AOCOPM 2023 Midyear Educational Conference-259668

259668 - Article 5

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The AOCOPM 2023 Midyear Educational Conference featured a presentation by Carl Werntz, D.O., MPH, focusing on spirometry updates for occupational medicine practitioners. The session aimed to provide a concise overview of spirometry, including predictive equations, and reviewed the evolution of standards and recommendations from 2005 through 2022 for interpreting spirometry results.<br /><br />Key objectives included a discussion of spirometry basics, such as Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 Second (FEV1), and the FEV1/FVC ratio, emphasizing the importance of these metrics for diagnosing lung function impairment. The seminar highlighted patterns in spirometry results, differentiating between restrictive and obstructive patterns and how to identify them using predicted value sets for various patient demographics.<br /><br />Werntz discussed recent updates to recommended practices, drawing attention to the American Thoracic Society (ATS) and European Respiratory Society (ERS) guidelines for performing and interpreting spirometry. Notably, there was a focus on the significance of the Lower Limit of Normal (LLN) based on the 5th percentile of population data, alongside using Z-scores for severity assessment.<br /><br />The presentation also addressed racial differences in lung capacity, stressing challenges in using predictive equations for multi-ethnicity patients and advocating for careful selection to reflect the patient population's diversity. Furthermore, the implications of standing versus seated spirometry measurements were discussed.<br /><br />Werntz highlighted the importance of serial spirometry for tracking lung function over time, illustrating the use of actual volumes over predicted percentages to flag significant changes, and outlined practical recommendations for workplace monitoring. The conference underscored that the proper interpretation of lung function tests should be integrated with clinical insights to account for inherent biological variability and testing uncertainty.

Keywords

spirometry

occupational medicine

Carl Werntz

predictive equations

lung function

American Thoracic Society

European Respiratory Society

racial differences

serial spirometry

workplace monitoring