Testing patients' lungs: spirometry as part of the physical examination.

Spirometric measurements of lung function are vital signs that unfortunately are not as widely used as blood pressure or cholesterol testing. Spirometry is an uncomplicated procedure that can easily be incorporated by primary care physicians into routine physical examinations, especially now that simple handheld spirometers suitable for all offices are available. Abnormal spirometric patterns can alert physicians to patients' additional risk of developing chronic lung disease and to the need for interventions that prevent or forestall morbidity and mortality. Spirometry also is an important tool for monitoring patients' response to therapy in a number of disorders (eg, asthma). Spirometric testing in adults should begin at age 40 for smokers and patients with unexplained dyspnea, cough, wheezing, or excessive mucus. Children with asthma and cystic fibrosis should be identified and followed with spirometry.