BACKGROUND: The California Department of Public Health received serial spirometry data for flavoring manufacturing workers at 20 companies at risk of bronchiolitis obliterans. METHODS: We graded spirometry quality; identified individual workers with excessive decline in forced expiratory volume in 1 s (FEV(1)) using relative longitudinal limits of decline based on 4% average within-person variability; and analyzed declines by occupational risk factors. RESULTS: The quality of 1,696 spirometry tests from 724 workers varied by 17 providers, with poorer quality from commercial providers. Of 416 workers with at least two tests, 40 (9.6%) had abnormal FEV(1) decline. Of 289 workers with high quality spirometry, 21 (7.3%) had abnormal decline. Only one of the 21 had airways obstruction. Abnormal FEV(1) decline rates (per person-month) were greater among workers at companies using ≥800 lbs/year diacetyl than at companies using lesser amounts. Abnormal FEV(1) decline rates were greater at companies previously having four-person clusters of spirometric obstruction than at companies with no or only one worker with obstruction. CONCLUSIONS: Spirometric surveillance of flavoring workers can identify individual workers with an abnormal FEV(1) decline for preventive intervention, even when the FEV(1) itself remains within the normal range. Good quality spirometry and classification of abnormal with relative longitudinal limit of decline minimize misclassification of possible work-related health effects.
BACKGROUND: The California Department of Public Health received serial spirometry data for flavoring manufacturing workers at 20 companies at risk of bronchiolitis obliterans. METHODS: We graded spirometry quality; identified individual workers with excessive decline in forced expiratory volume in 1 s (FEV(1)) using relative longitudinal limits of decline based on 4% average within-person variability; and analyzed declines by occupational risk factors. RESULTS: The quality of 1,696 spirometry tests from 724 workers varied by 17 providers, with poorer quality from commercial providers. Of 416 workers with at least two tests, 40 (9.6%) had abnormal FEV(1) decline. Of 289 workers with high quality spirometry, 21 (7.3%) had abnormal decline. Only one of the 21 had airways obstruction. Abnormal FEV(1) decline rates (per person-month) were greater among workers at companies using ≥800 lbs/year diacetyl than at companies using lesser amounts. Abnormal FEV(1) decline rates were greater at companies previously having four-person clusters of spirometric obstruction than at companies with no or only one worker with obstruction. CONCLUSIONS: Spirometric surveillance of flavoring workers can identify individual workers with an abnormal FEV(1) decline for preventive intervention, even when the FEV(1) itself remains within the normal range. Good quality spirometry and classification of abnormal with relative longitudinal limit of decline minimize misclassification of possible work-related health effects.
Authors: Ann F Hubbs; Kara L Fluharty; Rebekah J Edwards; Jamie L Barnabei; John T Grantham; Scott M Palmer; Francine Kelly; Linda M Sargent; Steven H Reynolds; Robert R Mercer; Madhusudan P Goravanahally; Michael L Kashon; John C Honaker; Mark C Jackson; Amy M Cumpston; William T Goldsmith; Walter McKinney; Jeffrey S Fedan; Lori A Battelli; Tiffany Munro; Winnie Bucklew-Moyers; Kimberly McKinstry; Diane Schwegler-Berry; Sherri Friend; Alycia K Knepp; Samantha L Smith; Krishnan Sriram Journal: Am J Pathol Date: 2016-11 Impact factor: 4.307
Authors: Kristin J Cummings; Randy J Boylstein; Marcia L Stanton; Chris A Piacitelli; Nicole T Edwards; Ryan F LeBouf; Kathleen Kreiss Journal: Occup Environ Med Date: 2014-06-02 Impact factor: 4.402
Authors: R Reid Harvey; Brie H Blackley; Eric J Korbach; Ajay X Rawal; Victor L Roggli; Rachel L Bailey; Jean M Cox-Ganser; Kristin J Cummings Journal: Front Public Health Date: 2021-05-20