Gli esami di funzionalità respiratoria nella sorveglianza sanitaria dei lavoratori esposti a polveri broncoirritanti

Together with the evaluation of occupational exposures,lung function tests are a fundamental tool in the risk assessement of workers exposed to airborne irritants.Quality control of laboratories on instruments and procedures according to standard guide-lines, as well as an adequate training of technicians and suitable reference values for the population under study are the most remarkable factors to get valid and interpretable measurements in cross-sectional and longitudinal surveys, manteining under control the within and between-subjects variability funcional results. Forced expiratory volumes and flows preferably determined also after a bronchodilator administration, are the basic spirometric parameters for assesment and monitoring of obstructive or restrictive funcional impairments associated with the different individual and occupational risk factor.Additional tests, as the measurement of static lun volemes and the determination of the carbon monoxide transfer factor, are often necessary for a better evaluation of interstitial or emphydematoous abnormalities. The study of non-specific bronchial hyperresonsivity is to be considered on the basis of invidual clinical findings of suspected asthma and/or specific occupational risk