Standard Operating Procedures (SOP s) provide a blue print for standardizing the test preparation steps; test procedures and data disposition to be followed by all trained and certified technicians performing spirometry. Not only is it a good idea to have such a manual, but it is now a requirement by the new 2005 ATS/ERS Spirometry Standard. Specifically, the Standard states: In any quality control program, an important element is a manual of procedures that contains the following: calibration procedures, test-performance procedures, calculations, criteria, reference values source, and action to be taken when panic (unusual) values are observed.

An SOP manual not only standardizes test procedures between testing personnel, but also between multiple clinics or facilities within the same organization. Each person performing spirometry testing should have their own copy and refer to it when questions of procedure arises Such SOP s, when rigorously followed, increase the sensitivity and specificity of this important test. Remember, spirometry is the only test available to primary care physicians for the early detection of Chronic Obstructive Pulmonary Diseases, (COPD) such as chronic bronchitis and emphysema. Although coughing, sputum production, and minor wheezing may occur early in the course of COPD, these symptoms are non-specific and of no concern to the subject.

All medical personnel performing spirometry should successfully complete a NIOSH approved spirometry training course as required by NIOSH and ACOEM. As part of that training, students learn of the required elements for an SOP manual and will have enough information to write one. Additional information for preparing an SOP manual can be obtained from the ATS website www.thoracic.org/education/labmanual.asp. Another alternative is to have Palmer Associates Inc. prepare a manual for you, customized for your facility and equipment.