Depending upon the industry occupation in which you work, the workplace risk assessment and method statement (RAMS) regarding respiratory health and upon your workplace COSHH risk assessment, or where there has been a diagnosed case of occupational asthma, it may be necessary for your staff to undergo periodic respiratory health surveillance.
Why do I need to have a respiratory assessment and spirometry?
Due to potential exposure to respiratory irritants in the workplace your employers have arranged for you to undergo routine health service to monitor your ongoing respiratory health and to establish whether any adjustments need to be put in place to maintain your health and wellbeing. This is of particular importance if you have any underlying respiratory health issues i.e. chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis and cystic fibrosis.
What does spirometry entail?
For lower risk occupations you will only be required to undertake a respiratory assessment, this is a health questionnaire to ask about potential symptoms related to respiratory issues.
For higher risk occupations (based upon your employer’s workplace risk assessment) spirometry will need to be undertaken (see below).
What is spirometry and how is a spirometry test undertaken?
Spirometry is a method of testing your current lung function it measures how well you breathe in and out. The clinician will ask you about your ethnicity and measure your height and weight, as these factors may impact upon the results obtained. The test is then undertaken using a spirometer, a machine which you blow into it via a disposable mouthpiece under the direction of a trained clinician. You will need to undertake each part of the test a few times to get an accurate result.
A clip may be put on to your nose to make sure that no air escapes from your nose.
What does the spirometer measure?
Spirometry measures the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled including:
Forced expiratory volume in one second (FEV1) - Total amount of air you can blow out within one second.
Forced vital capacity (FVC) - Total amount of air that you blow out in one breath.
FEV1 divided by FVC (FEV1/FVC) - Of the total amount of air that you can blow out in one breath, this is the proportion that you can blow out in one second.
A spirometry reading usually shows one of four main patterns:
Normal spirometry
Obstructive pattern on spirometry – indicative of asthma and COPD.
Restrictive pattern on spirometry – indicative of a condition that affects the lung tissue itself, or their capacity to expand.
A combined obstructive and restrictive pattern on spirometry – where you may have two conditions - for example, asthma plus another lung disorder.
Is spirometry the same as peak flow readings?
No, although a peak flow reading may provide an indication of airways narrowing; spirometry is a more accurate test for diagnosis.
Do I need to do anything prior to my assessment?
Do not eat a heavy meal, or do vigorous exercise for a few hours before the test. Ideally, you should not smoke for 24 hours before the test.
Is there any risk in having spirometry?
Spirometry is a very low-risk test assessment but you may, depending upon your ability to undertake day to day tasks etc. be advised not to have spirometry if you:
Have unstable angina
Have had a recent pneumothorax
Have had a recent heart attack or stroke
Have had recent eye or abdominal surgery
Have coughed up blood recently and the cause is not known
What happens once I have completed the assessment?
After your test you will be advised by the clinician of your fitness for work. Where necessary advice may be provided to you and your employer with regards to any adjustments which may be necessary to facilitate you working with respiratory irritants within the workplace and the use of respiratory protective equipment including:
Declared RPE not adequate and/or comfortable. Recommend review PPE.
Not done due to an underlying health condition.
Advised to always wear RPE, when exposed to respiratory irritants.
Recommend be provided with appropriate RPE due to exposure to respiratory irritants.
Recommend individual completes a respiratory symptom diary.
RPE - Recommend removes facial hair or be provided with RPE which is compatible with facial hair.
Where symptoms are significant you may be referred to speak with either an occupational health nurse (OHA) or doctor (OHP).