjects when stratified by age, height, and smoking status except among older utility workers, who demonstrated modestly better FEV1 and FVC values compared to the study population. Multivariate regression analysis demonstrated that significant predictors of FEV1 included age, height, pack-years of smoking, and status as utility worker (all p-values<0.05). Significant predictors of FVC included age, height, and status as a utility worker (all p-values<0.05). Logistic regression analysis to evaluate associations with FEV1/FVC ratios<0.80 demonstrated significant associations with age, height, and smoking history, but not status as a utility worker. The results of this investigation did not find any pulmonary function deficits in the examined utility worker population. This study demonstrates the feasibility of using mandated occupational health monitoring data to conduct efficient occupational health surveillance.