Professional groups call to stop routine pulmonary function testing


By Michael Woodhead

24 Mar 2020

Pulmonary function testing should be avoided for non-urgent cases professional groups say in light of the risks of COVID-19 transmission.

The American Thoracic Society says that while the evidence for COVID-19 is rapidly changing, it believes that the risks of transmission of the virus in pulmonary testing facilities may be significant.

“Concern has been raised that pulmonary function testing could represent a potential avenue for COVID 19 transmission due to the congregation of patients with lung disease and because of the potential for coughing and droplet formation surrounding pulmonary function testing procedures,” it says.

It recommends that pulmonary function testing be restricted to essential tests for immediate treatment decisions, and that measures to protect both the staff and individuals being tested should be put in place.

“Decisions regarding the conduct of pulmonary function tests need to balance the potential risks against the need for assessment of lung function to make treatment decisions. We realise that this is an evolving situation and that the risk/benefit ratio will also continue to change over time,” it advises.

Similar advise has been issued by British Thoracic Society, which noted that many NHS units had already ceased routine pulmonary function testing and are only offering it for urgent cases.

It referred to guidelines that advise postponement of non-urgent tests and the use of  “virtual options” wherever possible.

The National Asthma Council has advised GP practices to reconsider whether the need for spirometry is urgent, and if in doubt to refer to a pulmonary testing laboratory.

In South Australia, health services have received funding to provide home spirometry devices for patients with cystic fibrosis, which can be used in conjunction with telehealth consultations with specialists.

“This model of telehealth will allow our Cystic Fibrosis specialists usually based at the Royal Adelaide Hospital to remain at home during appointments,” said Dr Judith Morton, Acting Clinical Lead of the Cystic Fibrosis Unit, Central Adelaide Local Health Network.

“[It] will allow patients to easily monitor the capacity of their lungs, while infections can be quickly detected and relayed back to the specialists.”

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