Spirometry and tests of bronchial hyperresponsiveness in population studies.

The use of spirometry in epidemiological studies has provided objective evidence of the acute and chronic effects of occupational and environmental exposure to many agents as well as data on exposure-response relationships necessary for establishing control levels. Methacholine or histamine challenge testing for the measurement of non-specific bronchial hyperresponsiveness (NSBH) in epidemiological settings is safe when carried out according to a standardised protocol. Measurement of NSBH, a useful tool in the clinical assessment of occupational asthma, has also been used in screening workers in surveys of workforces at risk for occupational asthma. Standardisation and quality control are the key to the success of using lung function testing in the field.