Testing patients' lungs: Spirometry as part of the physical examination

Spirometric measurements of lung function are vital signs that unfortunatel y are not as widely used as blood pressure or cholesterol testing. Spiromet ry is an uncomplicated procedure that can easily be incorporated by primary care physicians into routine physical examinations, especially now that si mple handheld spirometers suitable for all offices are available. Abnormal spirometric patterns can alert physicians to patients' additional risk of d eveloping chronic lung disease and to the need for interventions that preve nt or forestall morbidity and mortality. Spirometry also is an important to ol for monitoring patients' response to therapy in a number of disorders (e g, asthma). Spirometric testing in adults should begin at age 40 for smoker s and patients with unexplained dyspnea, cough,wheezing, or excessive mucus . Children with asthma and cystic fibrosis should be identified and followe d with spirometry.