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Health Hazards of Smoke Winter/Spring 1992

Lung Function Tests

The American Thoracic Society recommends that individuals at risk for lung disease have at least one spirometry (lung or pulmonary function) test performed annually. This includes smokers, individuals with asthma, bronchitis, and other lung problems, those exposed to environmental air pollution, and workers with occupational exposure to inhaled particles and gases. Lung function tests have been used to evaluate the effects of acute and chronic exposure to smoke from wildland fires and prescribed burns. Materna et al. (1992) recommend the use of lung function tests as part of an occupational health surveillance program for firefighters. Lung function tests may aid in the selection of workers who are able to perform firefighting duties while wearing a respiratory protective device.

The test is conducted with a calibrated spirometer that measures gas volumes and flow rates in a maximum effort test. The subject takes a maximal inspiration and then exhales as quickly and forcefully as possible through a tube connected to the spirometer. The subject continues to exhale until all the air is expelled from the lungs. In some cases the subject also may be asked to quickly and forcefully inhale until the lungs are full, which provides information about inspiratory as well as expiratory capacity. The computerized device then calculates important volumes and flow rates and provides a graphic display. After a brief rest, the test is repeated.

Important measures' include (Figure 2):

FVC or forced vital; capacity

-shows lung capacity FEV1 or forced expiratory volume in 1 second

FEV1 /FC% or FEV1 as % of FVC

- shows ability to move air quickly

FEF 25-75% or mid-expiratory flow

- shows small airway flow PEFR or peak expiratory flow rate

PIFR or peak inspiratory flow rate

Image showing results from a lung function test.
Figure 2—Lung function test report including test results
and graphic representation of test volumes (L) and flow rates (L/s).

These measures are used to evaluate pulmonary function and to provide a baseline for comparison following occupational exposures. Along with a related test, the maximal voluntary ventilation (MVV), these lung function measurements can be useful in the selection of workers capable of performing prolonged arduous work while wearing a respiratory protective device.

Previous editions of this report have indicated the effects of exposure on pulmonary function. Individuals with a history of shortness of breath upon exertion, wheezing or tightness in the chest, frequent colds or allergic rhinitis, or other lung problems may need to be tested. Some units include spirometry as part of the wellness program, and lung function tests may become part of an occupational health surveillance program.

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