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vol.11DINAMOMETRIA- SABEMOS O SUFICIENTE PARA A UTILIZAR ADEQUADAMENTE NA SAÚDE OCUPACIONAL?EVENTUAIS RELAÇÕES ENTRE O RUIDO LABORAL E OS ACIDENTES DE TRABALHO índice de autoresíndice de assuntosPesquisa de artigos
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Revista Portuguesa de Saúde Ocupacional online

versão impressa ISSN 2183-8453

Resumo

SANTOS, M; ALMEIDA, A  e  LOPES, C. WHAT IS THE VALIDITY OR UTILITY OF THE SPIROMETRIES PERFORMED AT OCCUPATIONAL HEALTH?. RPSO [online]. 2021, vol.11, pp.183-199.  Epub 07-Jan-2022. ISSN 2183-8453.  https://doi.org/10.31252/rpso.09.01.2021.

Introduction/framework/objectives:

Spirometry performance and interpretation is dependent on multiple conditions that make this exam extremely complex, both in the execution phase and in extrapolation from its reading, which requires specific training by health professionals involved. In addition, spirometry is not always executed in workers with risk factors capable of altering respiratory capacity or with tasks capable of being negatively modulated by alterations in the latter. The technician who generally executes has no training and is not able to integrate the data obtained with the clinical situation and provide an accurate result. In addition, some physicians (not Pneumologists) little training have relative to interpretation of the exam, being that the automatic report provided by the spirometer can have little quality.

The aim of this bibliographic review is to summarily explain the exam and to attempt to analyze the validity or usefulness of it for Occupational Health, based on the conditions in which it was generally carried out.

Methodology:

This is a Bibliographic Review, initiated through a research carried out in November 2020, in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”.

Content:

Spirometry is the most frequently performed test to assess lung function. It measures the air entering and leaving the lungs, allowing the diagnosis and quantification of ventilatory abnormalities, and the reference values ​​depend on factors such as ethnicity, weight, height, sex, age, altitude and temperature.

Few studies have mentioned direct data related to the validity and usefulness of spirometry performed in an occupational context, however, some articles have compared its performance in hospital settings and in primary health care, allowing extrapolation.

For occupational health, the quantification of lung function is relevant to the classification of fitness and other decisions. Its effectiveness, when performed periodically, depends on the quality of execution; if it is precarious, it can give rise to false positives and false negatives, attributing incorrect health status to workers.

Discussion and Conclusions:

By assimilating what is generally described about spirometry as a whole, it can be inferred that, depending on the conditions under which the exam is usually performed in Occupational Health and the qualifications/training of the professionals who try to perform and read it, it will be most likely they are not an asset for the classification of job aptitude or other decisions

It would be desirable that this exam will be carried out only by qualified technicians, to produce reliable results, capable of meeting minimum quality criteria and producing complete and accurate reports; as well as providing reading training to Occupational Physicians, less familiar with the exam.

It would be very interesting if there were one or more Occupational Health teams with capacity and boldness to evaluate themselves in relation to the ability to perform and read spirometries, disseminating the data and conclusions obtained, as well as suggestions for improvement, useful to any professional/company that works in this sector, published in a scientific article.

Palavras-chave : spirometry; occupational health; work medicine.

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