104 - Interpreting Spirometry Test Results in the Occupational Setting Since 2023

In discussions of spirometry, the importance of technical errors was always central until 2023 when a big change was recommended in how we interpret test results. Occupational health has always adhered closely to American Thoracic Society (ATS) recommendations, which have changed only incrementally over the past decades. However, in 2023, The ATS recommended replacing race-specific predicted values like NHANES Ill with one overall racial-composite predicted value, GLI-Global, called 'race-neutral', for people of all self-identified races/ethnicities. This recommendation was made before the impact of this approach was evaluated in practice. Occupational regulations and recommendations often require NHANES Ill reference values, or are at least constructed using race-specific values, which have been in place for over 4 decades. This talk will show the unintended negative consequences caused by following this new ATS recommendation and the reasons why we should not yet routinely apply it in occupational health. Educational Gaps:Many practitioners have followed the successive recommendations from the American Thoracic Society for decades. But the 2023 recommendation to abandon race-specific values such as NHANES Ill, which is often used by occupational health providers, will turn some occupational assessments of spirometry results upside down. Practitioners should exercise caution before following this recommendation.