The Value of Periodic Spirometry for Early Recognition of Long-Term Excessive Lung Function Decline in Individuals

Abstract

To establish the value of workplace spirometry monitoring methods for early recognition of long-term excessive lung function decline in individuals. 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. 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. The limits of longitudinal decline are more useful for early recognition of long-term excessive FEV1 decline than the linear regression slope.