Pulmonary Function Screening of Submarine Personnel Prior to Pressurized Submarine Escape Training: Development of Lung Function Standards

摘要

The US Navy is constructing a 30 ft (9m) submarine escape training tower at Naval Subase New London. Once completed pressurized submarine escape training using the Mk 10 Submarine Escape Immersion Suit (SEIE) will commence. All candidates will undergo medical screening to identify individuals with disqualifying medical conditions. Prior to construction of the new trainer the opportunity was taken to record lung function of students attending the existing submarine escape trainer. Using these data, normal values of lung function specific to the population group undergoing training were calculated. Over a 16 month period a total of 2173 individuals underwent spirometry. Predicted reference values for forced expiratory volume (FEVI) and forced vital capacity (FVC) were calculated for white non-smoking submariners. The number of black, Hispanic, and students of other ethnicities were insufficient to enable reliable calculation of predicted reference values for these groups. The predicted reference values of FEV1 for white non-smoking subjects obtained by this study closely match the values reported for the general US population by Hankinson et al. This was not the case with regard to FVC for white non-smoking subjects where up until the age of 40 predicted values for submariners exceeded those for the general US population. The findings of this study are consistent with the experience of the UK RN that lung function volumes among military personnel exceed those of the general population when matched for age and height. For this reason general population derived spirometric reference values should be used with caution when assessing a highly selected occupational group such as military personnel. However, due to the current absence of sufficient data to produce occupational group specific spirometric reference values for black, Hispanic, and other ethnicities, there is no alternative other than to use general population derived spirometric reference values.