Spirometry training provides the student with the basic knowledge and skills to correctly perform the test and obtain meaningful data. There needs to be a complete understanding of the three phases of the spirogram curve and what happens to them when acceptability errors are detected or abnormal data is present and how to identify sub maximal efforts and provided re-instruction as required. Without training testers don’t know what to look for, and miss the opportunity to correct the problem as they occur. The NIOSH spirometry training course is actually required and is exposure driven.
The latest exposure specific standards that were published where the NIOSH training is required is the:
2014 – NIOSH Medical Examination of Coal Miners for MSHA Final Rule (42 CFR Part 37)
2016 – OSHA Final Rule For Respirable Crystalline Silica (29 CFR 1910.1053)
The ACOEM position paper on Spirometry summarizes this training need:
Spirometry is simple but fraught with technical pitfalls that can invalidate the pulmonary function measurements. Failure to obtain full understanding, cooperation and effort from a subject during any part of the test usually results in an underestimation of the true pulmonary function. Poorly maintained spirometers also affect the accuracy of observed spirometric values. Such erroneous measurements may cause a normal, healthy subject to be mislabeled as ‘impaired’ or lead to incorrect assessments of impaired subjects. When evaluating changes over time, small decrements in pulmonary function may be lost in the noise of the measurements if testing equipment and/or testing technique are not as accurate, precise, rigorous, and standardized as possible. For analysis of group data, small differences between groups, which may be scientifically important, can be obscured by poor quality data caused be inadequate testing technique
In occupational medicine, the consequences of such misinterpretations can go beyond simply making an inaccurate diagnosis; decisions regarding fitness for duty, workplace accommodation, and compensation for work related illness may be affected. Furthermore, since occupational spirometry tests are often conducted in the regulatory and medical-legal arenas, the validity of the spirometry test is likely to be scrutinized. therefore, it is critical for both clinical and administrative purposes that occupational medicine physicians understand the need for standardization and quality control in spirometry.
(ACOEM Spirometry Positions Paper. 2000)