SOM MINI CPD: Modernizing Spirometry in OH with Z Scores with Rebecca Burton

In this monthly Continuing Professional Development (CPD) episode of the SOM Podcast, host Steve Randall talks with Rebecca Burton, a qualified occupational health advisor with over 11 years of experience and a clinical trainer for Diagtech. The conversation centres around spirometry screening in occupational health settings and explores why traditional diagnostic criteria are increasingly being superseded by modern statistical approaches. Rebecca details the fundamental shift from using a fixed percentage cut-off (such as 70% or 75% of predicted values) to implementing Z-scores for evaluating lung function. She explains how fixed thresholds fail to account for natural age-related lung decline or physiological variations based on height and sex at birth. This oversight frequently leads to false positives in older workers and dangerous under-diagnosis or false negatives in younger, fitter employees who may be exposed to workplace hazards like respirable crystalline silica or flour dust. The discussion highlights recent shifts in clinical standards, noting that joint guidelines from the American Thoracic Society (ATS) and European Respiratory Society (ERS) formally replaced percentage-predicted models with Z-scores in 2022, a move endorsed by the Association for Respiratory Technology & Physiology (ARTP) in 2025. Rebecca emphasises that occupational health practitioners must look beyond simple software outputs, evaluate longitudinal changes in lung capacity over time, and always weigh clinical context and worker symptoms alongside spirometry data. Review the full ATS/ERS Spirometry Standards (https://www.thoracic.org/) and ARTP (https://www.artp.org.uk/) Guidelines (https://www.artp.org.uk/resources?c=113) to ensure your practice aligns with current global standards. Don't forget to subscribe to the SOM Podcast for monthly clinical insights. The SOM podcast is sponsored by Orchid Live - specialist occupational health software used by a number of SOM members to run every aspect of their occupational health operations. They hold healthcare records for over 1 million UK workers and work with both in-house OH teams and OH providers. You can find out more at OrchidLive.com (https://orchidlive.com) .