Spirometry surveillance is the repeated lung function testing of workers exposed to respiratory hazards, with each result compared against the worker’s own baseline so that a decline shows early. Spirometry is a pulmonary function test of how well a person moves air in and out of the lungs. OSHA’s silica standard names its key measures: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio.
How it works in practice
A joint OSHA and NIOSH infosheet covers:
- Baseline first. Spirometry can establish a baseline before a worker is assigned to physically demanding tasks, respirator use or respiratory hazards, then track lung function over time and evaluate workers with symptoms.
- Compare with the worker’s own history. Results are compared with normal (predicted) values and with the worker’s previous baseline values, which the infosheet calls the preferred method of evaluating change over time.
- Look at groups too. Surveillance can detect changes among groups of workers with similar exposures (a similar exposure group).
- Quality. Technicians should hold a valid certificate from a NIOSH-approved course or equivalent, the spirometer’s calibration should be checked before use each day, and equipment should comply with current American Thoracic Society/European Respiratory Society standards.
- Frequency. Periodic tests must follow OSHA standards where they apply. Where none applies, testing less often than every 3 years is not recommended.
In MyC’s health surveillance software, results from connected spirometers land straight in the record and can be compared against the worker’s own baseline, so a shift in lung function shows at the next exam.
What the regulations say
US federal OSHA. The general industry respirable crystalline silica standard, 29 CFR 1910.1053, requires the employer to make medical surveillance available at no cost for each employee exposed at or above the action level (25 µg/m³ as an 8-hour TWA) for 30 or more days per year (§1910.1053(b), (i)(1)(i)). The initial (baseline) exam is due within 30 days after initial assignment, unless the worker had a qualifying exam in the last three years (§1910.1053(i)(2)). It includes a pulmonary function test covering FVC, FEV1 and the FEV1/FVC ratio, given by a spirometry technician with a current certificate from a NIOSH-approved course (§1910.1053(i)(2)(iv)). Periodic exams follow at least every three years, or more often if the licensed health care professional recommends (§1910.1053(i)(3)). Construction work is covered by a parallel standard, 29 CFR 1926.1153 (§1910.1053(a)(1)(i)).
Great Britain. For workers exposed to substances that can cause occupational asthma, HSE’s COSHH guidance sheet G402 says health surveillance should involve an appropriate questionnaire and spirometry. Respiratory health should be assessed before exposure or, if not, as soon as possible after it starts (for example within six weeks) to provide a baseline, with ongoing assessments usually annually and more often for new workers. An occupational health professional should interpret results for individuals and for groups of similarly exposed workers. The employer must keep a health record for each worker under surveillance, and HSE says these records should be kept securely for at least 40 years from the date of the last entry. See how long to keep occupational health records.
Related terms
- Health surveillance: Health surveillance is a program of repeated health assessments for workers still exposed to a hazard after controls, to identify ill health caused by work.
- Medical surveillance: Medical surveillance is the program of medical exams and tests that specific OSHA standards require employers to offer workers exposed to certain hazards.
- Similar exposure group (SEG): A similar exposure group (SEG) is a group of workers expected to share the same exposure profile, used to plan monitoring and read surveillance results.