257 page NIOSH SPIROMETRY TRAINING GUIDE Respiratory Lung Disease Studies on CD

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Thank you! If you do not wish to have your item(s) delivered on data disc(s), I can provide them on a flash drive and other means as well. Just let me know if a disc does not work for you and we can discuss delivery by other methods. COMBINING SHIPPING COSTS Are you purchasing multiple items? I will: a) combine all invoices before payment and charge shipping equivalent to one item, or b) refund all shipping costs in excess of one item after payment. All derivative (i.e. change in media; by compilation) work from this underlying U.S. Government public domain/public release data is COPYRIGHT © GOVPUBS $3.00 first class shipping in U.S.; $13.00 for air post outside of United States. I will combined auctions for reduced postage prior to payment – simply ask for a combined invoice! See numerous images of actual pages within manual. Be sure to see my many other flight manual and aviation maintenance and parts manuals on CD auctions.   Public domain U.S. government manual in PDF format copied to blank CD. Includes the easy to use Adobe Acrobat Reader software for viewing and printing publications. INTRODUCTION BACKGROUND: The NIOSH Spirometry Training Guide is based on two earlier publications, the NIOSH Spirometry Workbook and the NIOSH Manual of Spirometry in Occupational Medicine. In the new curriculum, the material covered in the NIOSH Manual of Spirometry in Occupational Medicine has been simplified and incorporated into the content of the NIOSH Spirometry Workbook. New material has also been added, including a comparison of volume and flow spirometers and volume/time and flow/volume tracings, quality assurance procedures, occupational lung diseases and hazards, and information from the American Thoracic Society Standardization of Spirometry–1994 Update (1). The American Thoracic Society is the medical section of the American Lung Association. It has provided a leading thrust in the standardization and upgrading of spirometric instruments and practices. Its first set of standards, ATS Statement–Snowbird Workshop on Standardization of Spirometry was essentially incorporated by OSHA in the Cotton Dust Standard, which was promulgated on June 23, 1978. The Snowbird Workshop standards were revised in 1987 (2), and again in 1994, and released as the ATS Standardization of Spirometry–1994 Update (1). PURPOSE: The NIOSH Spirometry Training Guide was prepared for use as an adjunct or supplement to a NIOSH approved course on spirometry. It is not intended to serve as a self-instructional package. Learning spirometry requires observation, demonstration, and hands-on practice. INTENDED AUDIENCE: This Guide is intended for individuals who are responsible for conducting spirometry in the workplace. It will be of special interest to occupational health physicians, nurses, and other health professionals. NOTE: Due to printing constraints of the NIOSH SPIROMETRY TRAINING GUIDE, the distance representing one second may vary from one spirogram to another. Check at the top of the spirogram to determine the distance for one second for each example and exercise.   COURSE GOAL AND OBJECTIVES Goal: The goal of this course is to increase the number of spirometry technicians who: 1. Use standardized methods to obtain acceptable and reproducible spirograms. 2. Correctly perform calculations for basic spirometric parameters. 3. Implement appropriate quality assurance procedures for spirometric equipment. 4. Recognize the applications, strengths, and limitations of spirometry in the occupational health setting.  Objectives: At the end of this course, students will be able to do the following:  Unit One: Overview of Pulmonary Anatomy and Physiology  Briefly describe: a. The function of the respiratory system and the mechanics of respiration. b. Mechanisms within the respiratory system to protect the lungs from airborne hazards. c. Obstructive and restrictive lung diseases.  Unit Two: Overview of Spirometry  Briefly describe: a. Common spirometric terms. b. Volume and flow spirometers. c. Volume/time and flow/volume tracings. d. Forced Expiratory Maneuver, Forced Vital Capacity (FVC), and Forced Expiratory Volume at One Second (FEV1). e. The role of spirometry in evaluating pulmonary function and detecting occupational lung diseases. f. The limitations of spirometry as a screening tool. g. The importance of accuracy and precision in spirometry.  Unit Three: Quality Assurance Procedures Perform spirometric equipment quality assurance procedures: a. Calibrate volume for volume and flow spirometers. b. Check that the mechanical recorder is working properly. c. Verify the accuracy of the ambient temperature reading. d. Inspect that the start of the test begins at the right time and at the right place on the graph paper. e. Check that the electronically-derived FEV1 is calculated using the back extrapolation method. f. Verify that the electronically-derived predicted normal values are calculated correctly. g. Maintain spirometer records and calibration and maintenance logs. h. Perform infection control procedures appropriate for the type of spirometer used.  Unit Four: Spirometric Technique a. Properly prepare equipment prior to testing. b. Identify suitable subjects and criteria for postponing the test. c. Prepare subjects to perform the test. d. Perform the test correctly. e. Determine the acceptability of spirograms obtained. f. Determine the reason(s) why the subject is having difficulty in completing a satisfactory test and make appropriate coaching changes as needed for retesting. g. Obtain at least two spirograms that are reproducible from at least three that are acceptable. h. Maintain subject records that include date/time, age, height, sex, race, testing position used, ambient air temperature, barometric pressure, spirometer used, tests performed, test results, predicted normal values used, and comment on subject cooperation and effort.  Unit Five: Basic Spirometric Calculations Correctly calculate the basic measures used for interpreting test results: a. Forced Vital Capacity (FVC) and variability between the two largest FVCs. b. Forced Expiratory Volume in One Second (FEV1) and variability between the two largest FEV1s. c. Back extrapolation and extrapolated volume. d. FEV1/FVC%. e. Forced Mid-Expiratory Flow Rate (FEF25-75%) (optional measurement). f. Conversion to BTPS.  Unit Six: Comparing Observed to Predicted Normal Values a. Select predicted normal value tables that are appropriate for the subjects and the employment setting. b. Use the same set of predicted values for all spirometric calculations and for future comparisons. c. Determine subjects’ predicted normal values and calculate the subjects’ percentage of the predicted values. d. List factors that affect normal predicted values (e.g., age, sex, height, race). e. Calculate the race correction factor for appropriate ethnic categories and occupational settings.  Unit Seven: Comparing Changes in Follow-Up Spirograms a. Determine subjects’ absolute change and percent change in follow-up spirograms. b. Identify common non-pathological factors that potentially affect changes in follow-up spirograms (e.g., age, height, season, time of day, etc.). Unit Eight: Overview of Standards for Spirometric Equipment a. List instrument specification for spirometers and calibration equipment from the Cotton Dust Standard and American Thoracic Society recommendations. Unit Nine: Additional Exercises a. Successfully complete the exercises.

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