Impacts of Altering Spirometric Prediction Equations in Occupational Health

OBJECTIVE: The aim of the study was to assess implications of applying "Race-neutral" GLI-Global spirometry prediction for workers in occupational medicine (OM). METHODS: We applied GLI-Global to 24 hypothetical male subjects (most industrial workers have been male for decades.) We examined the following: 1) four reference/prediction equations; 2) four racial groups; and 3) 80%, 100%, and 120% of race-specific predicted forced vital capacity (FVC). RESULTS: The effect of changing to GLI-Global varied by group: White > Northeast (NE) Asian > Southeast (SE) Asian > Black. GLI-Global predicted values are midway between Blacks' and Whites,' and among those with lower lung function (80% predicted FVC), Blacks and SE Asians show declining %predicted values and Z-scores and increasing FVCs<LLN, while Whites and NE Asians show increasing % predicted and Z-scores and decreasing FVCs<LLN. CONCLUSIONS: OM clinicians and policymakers must carefully consider the implications of changing prediction equations.