- The training program includes a pre-learning phase that allows participants to familiarize themselves with foundational concepts before engaging in in-person interactions with the facilitator.
- Following the pre-learning phase, participants will have the opportunity to meet with the facilitator in a physical classroom setting. This direct interaction is crucial for addressing any questions or concerns that may have arisen during the self-study period.
- Additionally, the physical classroom component is designed to facilitate hands-on practical training. This aspect of the program allows participants to apply theoretical knowledge in real-world scenarios, enhancing their understanding and retention of the material. Working under the guidance of an experienced facilitator, learners can practice skills, collaborate with peers, and gain valuable insights that are difficult to achieve through online learning alone.
- Overall, this structured approach—combining pre-learning with direct facilitator contact and practical classroom experiences—ensures a comprehensive and effective learning journey that accommodates various learning styles and maximizes participant engagement.
Reference values Copy TEST COURSE Jan 2023
Reference values
Reference values are predicted values against which a worker’s blow is measured. Reference values are based on equations that take into account age, height and sex. Reliable interpretation of spirometry results relies on the availability of appropriate reference data to help distinguish between health and disease and to assess the severity and nature of any impairment.
What is Normal?
The range of values obtained from a “healthy population” is assumed to represent normal. Unlike many other medical observations, lung function measurements are related to body size and age, where height is a proxy for chest size, and age reflects maturity. During childhood and adolescence, growth is particularly rapid with lung function increasing 20-fold during the first 10 years of life. By contrast, once peak lung function has been attained during early adulthood, this peak being some 5 years later in males (25 years) than females (20 years), there is a steady age-related decline in lung function. Height, age, sex and, ideally, ethnic/racial group must be taken into consideration when defining the normal range for lung function.
Reference values in the past
A vast number of reference equations have been produced, studying different populations. The overwhelming number of published reference equations in the past and the differences in the methods of each study complicates the selection of an appropriate reference. The use of inappropriate reference equations and misinterpretation, even when potentially appropriate equations are used, can lead to serious errors in both under and over diagnosis, with its associated burden in terms of financial and human costs.
| To ensure consistency, the reference values used should be standardised throughout the population. All of one worker’s spirometry test results should be evaluated against a single set of reference values, regardless of which reference set is selected. |
Present and future
In the past, spirometry conducted in the Occupational Health setting was measured using the European Community of Coal and Steel (ECCS) reference equations as a standard for testing our South African population. This was not ideal but the best option we had until the Global Lung Function Initiative (GLI) reference values were published in 2012. The Global Lung Function Initiative (GLI) reference equations for people aged 3 – 95 years cover many ethnic groups and have been endorsed by all major respiratory societies. These reference values provide the best, most advanced statistical methods and a globally unified approach to the interpretation of spirometry. If you are starting a new spirometry service, the use of the GLI reference values is recommended.
| Even if results are acceptable and repeatable, if the operator does not select an appropriate reference value for the measurement of lung function, the results of the test and the worker’s outcome may be compromised. |
