Spirometry (Pulmonary Function Tests) measurers lung function, specifically the amount and/or speed of air that can be inhaled and exhaled. It is the most common type of pulmonary function test and is essential in assessing breathing patterns that are typically commonplace in conditions such as asthma, pulmonary fibrosis, and COPD. Spirometry is often used in pre-employment and medical surveillance as a means to influence decisions about workers’ job assignments, PPE requirements, and assess exposure related health effects.
At the beginning of the pandemic, in March 2020, many clinics put spirometry testing on hiatus based on recommendations by the American College of Occupational and Environmental Medicine (ACOEM). Later “in July 2020, in the midst of the pandemic surge, ACOEM updated its statement to recommend deferring spirometry except in unusual circumstances in which it was urgently necessary.”
While vaccines are now widely available, the introduction of new, and more transmissible variants has led to continued complications for spirometry testing. Precautions during spirometry testing are still recommended by the Centers for Disease Control and Prevention (CDC), the ACOEM, and the American Thoracic Society (ATS). The ATS recommends that “pulmonary function testing be limited to tests that are only essential for immediate [diagnosis] and treatment decisions, that the type of pulmonary function testing be limited to the most essential tests when possible, and that measures to protect both the staff and individuals being tested should be put in place.” When determining if a spirometry test is necessary, a risk assessment should be made. Risk is determined by:
- National and Regional Infection Rates
- Community Incidence
- Workforce Prevalence
- Resources Available
- Clinic Characteristics
- Provider Availability
As clinics continue to struggle with surges in variants, there will likely be differentiating circumstances region to region. This could lead to some confusion for employers who have a nationwide workforce. It is important to follow local COVID-19 incidence rates as well as governmental recommendations and mandates when making decisions regarding the safe resumption of testing for your employees.
For healthcare professionals who perform spirometry testing, the American Lung Association has compiled a list of considerations for conducting spirometry during and after COVID-19.