title: Periodic spirometry in occupational setting: improving quality, accuracy, and precision.
abstract: OBJECTIVE
  Effectiveness of periodic spirometry in medical monitoring depends on spirometry quality. We describe an intervention on spirometry quality and its impact on accuracy and precision of longitudinal measurements.
  
  
  METHODS
  The intervention was conducted from 2005 to 2010 in a monitoring program involving approximately 2500 firefighters. Intervention supported adherence to 2005 American Thoracic Society/European Respiratory Society recommendations through monitoring of spirometry quality and longitudinal data precision, technician training, change of spirometer, and quality control.
  
  
  RESULTS
  The percentage of forced vital capacity tests meeting the American Thoracic Society/European Respiratory Society criteria increased from 60% to 95% and the mean longitudinal forced expiratory volume in 1 second within-person variation decreased from 6% to 4%. The increased accuracy and precision of measurements and estimated rates of forced expiratory volume in 1 second decline were statistically significant.
  
  
  CONCLUSIONS
  Monitoring of quality and data precision helped to recognize the need for intervention. The intervention improved accuracy and precision of spirometry measurements and their usefulness.
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA. ehnizdo@cdc.gov
authors.forename: Eva
authors.initials: E
authors.lastname: Hnizdo
authors.forename: Artak
authors.initials: A
authors.lastname: Hakobyan
authors.forename: James L
authors.initials: JL
authors.lastname: Fleming
authors.forename: Lu-Ann
authors.initials: LA
authors.lastname: Beeckman-Wagner
mesh_terms: D000328:Adult; D005541:Forced Expiratory Volume; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000175:diagnosis* / Q000503:physiopathology; D009784:Occupational Diseases / Q000175:diagnosis* / Q000503:physiopathology; D009786:Occupational Health Services / Q000592:standards; D011159:Population Surveillance; D015397:Program Evaluation; D011786:Quality Control; D058996:Quality Improvement; D013147:Spirometry / Q000592:standards*