title: Longitudinal assessment of lung function decline in the occupational setting.
abstract: OBJECTIVE
  Spirometry is performed in the work setting as part of medical surveillance of workers with potentially respiratory hazardous work exposures, to identify early disease and evaluate the effectiveness of preventive interventions. However, many clinicians are not familiar with workplace medical surveillance and how to evaluate longitudinal spirometry over time.
  
  
  RESULTS
  A recent American Thoracic Society technical standards report addressed issues related to performing spirometry in the work setting, including the interpretation of longitudinal lung function. Important considerations in assessing longitudinal lung function are reviewed. Recent studies evaluating the impact of selected occupational exposures on longitudinal lung function are reviewed.
  
  
  CONCLUSIONS
  Recent longitudinal studies of exposed workers have identified novel occupational respiratory diseases such as flavoring-related lung disease, and advanced our understanding of more familiar exposures such as mineral dusts. Clinicians will increasingly need to be able to evaluate longitudinal spirometry, including thresholds that trigger further evaluation.
authors.affiliation: aPulmonary Section and Occupational and Environmental Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA bDepartment of Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Redlich
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tarlo
mesh_terms: D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000175:diagnosis / Q000503:physiopathology; D009784:Occupational Diseases / Q000175:diagnosis / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D013147:Spirometry / Q000592:standards; D013997:Time Factors