A cross-sectional study of pulmonary function in autobody repair workers.

PubMed Central

Parker, D L; Waller, K; Himrich, B; Martinez, A; Martin, F

1991-01-01

This study evaluated pulmonary function in workers from 39 autobody repair shops. Based on 152 White male workers with known smoking status, the mean percent predicted FEV1, FVC, and FEV1/FVC were 93.6, 96.8, and 96.6, respectively. Twenty-three percent of workers had a FEV1/FVC ratio less than the fifth percentile. Isocyanate levels ranged from nondetectable to 0.06 parts per million (STEL = 0.02 ppm). No shop had an adequate respiratory protection program. We concluded that there was an increase in abnormal pulmonary function in autobody workers. Three recommendations were made to shop owners: functional paint booths should be maintained, respiratory protection programs should be developed, and isocyanate-free paints should be used. PMID:2029053

Effects of blood lead levels on airflow limitations in Korean adults: Findings from the 5th KNHNES 2011

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, Hye Kyung; Chang, Yoon Soo, E-mail: yschang@yuhs.ac; Ahn, Chul Woo

This study aimed to examine whether blood levels of heavy metals, such as lead, mercury and cadmium, are related with pulmonary function in Korean adults. This investigation included 870 Korean adults (≥40 years) who received pulmonary function testing in the Korea National Health and Nutrition Examination Survey (KNHANES) V-2, 2011. Data of blood levels of heavy metals, pulmonary function tests and anthropometric measurements were acquired. Blood lead levels showed inverse correlations with the FEV{sub 1}/FVC ratio before (r=−0.276, p<0.001) and after adjustment of multiple compounding factors (r=−0.115, p=0.001). A logistic multiple regression analysis revealed that blood lead levels were amore » significant influencing factor for the FEV{sub 1}/FVC ratio (β=−0.017, p=0.001, adjusted R{sup 2}=0.267). The odds ratios (ORs) for the FEV{sub 1}/FVC ratio were significantly lower in the highest tertile group of the blood lead levels than in the lowest tertile group in Model 1 (OR=0.007, 95% CI=0.000−0.329) and Model 2 (OR=0.006, 95% CI=0.000−0.286). These findings imply that environmental exposure to lead might be an important factor that may cause airflow limitations in Korean adults. - Highlights: • Blood lead levels showed inverse correlations with the FEV{sub 1}/FVC ratio. • Blood lead level was a significant influencing factor for the FEV{sub 1}/FVC ratio. • ORs for FEV{sub 1}/FVC were lower in the highest blood lead group than in the lowest group. • Environmental exposure to lead might be an important factor for airflow limitations.« less

Gender Differences in the Association of Individual and Contextual Exposures with Lung Function in a Rural Canadian Population.

PubMed

Janzen, Bonnie; Karunanayake, Chandima; Rennie, Donna; Pickett, William; Lawson, Joshua; Kirychuk, Shelley; Hagel, Louise; Senthilselvan, Ambikaipakan; Koehncke, Niels; Dosman, James; Pahwa, Punam

2017-02-01

To investigate the association of individual and contextual exposures with lung function by gender in rural-dwelling Canadians. A cross-sectional mail survey obtained completed questionnaires on exposures from 8263 individuals; a sub-sample of 1609 individuals (762 men, 847 women) additionally participated in clinical lung function testing. The three dependent variables were forced expired volume in one second (FEV 1 ), forced vital capacity (FVC), and FEV 1 /FVC ratio. Independent variables included smoking, waist circumference, body mass index, indoor household exposures (secondhand smoke, dampness, mold, musty odor), occupational exposures (grain dust, pesticides, livestock, farm residence), and socioeconomic status. The primary analysis was multiple linear regression, conducted separately for each outcome. The potential modifying influence of gender was tested in multivariable models using product terms between gender and each independent variable. High-risk waist circumference was related to reduced FVC and FEV 1 for both genders, but the effect was more pronounced in men. Greater pack-years smoking was associated with lower lung function values. Exposure to household smoke was related to reduced FEV 1 , and exposure to livestock, with increased FEV 1 . Lower income adequacy was associated with reduced FVC and FEV 1 . High-risk waist circumference was more strongly associated with reduced lung function in men than women. Longitudinal research combined with rigorous exposure assessment is needed to clarify how sex and gender interact to impact lung function in rural populations.

CT densitovolumetry in children with obliterative bronchiolitis: correlation with clinical scores and pulmonary function test results*,**

PubMed Central

Mocelin, Helena; Bueno, Gilberto; Irion, Klaus; Marchiori, Edson; Sarria, Edgar; Watte, Guilherme; Hochhegger, Bruno

2013-01-01

OBJECTIVE: To determine whether air trapping (expressed as the percentage of air trapping relative to total lung volume [AT%]) correlates with clinical and functional parameters in children with obliterative bronchiolitis (OB). METHODS: CT scans of 19 children with OB were post-processed for AT% quantification with the use of a fixed threshold of −950 HU (AT%950) and of thresholds selected with the aid of density masks (AT%DM). Patients were divided into three groups by AT% severity. We examined AT% correlations with oxygen saturation (SO2) at rest, six-minute walk distance (6MWD), minimum SO2 during the six-minute walk test (6MWT_SO2), FVC, FEV1, FEV1/FVC, and clinical parameters. RESULTS: The 6MWD was longer in the patients with larger normal lung volumes (r = 0.53). We found that AT%950 showed significant correlations (before and after the exclusion of outliers, respectively) with the clinical score (r = 0.72; 0.80), FVC (r = 0.24; 0.59), FEV1 (r = −0.58; −0.67), and FEV1/FVC (r = −0.53; r = −0.62), as did AT%DM with the clinical score (r = 0.58; r = 0.63), SO2 at rest (r = −0.40; r = −0.61), 6MWT_SO2 (r = −0.24; r = −0.55), FVC (r = −0.44; r = −0.80), FEV1 (r = −0.65; r = −0.71), and FEV1/FVC (r = −0.41; r = −0.52). CONCLUSIONS: Our results show that AT% correlates significantly with clinical scores and pulmonary function test results in children with OB. PMID:24473764

Lung function changes in coke oven workers during 12 years of follow up

PubMed Central

Wu, J; Griffiths, D; Kreis, I; Darling, C

2004-01-01

Aims: To investigate the effect of exposure to coke oven emissions on the lung function of coke oven workers. Methods: The study population, followed from 1978 and 1990, was 580 male workers with at least two sets of lung function measurements (FVC, FEV1, FEV1/FVC, and FEF25–75%). An annual rate of change (time slope) for age and height adjusted lung function index was estimated for each subject. This "time slope" was then treated as the response variable in a weighted multiple regression analysis with selected predictors. Results: For all 580 subjects, each year of working in the "operation" group (the most exposed) was found to increase the FVC decline by around 0.7 ml/year (95% CI 0.1 to 1.3 ml/year). After the exclusion of 111 subjects without detailed work history, the above finding was confirmed and each year of exposure in "operation" was also found to increase the FEV1 decline by around 0.8 ml/year (95% CI 0.1 to 1.4 ml/year). Conclusions: These findings are consistent with the results of previous cross-sectional studies. Work duration in the most exposed position in the coke ovens was associated with increased annual decline for FVC and FEV1. The estimated effect of one year of work exposure in "operation" is equivalent, in terms of the reduction in lung function, to an estimated 2.1 pack-years of smoking for FVC and 1.2 pack-years of smoking for FEV1. PMID:15258275

Effect of occupational silica exposure on pulmonary function.

PubMed

Hertzberg, Vicki Stover; Rosenman, Kenneth D; Reilly, Mary Jo; Rice, Carol H

2002-08-01

To assess the effect of occupational silica exposure on pulmonary function. Epidemiologic evaluation based on employee interview, plant walk-through, and information abstracted from company medical records, employment records, and industrial hygiene measurements. Drawn from 1,072 current and former hourly wage workers employed before January 1, 1986. Thirty-six individuals with radiographic evidence of parenchymal changes consistent with asbestosis or silicosis were excluded. In addition, eight individuals whose race was listed as other than white or black were excluded. Analysis of spirometry data (FVC, FEV1, FEV1/FVC) only using the test results that met American Thoracic Society criteria for reproducibility and acceptability shows decreasing percent-predicted FVC and FEV1 and decreasing FEV1/FVC in relationship to increasing silica exposure among smokers. Logistic regression analyses of abnormal FVC and abnormal FEV1 values (where abnormal is defined as < 95% confidence limit for predicted using the Knudson prediction equations) show odds ratios of 1.49 and 1.68, respectively, for occurrence of abnormal result with 40 years of exposure at the Occupational Safety and Health Administration (OSHA)-allowable level of 0.1 mg/m3. Longitudinal analyses of FVC and FEV1 measurements show a 1.6 mL/yr and 1.1 mL/yr, respectively, decline per milligram/cubic meter mean silica exposure (p = 0.011 and p = 0.001, respectively). All analyses were adjusted for weight, height, age, ethnicity, smoking status, and other silica exposures. Systematic problems leading to measurement error were possible, but would have been nondifferential in effect and not related to silica measurements. There is a consistent association between increased pulmonary function abnormalities and estimated measures of cumulative silica exposure within the current allowable OSHA regulatory level. Despite concerns about the quality control of the pulmonary function measurements use in these analyses, our results support the need to lower allowable air levels of silica and increase efforts to encourage cessation of cigarette smoking among silica-exposed workers.

Association between pulmonary function and renal function: findings from China and Australia.

PubMed

Yu, Dahai; Chen, Tao; Cai, Yamei; Zhao, Zhanzheng; Simmons, David

2017-05-01

The relationship between obstructive lung function and impaired renal function is unclear. This study investigated the dose-response relationship between obstructive lung function and impaired renal function. Two independent cross-sectional studies with representative sampling were applied. 1454 adults from rural Victoria, Australia (1298 with normal renal function, 156 with impaired renal function) and 5824 adults from Nanjing, China (4313 with normal renal function, 1511 with impaired renal function). Pulmonary function measurements included forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Estimated glomerular filtration rate (eGFR), and impaired renal function marked by eGFR <60 mL/min/1.73m 2 were used as outcome. eGFR increased linearly with FEV1 in Chinese participants and with FVC in Australians. A non-linear relationship with peaked eGFR was found for FEV1 at 2.65 L among Australians and for FVC at 2.78 L among Chinese participants, respectively. A non-linear relationship with peaked eGFR was found for the predicted percentage value of forced expiratory volume in 1 s (PFEV1) at 81-82% and for the predicted percentage value of forced vital capacity (PFVC) at 83-84% among both Chinese and Australian participants, respectively. The non-linear dose-response relationships between lung capacity measurements (both for FEV1 and FVC) and risk of impaired renal function were consistently identified in both Chinese and Australian participants. An increased risk of impaired renal function was found below 3.05 L both for FEV1 and FVC, respectively. The non-linear relationship between PFEV and PVC and the risk of impaired renal function were consistently identified in both Chinese and Australian participants. An increased risk of impaired renal function was found below 76-77% for PFEV1 and 79-80% for PFVC, respectively. In both Australian and Chinese populations, the risk of impaired renal function increased both with FEV1 and FVC below 3.05 L, with PFEV1 below 76-77% or with PFVC below 79-80%, respectively. Obstructive lung function was associated with increased risk of reduced renal function. The screen for impaired renal function in patients with obstructive lung disease might be useful to ensure there was no impaired renal function before the commencement of potentially nephrotoxic medication where indicated (eg diuretics).

Functional improvement in patients with idiopathic pulmonary fibrosis undergoing single lung transplantation *

PubMed Central

Rubin, Adalberto Sperb; Nascimento, Douglas Zaione; Sanchez, Letícia; Watte, Guilherme; Holand, Arthur Rodrigo Ronconi; Fassbind, Derrick Alexandre; Camargo, José Jesus

2015-01-01

Abstract Objective: To evaluate the changes in lung function in the first year after single lung transplantation in patients with idiopathic pulmonary fibrosis (IPF). Methods: We retrospectively evaluated patients with IPF who underwent single lung transplantation between January of 2006 and December of 2012, reviewing the changes in the lung function occurring during the first year after the procedure. Results: Of the 218 patients undergoing lung transplantation during the study period, 79 (36.2%) had IPF. Of those 79 patients, 24 (30%) died, and 11 (14%) did not undergo spirometry at the end of the first year. Of the 44 patients included in the study, 29 (66%) were men. The mean age of the patients was 57 years. Before transplantation, mean FVC, FEV1, and FEV1/FVC ratio were 1.78 L (50% of predicted), 1.48 L (52% of predicted), and 83%, respectively. In the first month after transplantation, there was a mean increase of 12% in FVC (400 mL) and FEV1 (350 mL). In the third month after transplantation, there were additional increases, of 5% (170 mL) in FVC and 1% (50 mL) in FEV1. At the end of the first year, the functional improvement persisted, with a mean gain of 19% (620 mL) in FVC and 16% (430 mL) in FEV1. Conclusions: Single lung transplantation in IPF patients who survive for at least one year provides significant and progressive benefits in lung function during the first year. This procedure is an important therapeutic alternative in the management of IPF. PMID:26398749

The Association of Normal Range Glycated Hemoglobin with Restrictive Lung Pattern in the General Population

PubMed Central

Oh, Il Hwan; Park, Jung Hwan; Lee, Chang Hwa; Park, Joon-Sung

2015-01-01

Glycated hemoglobin (HbA1c) is an important diagnostic indicator of diabetes mellitus, and some authors have argued that it is related to impaired lung function in the diabetic population. However, there was rare study for association between lung function and HbA1c in the non-diabetic population. We investigated whether HbA1c below the diagnostic threshold is related to deficits in lung function. We analyzed biochemical and spirometry data from a nation-wide, population-based, case-control study (the KNHANES IV and V). Eligible as cases were all native Koreans aged 40 years or more with no medical illness. A total of 3670 participants were divided into 4 groups according to HbA1c (%) as follows: Group I (n = 842), ≥ 4.0 and ≤ 5.3; Group II (n = 833), > 5.3 and ≤ 5.5; Group III (n = 898), > 5.5 and ≤ 5.7; and Group IV (n = 1097), > 5.7 and ≤ 6.4. Group I had the greatest forced vital capacity (FVC, 96.3 ± 0.5% pred, P < 0.0001), forced expiratory volume per second (FEV1, 93.8 ± 0.5% pred, P < 0.0001) and FEV1/FVC (0.792 ± 0.003, P < 0.0001) compared with the other groups. Linear regression showed that HbA1c was closely related to FVC (β = -6.972154, P < 0.0001) and FEV1 (β = -5.591589, P < 0.0001), but not to FEV1/FVC. Logistic regression analysis revealed a significant association between HbA1c and a restrictive spirometric pattern (FVC < 80% pred., FEV1/FVC ≥ 0.70; OR = 3.772, 95% CI = 1.234-11.53), indicating that elevated HbA1c is closely associated with lung impairment in the non-diabetic population. In the healthy population, relatively high HbA1c level is associated with decrements of FVC and FEV1 and may be a reliable predictor of poor lung function, especially the restrictive pattern. PMID:25658743

Change in Pulmonary Function after Incentive Spirometer Exercise in Children with Spastic Cerebral Palsy: A Randomized Controlled Study

PubMed Central

Choi, Ja Young; Rha, Dong-wook

2016-01-01

Purpose The aim of this study was to investigate the effect of incentive spirometer exercise (ISE) on pulmonary function and maximal phonation time (MPT) in children with spastic cerebral palsy (CP). Materials and Methods Fifty children with CP were randomly assigned to two groups: the experimental group and the control group. Both groups underwent comprehensive rehabilitation therapy. The experimental group underwent additional ISE. The forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), and MPT were assessed as outcome measures before and after 4 weeks of training. Results There were significant improvements in FVC, FEV1, PEF, and MPT in the experimental group, but not in the control group. In addition, the improvements in FVC, FEV1, and MPT were significantly greater in the experimental group than in the control group. Conclusion The results of this randomized controlled study support the use of ISE for enhancing pulmonary function and breath control for speech production in children with CP. PMID:26996580

South African and international reference values for lung function and its relationship with blood pressure in Africans.

PubMed

van Rooyen, Yolandi; Huisman, Hugo W; Schutte, Aletta E; Eloff, Fritz C; Du Plessis, Johan L; Kruger, Annamarie; Van Rooyen, Johannes M

2015-06-01

In South Africa respiratory diseases are highly prevalent, with cardiovascular disease being a manifestation. However, international reference values for lung function are commonly used, which may not be appropriate to correctly identify reduced lung function. An inverse relationship exists between lung function and blood pressure (BP) but is not investigated extensively in black South Africans. We included 2010 Africans from the PURE (Prospective Urban Rural Epidemiology) study (aged > 35 years) in the North West Province. Spirometry was performed and predicted values for forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were calculated from South African, European and United States prediction equations. With the exception of the European predicted values, all other predicted mean FEV1 and FVC were above 80%. South African reference values displayed the highest percentages of the predicted values for FEV1 and FVC (87.9 and 99.7%, respectively.) BP increased from quintiles five to one for both FEV1 and FVC, (p for trend <0.001). After adjustment the differences remained (p<0.05). South African reference values yielded higher percentages of predicted FEV1 and FVC values than European and US equations suggesting that South African prediction equations may be more useful when investigating lung function in black South Africans. Elevated BP is related to reduced lung function, highlighting the importance in managing both respiratory- and cardiovascular disease. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

FEV1 Is a Better Predictor of Mortality than FVC: The PLATINO Cohort Study

PubMed Central

Menezes, Ana Maria B.; Pérez-Padilla, Rogelio; Wehrmeister, Fernando César; Lopez-Varela, Maria Victorina; Muiño, Adriana; Valdivia, Gonzalo; Lisboa, Carmen; Jardim, José Roberto B.; de Oca, Maria Montes; Talamo, Carlos; Bielemann, Renata; Gazzotti, Mariana; Laurenti, Ruy; Celli, Bartolomé; Victora, Cesar G.

2014-01-01

Objective To determine whether the presence of chronic obstructive lung disease (COPD) and reduction of lung function parameters were predictors of mortality in a cohort. Materials/Patients and Methods Population based cohorts were followed in Montevideo, Santiago and Sao Paulo during 5, 6 and 9 years, respectively. Outcomes included all-cause, cardiovascular, respiratory and cancer mortality; exposures were COPD, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Cox regression was used for analyses. Sensitivity, specificity, positive and negative predictive values, receiver operator characteristics curves and Youden's index were calculated. Results Main causes of death were cardiovascular, respiratory and cancer. Baseline COPD was associated with overall mortality (HR = 1.43 for FEV1/FVC

Bronchodilator efficacy of tiotropium in patients with mild to moderate COPD.

PubMed

Johansson, Gunnar; Lindberg, Anne; Romberg, Kerstin; Nordström, Lars; Gerken, Fronke; Roquet, Annika

2008-09-01

Evaluation of tiotropium efficacy in patients with mild chronic obstructive pulmonary disease (COPD) defined by the 2003 Swedish Society of Respiratory Medicine guidelines (post-bronchodilator FEV1/FVC <70%; FEV1 >60% predicted). In this 12-week, randomised, double-blind, placebo-controlled study of tiotropium 18 mcg once daily versus placebo, respiratory function was assessed on Days 1, 15 and 85 (baseline: pre-dose Day 1). Mean+/-SD baseline FEV1 (% predicted) was 73.4+/-12.5 (tiotropium, n=107; placebo, n=117). Tiotropium significantly improved change from baseline in area under the curve from pre-dose to 2 hours post-dose (AUC0-2 h) FEV1 versus placebo, by 166+/-26 mL (mean+/-SE) at study end (p<0.0001). With tiotropium, there were significant increases in the change in AUC0-2 h FVC versus baseline, and trough FEV1 and FVC, versus placebo, on all test days (p<0.01). Adverse event rates were similar. Compared with placebo, tiotropium improved lung function in patients with mild COPD.

Tobacco Use and Its Health Effects among Professional Athletes in Qatar

PubMed Central

Chaabane, Zaina; Mahfoud, Ziyad

2016-01-01

The objective of the study was to determine the effects of tobacco use on selected markers of health and lung function in professional athletes. A total of 108 male professional athletes participated in the study from ten ball game teams in the same sport league in Qatar (age = 26.4 ± 5.1 yrs, height = 190.6 ± 11.9 cm, and weight = 91.5 ± 16.4 kg). The athletes have been playing professionally for about 6.3 years on average. In addition to demographic and tobacco use status, the following clinical variables were measured: resting blood pressure, heart rate, FVC, FEV1 sec, and PEF. The prevalence of tobacco use among the athletes was 27.7%. The FVC, FVC%, and FEV1% were significantly lower among the smokers compared to the nonsmokers (p = 0.003, 0.044, and 0.001, resp.). There were no significant differences between cigarettes smokers and nonsmokers in BP, HR, FEV1, FEV1/FVC, PEF, and PEF%. Similarly, those who smoked shisha had lower FEV1% values as compared to those who did not smoke shisha (p = 0.001). The decrease of FEV1 and FVC among smokers compared to nonsmokers is similar to what has been reported in the literature about other populations. PMID:28025593

Insulin resistance, metabolic syndrome, and lung function in US adolescents with and without asthma.

PubMed

Forno, Erick; Han, Yueh-Ying; Muzumdar, Radhika H; Celedón, Juan C

2015-08-01

Obesity increases both the risk of asthma and asthma severity and is a well-known risk factor for insulin resistance and the metabolic syndrome (MS) in children and adolescents. We aimed to examine the association among obesity, insulin sensitivity, MS, and lung function in US adolescents with and without asthma. We performed a cross-sectional study of 1429 adolescents aged 12 to 17 years in the 2007-2010 National Health and Nutrition Examination Survey. Adjusted regression was used to assess the relationships among obesity, insulin sensitivity/resistance, MS, and lung function in children with and without asthma. Insulin resistance was negatively associated with FEV1 and forced vital capacity (FVC) in adolescents with and without asthma, whereas MS was associated with lower FEV1/FVC ratios, with a more pronounced decrease found among asthmatic patients; these associations were driven by overweight/obese adolescents. Higher body mass index was associated with a decrease in FEV1/FVC ratios among adolescents with insulin resistance. Compared with healthy participants, adolescents with MS had an approximately 2% decrease in FEV1/FVC ratios, adolescents with asthma had an approximately 6% decrease, and those with MS and asthma had approximately 10% decreased FEV1/FVC ratios (P < .05). Insulin resistance and MS are associated with worsened lung function in overweight/obese adolescents. Asthma and MS synergistically decrease lung function, as do obesity and insulin resistance. These factors might contribute to the pathogenesis of asthma severity in obese patients and warrant further investigation. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Work related decrement in pulmonary function in silicon carbide production workers.

PubMed Central

Osterman, J W; Greaves, I A; Smith, T J; Hammond, S K; Robins, J M; Thériault, G

1989-01-01

The relation between pulmonary function, cigarette smoking, and exposure to mixed respirable dust containing silicon carbide (SiC), hydrocarbons, and small quantities of quartz, cristobalite, and graphite was evaluated in 156SiC production workers using linear regression models on the difference between measured and predicted FEV1 and FVC. Workers had an average of 16 (range 2-41) years of employment and 9.5 (range 0.6-39.7) mg-year/m3 cumulative respirable dust exposure; average dust exposure while employed was 0.63 (range 0.18-1.42) mg/m3. Occasional, low level (less than or equal to 1.5 ppm) sulphur dioxide (SO2) exposure also occurred. Significant decrements in FEV1 (8.2 ml; p less than 0.03) and FVC (9.4 ml; p less than 0.01) were related to each year of employment for the entire group. Never smokers lost 17.8 ml (p less than 0.02) of FEV1 and 17.0 (p less than 0.05) of FVC a year, whereas corresponding decrements of 9.1 ml (p = 0.12) in FEV1 and 14.4 ml (p less than 0.02) in FVC were found in current smokers. Similar losses in FEV1 and FVC were related to each mg-year/m3 of cumulative dust exposure for 138 workers with complete exposure information; these findings, however, were generally not significant owing to the smaller cohort and greater variability in this exposure measure. Never smokers had large decrements in FEV1 (40.7 ml; p less than 0.02) and FVC (32.9 ml; p = 0.08) per mg-year/m3 of cumulative dust exposure and non-significant decrements were found in current smokers (FEV1: -7.1 ml; FVC: -11.7 ml). A non-significant decrement in lung function was also related to average dust exposure while employed. No changes were associated with SO(2) exposure or and SO(2) dust interaction. These findings suggest that employment in SiC production is associated with an excessive decrement in pulmonary function and that current permissible exposure limits for dusts occurring in this industry may not adequately protect workers from developing chronic pulmonary disease. PMID:2818959

Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study

PubMed Central

Abdelaal, Ashraf Abdelaal Mohamed; Abd El Kafy, Ehab Mohamed Abo El Soad; Elayat, Mohamed Salah Eldien Mohamed; Sabbahi, Mohamed; Badghish, Mohamed Salem Saed

2017-01-01

Objective This observational cohort study aimed to evaluate ventilatory function (VF) and functional exercise capacity (FEC) in mild adolescent idiopathic scoliosis (AIS). Methods Seventy-three adolescents with idiopathic scoliosis, aged approximately 10 to 17 years (mean age: 13.43 ± 1.27 years), with a Cobb angle less than 20° (mean: 16.44° ± 1.59°), met the inclusion criteria and were assigned to group A. Another 34 healthy adolescents with normal VF and FEC served as controls (group B). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximum voluntary ventilation (MVV), and FEC (by the 6-minute walk test [6MWT]) were the main outcome measures. Results Post-study mean values of FVC, FEV1, FEV1/FVC, MVV, and the 6MWT were 2.42 ± 0.36 L and 3.26 ± 0.59 L, 2.14 ± 0.31 L and 3.03 ± 0.43 L, 88.13% ± 3.89% and 91.14% ± 4.67%, 76.96 ± 6.85 L/m and 107.61 ± 11.44 L/m, and 581.12 ± 12.25 m and 627.74 ± 15.27 m in groups A and B, respectively. Between-group comparisons showed significant differences in FVC, FEV1, FEV1/FVC, MVV, and the 6MWT. Conclusion Mild pulmonary and functional restrictions start early in mild AIS. This issue requires immediate intervention to prevent further deterioration. PMID:28661261

Association between the Type of Workplace and Lung Function in Copper Miners

PubMed Central

Gruszczyński, Leszek; Wojakowska, Anna; Ścieszka, Marek; Turczyn, Barbara; Schmidt, Edward

2016-01-01

The aim of the analysis was to retrospectively assess changes in lung function in copper miners depending on the type of workplace. In the groups of 225 operators, 188 welders, and 475 representatives of other jobs, spirometry was performed at the start of employment and subsequently after 10, 20, and 25 years of work. Spirometry Longitudinal Data Analysis software was used to estimate changes in group means for FEV1 and FVC. Multiple linear regression analysis was used to assess an association between workplace and lung function. Lung function assessed on the basis of calculation of longitudinal FEV1 (FVC) decline was similar in all studied groups. However, multiple linear regression model used in cross-sectional analysis revealed an association between workplace and lung function. In the group of welders, FEF75 was lower in comparison to operators and other miners as early as after 10 years of work. Simultaneously, in smoking welders, the FEV1/FVC ratio was lower than in nonsmokers (p < 0,05). The interactions between type of workplace and smoking (p < 0,05) in their effect on FVC, FEV1, PEF, and FEF50 were shown. Among underground working copper miners, the group of smoking welders is especially threatened by impairment of lung ventilatory function. PMID:27274987

Pulmonary functions of children with asthma improve following massage therapy.

PubMed

Fattah, Mohammed Abdel; Hamdy, Basant

2011-11-01

This study aimed at evaluating the effect of massage therapy on the pulmonary functions of stable Egyptian children with asthma. This study was an open, randomized, controlled trial. The study was conducted in pediatric allergy and chest unit of the New Children's Hospital of Cairo University, Egypt. Sixty (60) children with asthma were divided randomly into two equal groups: massage therapy group and control group. Subjects in the massage therapy group received a 20-minute massage therapy by their parents at home before bedtime every night for 5 weeks in addition to the standard asthma treatment. The control group received the standard asthma treatment alone for 5 weeks. Spirometry was performed for all children on the first and last days of the study. Forced expiratory flow in first second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) were recorded. At the end of the study, mean FEV1 of the massage therapy group was significantly higher than controls (2.3-0.8 L versus 1.9-0.9 L, p=0.04). There was no significant difference in FVC (2.5-0.8 L versus 2.7-0.7 L, p=0.43). However, FEV1/FVC ratio showed a significant improvement in the massage therapy group (92.3-21.5 versus 69.5-17, p<0.01). PEF difference was not significant (263.5-39.6 L/minute versus 245.9-32 L/minute, p=0.06). A beneficial role for massage therapy in pediatric asthma is suggested. It improved the key pulmonary functions of the children, namely, FEV1 and FEV1/FVC ratio. However, further research on a larger scale is warranted. © Mary Ann Liebert, Inc.

A genome-wide association study identifies risk loci for spirometric measures among smokers of European and African ancestry.

PubMed

Lutz, Sharon M; Cho, Michael H; Young, Kendra; Hersh, Craig P; Castaldi, Peter J; McDonald, Merry-Lynn; Regan, Elizabeth; Mattheisen, Manuel; DeMeo, Dawn L; Parker, Margaret; Foreman, Marilyn; Make, Barry J; Jensen, Robert L; Casaburi, Richard; Lomas, David A; Bhatt, Surya P; Bakke, Per; Gulsvik, Amund; Crapo, James D; Beaty, Terri H; Laird, Nan M; Lange, Christoph; Hokanson, John E; Silverman, Edwin K

2015-12-03

Pulmonary function decline is a major contributor to morbidity and mortality among smokers. Post bronchodilator FEV1 and FEV1/FVC ratio are considered the standard assessment of airflow obstruction. We performed a genome-wide association study (GWAS) in 9919 current and former smokers in the COPDGene study (6659 non-Hispanic Whites [NHW] and 3260 African Americans [AA]) to identify associations with spirometric measures (post-bronchodilator FEV1 and FEV1/FVC). We also conducted meta-analysis of FEV1 and FEV1/FVC GWAS in the COPDGene, ECLIPSE, and GenKOLS cohorts (total n = 13,532). Among NHW in the COPDGene cohort, both measures of pulmonary function were significantly associated with SNPs at the 15q25 locus [containing CHRNA3/5, AGPHD1, IREB2, CHRNB4] (lowest p-value = 2.17 × 10(-11)), and FEV1/FVC was associated with a genomic region on chromosome 4 [upstream of HHIP] (lowest p-value = 5.94 × 10(-10)); both regions have been previously associated with COPD. For the meta-analysis, in addition to confirming associations to the regions near CHRNA3/5 and HHIP, genome-wide significant associations were identified for FEV1 on chromosome 1 [TGFB2] (p-value = 8.99 × 10(-9)), 9 [DBH] (p-value = 9.69 × 10(-9)) and 19 [CYP2A6/7] (p-value = 3.49 × 10(-8)) and for FEV1/FVC on chromosome 1 [TGFB2] (p-value = 8.99 × 10(-9)), 4 [FAM13A] (p-value = 3.88 × 10(-12)), 11 [MMP3/12] (p-value = 3.29 × 10(-10)) and 14 [RIN3] (p-value = 5.64 × 10(-9)). In a large genome-wide association study of lung function in smokers, we found genome-wide significant associations at several previously described loci with lung function or COPD. We additionally identified a novel genome-wide significant locus with FEV1 on chromosome 9 [DBH] in a meta-analysis of three study populations.

Reliability of FEV1/FEV6 to Diagnose Airflow Obstruction Compared with FEV1/FVC: The PLATINO Longitudinal Study

PubMed Central

Perez-Padilla, Rogelio; Wehrmeister, Fernando C.; Celli, Bartolome R.; Lopez-Varela, Maria Victorina; Montes de Oca, Maria; Muiño, Adriana; Talamo, Carlos; Jardim, Jose R.; Valdivia, Gonzalo; Lisboa, Carmen; Menezes, Ana Maria B.

2013-01-01

QUESTION A 6-second spirometry test is easier than full exhalations. We compared the reliability of the ratio of the Forced expiratory volume in 1 second/Forced expiratory volume in 6 seconds (FEV1/FEV6) to the ratio of the FEV1/Forced vital capacity (FEV1/FVC) for the detection of airway obstruction. METHODS The PLATINO population-based survey in individuals aged 40 years and over designed to estimate the prevalence of post-Bronchodilator airway obstruction repeated for the same study participants after 5–9 years in three Latin-American cities. RESULTS Using the FEV1/FVC

Pulmonary Function Test Abnormalities in Children With Inflammatory Bowel Disease: Is It Common?

PubMed

El Amrousy, Doaa Mohamed; Hassan, Samir; El-Ashry, Heba; Yousef, Mohamed; Sharshar, Ragia

2018-04-03

The aim of the study was to evaluate the frequency and type of pulmonary dysfunction in newly diagnosed children with inflammatory bowel disease (IBD) and the correlation between pulmonary function tests (PFTs) and IBD activity. It is an observational case-control study. One hundred newly diagnosed children with IBD were enrolled as the patient group, which was subdivided into 52 with Crohn disease (CD) and 48 with ulcerative colitis (UC). Fifty healthy children matched for age, sex, height, and body mass index (BMI) served as the control group. PFTs in the form of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, residual volume (RV), total lung capacity (TLC), mid-forced expiratory flow of 25% to 75% (FEF 25%-75%) and diffusing capacity of the lung for carbon monoxide (DLCO) were evaluated in all studied children. PFTs were measured at diagnosis, every 6 months for a period of 3 years, during remission and at least once during activity in patient group. There was significant progressive deterioration in all PFTs in IBD patients compared with their PFTs at the start of the study (P < 0.05) except for FEV1/FVC, RV, and TLC (P > 0.05). There was significant deterioration during disease activity compared with remission state regarding FEV1, FVC, FEV 25% to 75%, and DLCO (P < 0.05). Significant negative correlation was found between disease activity in both UC and CD groups and FEV1, FVC, FEV 25% to 75%, and DLCO. Subclinical PFT abnormalities are common in pediatric IBD even during remission period. So, periodic PFT evaluation should be considered in the routine follow-up of IBD children.

Overweight and obesity may lead to under-diagnosis of airflow limitation: findings from the Copenhagen City Heart Study.

PubMed

Çolak, Yunus; Marott, Jacob Louis; Vestbo, Jørgen; Lange, Peter

2015-02-01

The prevalence of obesity has increased during the last decades and varies from 10-20% in most European countries to approximately 32% in the United States. However, data on how obesity affects the presence of airflow limitation (AFL) defined as a reduced ratio between forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) are scarce. Data was derived from the third examination of the Copenhagen City Heart Study from 1991 until 1994 (n = 10,135). We examine the impact of different adiposity markers (weight, body mass index (BMI), waist circumference, waist-hip ratio, and abdominal height) on AFL. AFL was defined in four ways: FEV1/FVC ratio < 0.70, FEV1/FVC ratio < lower limit of normal (LLN), FEV1/FVC ratio <0.70 including at least one respiratory symptom, and FEV1/FVC ratio < LLN and FEV1% of predicted < LLN. All adiposity markers were positively and significantly associated with FEV1/FVC independent of age, sex, height, smoking status, and cumulative tobacco consumption. Among all adiposity markers, BMI was the strongest predictor of FEV1/FVC. FEV1/FVC increased with 0.04 in men and 0.03 in women, as BMI increased with 10 units (kg · m-2). Consequently, diagnosis of AFL was significantly less likely in subjects with BMI ≥ 25 kg · m-2 with odds ratios 0.63 or less compared to subjects with BMI between 18.5-24.9 kg · m-2 when AFL was defined as FEV1/FVC < 0.70. High BMI reduces the probability of AFL. Ultimately, this may result in under-diagnosis and under-treatment of COPD among individuals with overweight and obesity.

Clinical and Radiographic Predictors of GOLD–Unclassified Smokers in the COPDGene Study

PubMed Central

Hokanson, John E.; Murphy, James R.; Regan, Elizabeth A.; Make, Barry J.; Lynch, David A.; Crapo, James D.; Silverman, Edwin K.

2011-01-01

Rationale: A significant proportion of smokers have lung function impairment characterized by a reduced FEV1 with a preserved FEV1/FVC ratio. These smokers are a poorly characterized group due to their systematic exclusion from chronic obstructive pulmonary disease (COPD) studies. Objectives: To characterize the clinical, functional, and radiographic features of Global Initiative for Chronic Obstructive Lung Disease (GOLD)-Unclassified (FEV1/FVC ≥ 0.7 and FEV1 < 80% predicted) and lower limits of normal (LLN)-unclassified (FEV1/FVC ≥ LLN and FEV1 < LLN) subjects compared to smokers with normal lung function and subjects with COPD. Methods: Data from the first 2,500 subjects enrolled in the COPDGene study were analyzed. All subjects had 10 or more pack-years of smoking and were between the ages of 45 and 80 years. Multivariate regression models were constructed to determine the clinical and radiological variables associated with GOLD-Unclassified (GOLD-U) and LLN-Unclassified status. Separate multivariate regressions were performed in the subgroups of subjects with complete radiologic measurement variables available. Measurements and Main Results: GOLD-U smokers account for 9% of smokers in COPDGene and have increased body mass index (BMI), a disproportionately reduced total lung capacity, and a higher proportion of nonwhite subjects and subjects with diabetes. GOLD-U subjects exhibit increased airway wall thickness compared to smoking control subjects and decreased gas trapping and bronchodilator responsiveness compared to subjects with COPD. When LLN criteria were used to define the “unclassified” group, African American subjects were no longer overrepresented. Both GOLD-U and LLN-Unclassified subjects demonstrated a wide range of lung function impairment, BMI, and percentage of total lung emphysema. Conclusions: Subjects with reduced FEV1 and a preserved FEV1/FVC ratio are a heterogeneous group with significant symptoms and functional limitation who likely have a variety of underlying etiologies beyond increased BMI. Clinical trial registered with www.clinicaltrials.gov (NCT000608764). PMID:21493737

Disparities in pulmonary function in healthy children across the Indian urban-rural continuum.

PubMed

Sonnappa, Samatha; Lum, Sooky; Kirkby, Jane; Bonner, Rachel; Wade, Angela; Subramanya, Vinita; Lakshman, Padmanabha T; Rajan, Babitha; Nooyi, Shalini C; Stocks, Janet

2015-01-01

Marked socioeconomic health-care disparities are recognized in India, but lung health inequalities between urban and rural children have not been studied. We investigated whether differences exist in spirometric pulmonary function in healthy children across the Indian urban-rural continuum and compared results with those from Indian children living in the UK. Indian children aged 5 to 12 years were recruited from Indian urban, semiurban, and rural schools, and as part of the Size and Lung Function in Children study, London. Anthropometric and spirometric assessments were undertaken. Acceptable spirometric data were obtained from 728 (58% boys) children in India and 311 (50% boys) UK-Indian children. As an entire group, the India-resident children had significantly lower z FEV1 and z FVC than UK-Indian children (P < 0.0005), when expressed using Global Lung Function Initiative-2012 equations. However, when India-resident children were categorized according to residence, there were no differences in z FEV1 and z FVC between Indian-urban and UK-Indian children. There were, however, significant reductions of ∼ 0.5 z scores and 0.9 z scores in both FEV1 and FVC (with no difference in FEV1/FVC) in Indian-semiurban and Indian-rural children, respectively, when compared with Indian-urban children (P < 0.0005). z Body mass index, socioeconomic circumstances, tobacco, and biomass exposure were individually significantly associated with z FEV1 and z FVC (P < 0.0005). The presence of an urban-rural continuum of lung function within a specific ethnic group emphasizes the impact of environmental factors on lung growth in emerging nations such as India, which must be taken into account when developing ethnic-specific reference values or designing studies to optimize lung health.

Long-term exposure to diesel engine exhaust induced lung function decline in a cross sectional study

PubMed Central

ZHANG, Li Ping; ZHANG, Xiao; DUAN, Hua Wei; MENG, Tao; NIU, Yong; HUANG, Chuan Feng; GAO, Wei Min; YU, Shan Fa; ZHENG, Yu Xin

2016-01-01

To clarify the effects of lung function following exposure to diesel engine exhaust (DEE), we recruited 137 diesel engine testing workers exposed to DEE and 127 non-DEE-exposed workers as study subjects. We performed lung function tests and measured cytokinesis-block micronucleus (CBMN) cytome index and levels of urinary polycyclic aromatic hydrocarbons (PAHs) metabolites. There was a significant decrease of forced expiratory volume in 1 second (FEV1), ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/ FVC), maximal mid expiratory flow curve (MMF), forced expiratory flow at 50% of FVC (FEF50%), and forced expiratory flow at 75% of FVC (FEF75%) in the DEE-exposed workers than non-DEE-exposed workers (all p<0.05). Among all study subjects, the decreases of FEF75% were associated with the increasing levels of PAHs metabolites (p<0.05), and there were negative correlations between FEV1, FEV1/FVC, MMF, FEF50%, and FEF75% with CBMN cytome index (all p<0.05). Our results show that long-term exposure to DEE can induce lung function decline which shows mainly obstructive changes and influence of small airways function. The decreased lung function is associated with internal dosage of DEE exposure, and accompany with the increasing CBMN cytome index. PMID:27334424

Air Pollution from Livestock Farms Is Associated with Airway Obstruction in Neighboring Residents.

PubMed

Borlée, Floor; Yzermans, C Joris; Aalders, Bernadette; Rooijackers, Jos; Krop, Esmeralda; Maassen, Catharina B M; Schellevis, François; Brunekreef, Bert; Heederik, Dick; Smit, Lidwien A M

2017-11-01

Livestock farm emissions may not only affect respiratory health of farmers but also of neighboring residents. To explore associations between spatial and temporal variation in pollutant emissions from livestock farms and lung function in a general, nonfarming, rural population in the Netherlands. We conducted a cross-sectional study in 2,308 adults (age, 20-72 yr). A pulmonary function test was performed measuring prebronchodilator and post-bronchodilator FEV 1 , FVC, FEV 1 /FVC, and maximum mid-expiratory flow (MMEF). Spatial exposure was assessed as (1) number of farms within 500 m and 1,000 m of the home, (2) distance to the nearest farm, and (3) modeled annual average fine dust emissions from farms within 500 m and 1,000 m of the home address. Temporal exposure was assessed as week-average ambient particulate matter <10 μm in diameter and ammonia (NH 3 ) concentrations before lung function measurements. Data were analyzed with generalized additive models (smoothing). A negative association was found between the number of livestock farms within a 1,000-m buffer from the home address and MMEF, which was more pronounced in participants without atopy. No associations were found with other spatial exposure variables. Week-average particulate matter <10 μm in diameter and NH 3 levels were negatively associated with FEV 1 , FEV 1 /FVC, and MMEF. In a two-pollutant model, only NH 3 remained associated. A 25-μg/m 3 increase in NH 3 was associated with a 2.22% lower FEV 1 (95% confidence interval, -3.69 to -0.74), FEV 1 /FVC of -1.12% (-1.96 to -0.28), and MMEF of -5.67% (-8.80 to -2.55). Spatial and temporal variation in livestock air pollution emissions are associated with lung function deficits in nonfarming residents.

Ambient air pollution, lung function and airway responsiveness in children with asthma

PubMed Central

Ierodiakonou, Despo; Zanobetti, Antonella; Coull, Brent A.; Melly, Steve; Postma, Dirkje S.; Boezen, H. Marike; Vonk, Judith M.; Williams, Paul V.; Shapiro, Gail G.; McKone, Edward F.; Hallstrand, Teal S.; Koenig, Jane Q.; Schildcrout, Jonathan S.; Lumley, Thomas; Fuhlbrigge, Anne N.; Koutrakis, Petros; Schwartz, Joel; Weiss, Scott T.; Gold, Diane R

2016-01-01

Background Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthma are lacking. Objective To investigate pollution effects in a longitudinal asthma study and effect modification by controller medications. Methods We examined associations of lung function and methacholine responsiveness (PC20) with ozone, carbon monoxide (CO), nitrogen dioxide (NO2) and sulfur dioxide (SO2) levels in 1,003 asthmatic children participating in a 4-year clinical trial. We further investigated whether budesonide and nedocromil modified pollution effects. Daily pollutant concentrations were linked to zip/postal code of residence. Linear mixed models tested associations of within-subject pollutant concentrations with FEV1 and FVC %predicted, FEV1/FVC and PC20, adjusting for seasonality and confounders. Results Same-day and 1-week average CO levels were negatively associated with post-bronchodilator %predicted FEV1 (change(95%CI) per IQR: −0.33(−0.49, −0.16), −0.41(−0.62, −0.21), respectively) and FVC (−0.19(−0.25, −0.07), −0.25(−0.43, −0.07)). Longer-term four-month averages of CO were negatively associated with prebronchodilator %predicted FEV1 and FVC (−0.36(−0.62, −0.10), −0.21(−0.42, −0.01)). Four-month averaged CO and ozone levels were negatively associated with FEV1/FVC (p<0.05). Increased four-month average NO2 levels were associated with reduced post-bronchodilator FEV1 and FVC %predicted. Long-term exposures to SO2 were associated with reduced PC20 (%change(95%CI) per IQR:-6(-11,-1.5)). Treatment augmented the negative short-term CO effect on PC20. Conclusions Air pollution adversely influences lung function and PC20 in asthmatic children. Treatment with controller medications may not protect but worsens the CO effects on PC20. This clinical trial design evaluates modification of pollution effects by treatment without confounding by indication. PMID:26187234

Lung Function before and after a Large Chlorine Gas Release in Graniteville, South Carolina

PubMed Central

Karmaus, Wilfried J. J.; Mohr, Lawrence C.; Cai, Bo; Balte, Pallavi; Gibson, James J.; Ownby, Dennis; Lawson, Andrew B.; Vena, John E.; Svendsen, Erik R.

2016-01-01

Rationale: On January 6, 2005 a train derailment led to an estimated 54,915-kg release of chlorine at a local textile mill in Graniteville, South Carolina. Objectives: We used the employee health spirometry records of the textile to identify enduring effects of chlorine gas exposure resulting from the incident on the lung function of workers employed at the textile mill. Methods: Spirometry records from 1,807 mill workers (7,332 observations) were used from 4 years before and 18 months after the disaster. Longitudinal analysis using marginal regression models produced annual population mean estimates for FEV1, FVC, and FEV1/FVC ratio. Covariate adjustment was made for sex, age, smoking, height, season tested, technician, obesity, season × year interactions, and smoker × year interactions. The increased prevalence of mill workers having accelerated FEV1 decline was also evaluated after the chlorine spill. Measurements and Main Results: In the year of the accident, we observed a significant reduction in mean FEV1 (–4.2% predicted; P = 0.019) when compared with the year before the incident. In the second year, partial recovery in the mean FVC % predicted level was seen, but the cohort’s average FEV1/FVC ratio continued to decrease over time. Severe annual FEV1 decline was most prevalent in the year of the accident, and independent of mill worker smoking status. Conclusions: The Graniteville mill worker cohort revealed significant reductions in lung function immediately after the chlorine incident. Improvement was seen in the second year; but the proportion of mill workers experiencing accelerated FEV1 annual decline significantly increased in the 18 months after the chlorine incident. PMID:26695511

Ambient air pollution, lung function, and airway responsiveness in asthmatic children.

PubMed

Ierodiakonou, Despo; Zanobetti, Antonella; Coull, Brent A; Melly, Steve; Postma, Dirkje S; Boezen, H Marike; Vonk, Judith M; Williams, Paul V; Shapiro, Gail G; McKone, Edward F; Hallstrand, Teal S; Koenig, Jane Q; Schildcrout, Jonathan S; Lumley, Thomas; Fuhlbrigge, Anne N; Koutrakis, Petros; Schwartz, Joel; Weiss, Scott T; Gold, Diane R

2016-02-01

Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthmatic patients are lacking. We sought to investigate pollution effects in a longitudinal asthma study and effect modification by controller medications. We examined associations of lung function and methacholine responsiveness (PC20) with ozone, carbon monoxide (CO), nitrogen dioxide, and sulfur dioxide concentrations in 1003 asthmatic children participating in a 4-year clinical trial. We further investigated whether budesonide and nedocromil modified pollution effects. Daily pollutant concentrations were linked to ZIP/postal code of residence. Linear mixed models tested associations of within-subject pollutant concentrations with FEV1 and forced vital capacity (FVC) percent predicted, FEV1/FVC ratio, and PC20, adjusting for seasonality and confounders. Same-day and 1-week average CO concentrations were negatively associated with postbronchodilator percent predicted FEV1 (change per interquartile range, -0.33 [95% CI, -0.49 to -0.16] and -0.41 [95% CI, -0.62 to -0.21], respectively) and FVC (-0.19 [95% CI, -0.25 to -0.07] and -0.25 [95% CI, -0.43 to -0.07], respectively). Longer-term 4-month CO averages were negatively associated with prebronchodilator percent predicted FEV1 and FVC (-0.36 [95% CI, -0.62 to -0.10] and -0.21 [95% CI, -0.42 to -0.01], respectively). Four-month averaged CO and ozone concentrations were negatively associated with FEV1/FVC ratio (P < .05). Increased 4-month average nitrogen dioxide concentrations were associated with reduced postbronchodilator FEV1 and FVC percent predicted. Long-term exposures to sulfur dioxide were associated with reduced PC20 (percent change per interquartile range, -6% [95% CI, -11% to -1.5%]). Treatment augmented the negative short-term CO effect on PC20. Air pollution adversely influences lung function and PC20 in asthmatic children. Treatment with controller medications might not protect but rather worsens the effects of CO on PC20. This clinical trial design evaluates modification of pollution effects by treatment without confounding by indication. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

The impact of exposure to biomass smoke versus cigarette smoke on inflammatory markers and pulmonary function parameters in patients with chronic respiratory failure.

PubMed

Ocakli, Birsen; Acarturk, Eylem; Aksoy, Emine; Gungor, Sinem; Ciyiltepe, Fulya; Oztas, Selahattin; Ozmen, Ipek; Agca, Meltem Coban; Salturk, Cuneyt; Adiguzel, Nalan; Karakurt, Zuhal

The aim of this study was to evaluate the impact of exposure to biomass smoke vs cigarette smoke on serum inflammatory markers and pulmonary function parameters in patients with chronic respiratory failure (CRF). A total of 106 patients with CRF divided into age and gender-matched groups of cigarette-smoke exposure (n=55, mean [SD] age: 71.0 [12.0] years, 92.7% were females) and biomass smoke exposure (n=51, mean [SD] age: 73.0 [11.0] years, 94.1% were females) were included in this retrospective study. Data on patient demographics (age and gender), inflammatory markers, including neutrophil-to-lymphocyte ratio, C-reactive protein, platelet/mean platelet volume ratio, arterial blood gas analysis, and pulmonary function test findings, including forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), and FEV 1 /FVC were obtained from medical records. Carbon dioxide partial pressure levels were significantly higher in the biomass smoke exposure than in the cigarette smoke exposure group (mean [SD] 51.0 [8.0] vs 47.0 [8.0] mmHg, p =0.026, respectively). Spirometry revealed similarly low levels for FEV 1 (%) (38.0 [16.0] vs 40.0 [12.0]%) and FVC (%) (45.0 [19.0] vs 39.0 [19.0]%) in cigarette-smoke and biomass smoke exposure groups, whereas biomass smoke exposure was associated with significantly higher FEV 1 /FVC (75.0 [14.0] vs 58.0 [12.0]%, p =0.001), lower FVC (mL) (mean [SD] 744.0 [410.0] vs 1,063.0 [592.0] mL, p =0.035) and lower percentage of patients with FEV 1 /FVC <70% (36.8% vs 82.0%, p <0.001) than cigarette smoke exposure. Our findings indicate similarly increased inflammatory markers and abnormally low pulmonary function test findings in both biomass smoke exposure and cigarette smoke exposure groups, emphasizing the adverse effects of biomass smoke exposure on lungs to be as significant as cigarette smoke exposure. Association of biomass smoke exposure with higher likelihood of FEV 1 /FVC ratio of >70% and more prominent loss of vital capacity than cigarette smoke exposure seems to indicate the likelihood of at least 18 years of biomass exposure to be sufficiently high to be responsible for both obstructive and restrictive pulmonary diseases.

Relationship between pulmonary function and indoor air pollution from coal combustion among adult residents in an inner-city area of southwest China

PubMed Central

Jie, Y.; Houjin, H.; Xun, M.; Kebin, L.; Xuesong, Y.; Jie, X.

2014-01-01

Few studies evaluate the amount of particulate matter less than 2.5 mm in diameter (PM2.5) in relation to a change in lung function among adults in a population. The aim of this study was to assess the association of coal as a domestic energy source to pulmonary function in an adult population in inner-city areas of Zunyi city in China where coal use is common. In a cross-sectional study of 104 households, pulmonary function measurements were assessed and compared in 110 coal users and 121 non-coal users (≥18 years old) who were all nonsmokers. Several sociodemographic factors were assessed by questionnaire, and ventilatory function measurements including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were compared between the 2 groups. The amount of PM2.5 was also measured in all residences. There was a significant increase in the relative concentration of PM2.5 in the indoor kitchens and living rooms of the coal-exposed group compared to the non-coal-exposed group. In multivariate analysis, current exposure to coal smoke was associated with a 31.7% decrease in FVC, a 42.0% decrease in FEV1, a 7.46% decrease in the FEV1/FVC ratio, and a 23.1% decrease in PEFR in adult residents. The slope of lung function decrease for Chinese adults is approximately a 2-L decrease in FVC, a 3-L decrease in FEV1, and an 8 L/s decrease in PEFR per count per minute of PM2.5 exposure. These results demonstrate the harmful effects of indoor air pollution from coal smoke on the lung function of adult residents and emphasize the need for public health efforts to decrease exposure to coal smoke. PMID:25296361

Work-related respiratory symptoms and lung function among solderers in the electronics industry: a meta-analysis.

PubMed

Mendy, Angelico; Gasana, Janvier; Forno, Erick; Vieira, Edgar Ramos; Dowdye, Charissa

2012-05-01

Research on the respiratory effect of exposure to solder fumes in electronics workers has been conducted since the 1970s, but has yielded inconsistent results. The aim of this meta-analysis was to clarify the potential association. Effect sizes with corresponding 95% confidence intervals (CIs) for odds of respiratory symptoms related to soldering and spirometric parameters of solderers were extracted from seven studies and pooled to generate summary estimates and standardized mean differences in lung function measures between exposed persons and controls. Soldering was positively associated with wheeze after controlling for smoking (meta-odds ratio: 2.60, 95% CI: 1.46, 4.63) and with statistically significant reductions in forced expiratory volume in 1 s (FEV1) (-0.88%, 95% CI: -1.51, -0.26), forced vital capacity (FVC) (-0.64%, 95% CI: -1.18, -0.10), and FEV1/FVC (-0.35%, 95% CI: -0.65, -0.05). However, lung function parameters of solderers were within normal ranges [pooled mean FEV1: 97.85 (as percent of predicted), 95% CI: 94.70, 100.95, pooled mean FVC: 94.92 (as percent of predicted), 95% CI: 81.21, 108.64, and pooled mean FEV1/FVC: 86.5 (as percent), 95% CI: 78.01, 94.98]. Soldering may be a risk factor for wheeze, but may not be associated with a clinically significant impairment of lung function among electronics workers.

Decline in lung function among cement production workers: a meta-analysis.

PubMed

Moghadam, Somayeh Rahimi; Abedi, Siavosh; Afshari, Mahdi; Abedini, Ehsan; Moosazadeh, Mahmood

2017-12-20

Several studies with different results have been performed regarding cement dust exposure and its pathogenic outcomes during the previous years. This study aims to combine these results to obtain a reliable estimate of the effect of exposure to cement dust. PubMed and other data banks were searched to identify required electronic articles. The search was extended interviewing with relevant experts and research centers. Point and pooled estimates of outcome with 95% confidence intervals were estimated. Participants were 5371 exposed and 2650 unexposed persons. Total mean differences (95% confidence intervals) were estimated as of -0.48 (-0.71 to -0.25) L for forced vital capacity (FVC), -0.7 (-0.92 to -0.47) L for forced expiratory volume in the first second (FEV1), -0.43 (-0.68 to -0.19) L for FEV1/FVC%, -0.73 (-1.15 to -0.30) L/min for PEFR and -0.36 (-0.51 to -0.21) L/s for FEF25-75. Our meta-analysis showed that cement dust has significant impact on lung function and reduces the indicators of FVC, FEV1, FEV1/FVC, PEFR and FEF25-75.

Lung function impact from working in the pre-revolution Libyan quarry industry.

PubMed

Draid, Marwan M; Ben-Elhaj, Khaled M; Ali, Ashraf M; Schmid, Kendra K; Gibbs, Shawn G

2015-05-07

The purpose of this study was to determine the lung impact from working within the Libyan quarry industry, and if the length of work impacted the degree of degradation. Eighty three workers from eight silica quarries in the Nafusa Mountains of Libya opted to participate. These quarries were working the upper cretaceous geological structure. Eighty-five individuals who lived in Gharyan City with no affiliation to quarry operations participated as controls. Spirometry variables evaluated were Forced Vital Capacity (FVC), Forced Expiratory Volume at 1.0 second (FEV1), FVC/FEV1 and Peak Expiratory Flow (PEF). Control and exposed groups had no differences in terms of height, weight, or smoking status (p = 0.18, 0.20, 0.98, respectively). Prior to adjustment for other variables, FVC, FEV1, and PEF are all significantly lower in the exposed group (p = 0.003, 0.009, 0.03, respectively). After adjustment for age, height, weight, and smoking status, there remain significant differences between the control and exposed groups for FVC, FEV1, and PEF. This analysis demonstrated that exposure to quarry dust has a detrimental effect on lung function, and that pre-revolution Libyan quarry workers were being exposed. This study shows that any exposure is harmful, as the reduction in lung function was not significantly associated with years of exposure.

Farm environment during infancy and lung function at the age of 31: a prospective birth cohort study in Finland.

PubMed

Lampi, Jussi; Koskela, Heikki; Hartikainen, Anna-Liisa; Ramasamy, Adaikalavan; Couto Alves, Alexessander; Järvelin, Marjo-Riitta; Pekkanen, Juha

2015-07-22

Farming as an occupation is considered a risk factor for asthma and reduced lung function. By contrast, living on a farm during infancy has been reported to be associated with lower risk of asthma in adulthood. However, little is known about the association between farming environment during infancy and lung function in adulthood. We aimed to study the prospective longitudinal association between farming environment during infancy and lung function in adulthood. A prospective birth cohort study. Northern Finland. 5666 participants born in 1966 were followed up at the age of 31 years. Spirometry at the age of 31 years. To be born into a farmer's family was associated with higher forced expiratory volume in 1 s (FEV1) (36 mL; 95% CI 6 to 67 mL) and forced vital capacity (FVC) (40 mL; 95% CI 5 to 75 mL) at the age of 31 years. Contact with farm animals during infancy was associated with higher FEV1. No associations were seen with FEV1/FVC (FEV1/FVC ratio). Having dogs in childhood revealed similar associations. There was a suggestive dose-dependent association with the number of animal species during childhood and higher FEV1 and FVC at adulthood, especially among women. Farming environment in early life may have a positive impact on lung function in adulthood. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

28 CFR Appendix A to Part 79 - FVC and FEV-1 Lower Limits of Normal Values

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false FVC and FEV-1 Lower Limits of Normal... RADIATION EXPOSURE COMPENSATION ACT Pt. 79, App. A Appendix A to Part 79—FVC and FEV-1 Lower Limits of Normal Values Table 1—Caucasian Males FVC Lower Limit of Normal Values, Hankinson, et al. (1999...

Vital capacity and COPD: the Swedish CArdioPulmonary bioImage Study (SCAPIS).

PubMed

Torén, Kjell; Olin, Anna-Carin; Lindberg, Anne; Vikgren, Jenny; Schiöler, Linus; Brandberg, John; Johnsson, Åse; Engström, Gunnar; Persson, H Lennart; Sköld, Magnus; Hedner, Jan; Lindberg, Eva; Malinovschi, Andrei; Piitulainen, Eeva; Wollmer, Per; Rosengren, Annika; Janson, Christer; Blomberg, Anders; Bergström, Göran

2016-01-01

Spirometric diagnosis of chronic obstructive pulmonary disease (COPD) is based on the ratio of forced expiratory volume in 1 second (FEV1)/vital capacity (VC), either as a fixed value <0.7 or below the lower limit of normal (LLN). Forced vital capacity (FVC) is a proxy for VC. The first aim was to compare the use of FVC and VC, assessed as the highest value of FVC or slow vital capacity (SVC), when assessing the FEV1/VC ratio in a general population setting. The second aim was to evaluate the characteristics of subjects with COPD who obtained a higher SVC than FVC. Subjects (n=1,050) aged 50-64 years were investigated with FEV1, FVC, and SVC after bronchodilation. Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPDFVC was defined as FEV1/FVC <0.7, GOLDCOPDVC as FEV1/VC <0.7 using the maximum value of FVC or SVC, LLNCOPDFVC as FEV1/FVC below the LLN, and LLNCOPDVC as FEV1/VC below the LLN using the maximum value of FVC or SVC. Prevalence of GOLDCOPDFVC was 10.0% (95% confidence interval [CI] 8.2-12.0) and the prevalence of LLNCOPDFVC was 9.5% (95% CI 7.8-11.4). When estimates were based on VC, the prevalence became higher; 16.4% (95% CI 14.3-18.9) and 15.6% (95% CI 13.5-17.9) for GOLDCOPDVC and LLNCOPDVC, respectively. The group of additional subjects classified as having COPD based on VC, had lower FEV1, more wheeze and higher residual volume compared to subjects without any COPD. The prevalence of COPD was significantly higher when the ratio FEV1/VC was calculated using the highest value of SVC or FVC compared with using FVC only. Subjects classified as having COPD when using the VC concept were more obstructive and with indications of air trapping. Hence, the use of only FVC when assessing airflow limitation may result in a considerable under diagnosis of subjects with mild COPD.

[Effect of the components of the metabolic syndrome on pulmonary function. The unexpected role of high-density lipoprotein cholesterol].

PubMed

Huerta-Ramírez, Saúl; Paniagua-Pérez, Angélica; Castro-Serna, David; Ledesma-Velázquez, Andrés; Rubio-Guerra, Alberto; Vargas-Ayala, Germán

2018-01-01

Metabolic syndrome is a condition that predisposes to cardiovascular disease and diabetes mellitus. In addition, it can have effects over neoplastic pathologies, liver and pulmonary function. Our objective is to analyze the effect of the metabolic syndrome and its components on pulmonary function. 110 subjects from Mexico City were evaluated and anthropometric measurements, glucose determination, triglycerides and high-density lipoprotein (HDL) cholesterol were made. They underwent a simple spirometry. Diagnosis of metabolic syndrome was made following the NCEP-ATPIII criteria. Of 110 individuals, 90 (82%) were women and 20 men (18%); 71 subjects (65%) presented metabolic syndrome. Subjects with central obesity had a forced vital capacity (FVC) lower than subjects without central obesity (2.72 vs. 3.11 liters; p < 0.05). Those with low HDL had better spirometric results than subjects with normal HDL (FEV1 2.36 vs. 1.85 liters; p < 0.05), FVC (2.95 vs. 2.45 liters; p < 0.05) and FEV1/FVC ratio (0.78 vs.74; p < 0.05). Hypertensive subjects presented lower volumes in FEV1 (1.91 vs. 2.38; p < 0.05) and FVC (2.49 vs. 2.99; p < 0.05). There is no difference between the spirometry volumes of patients with metabolic syndrome versus the metabolically healthy subjects. The only factors associated with a decrease in FEV1 and FVC are central obesity and arterial hypertension. An unexpected finding was the negative correlation between HDL levels and lung function. Copyright: © 2018 Permanyer.

The Effects of Game-Based Breathing Exercise on Pulmonary Function in Stroke Patients: A Preliminary Study.

PubMed

Joo, Sunghee; Shin, Doochul; Song, Changho

2015-06-22

Reduction of respiratory function along with hemiparesis leads to decreased endurance, dyspnea, and increased sedentary behavior, as well as to an increased risk of stroke. The main purpose of this study was to investigate the preliminary effects of game-based breathing exercise (GBE) on pulmonary function in stroke patients. Thirty-eight in-patients with stroke (22 men, 16 women) were recruited for the study. Participants were randomly allocated into 2 groups: patients assigned to the GBE group (n=19), and the control group (n=19). The GBE group participated in a GBE program for 25 minutes a day, 3 days a week, during a 5 week period. For the same period, both groups participated in a conventional stroke rehabilitation program. Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), FEV1/FVC, and maximum voluntary ventilation (MVV) were measured by a spirometer in pre- and post-testing. The GBE group had significantly improved FVC, FEV1, and MVV values compared with the control group (p<0.05), although there was no significant difference in FEV1/FVC value between groups. Significant short-term effects of the GBE program on pulmonary function in stroke patients were recorded in this study. These findings gave some indications that it may be feasible to include GBE in rehabilitation interventions with this population.

The effects of marijuana exposure on expiratory airflow. A study of adults who participated in the U.S. National Health and Nutrition Examination Study.

PubMed

Kempker, Jordan A; Honig, Eric G; Martin, Greg S

2015-02-01

Given the inconclusive science on the long-term effects of marijuana exposure on lung function, the increasing tetrahydrocannabinol composition of marijuana over time, and the increasing legal accessibility of the substance, continued investigation is needed. To determine the independent association between recent and chronic marijuana smoke exposure with spirometric parameters of lung function and symptoms of respiratory health in a large cohort of U.S. adults. This is a cross-sectional study of U.S. adults who participated in the National Health and Nutrition Examination Survey cycles from 2007-2008 and 2009-2010, using the data from standardized spirometry and survey questions performed during these years. In the combined 2007-2010 cohort, 59.1% replied that they had used marijuana at least once, and 12.2% had used in the past month. For each additional day of marijuana use in the prior month, there were no changes in percent predicted FEV1 (0.002 ± 0.04%; P = 0.9), but there was an associated increase in percent predicted FVC (0.13 ± 0.03%, P = 0.0001) and decrease in the FEV1/FVC ratio (-0.1 ± 0.04%; P < 0.0001). In multivariable regressions, 1-5 and 6-20 joint-years of marijuana use were not associated with an FEV1/FVC less than 70% (odds ratio [OR] = 1.1, 95% confidence interval [CI] = 0.7-1.6, P = 0.8, and OR = 1.2, 95% CI = 0.8-1.8, P = 0.4, respectively), whereas over 20 joint-years was associated with an FEV1/FVC less than 70% (OR = 2.1; 95% CI = 1.1-3.9; P = 0.02). For each additional marijuana joint-year smoked, there was no associated change in the mean percent predicted FEV1 (0.02 ± 0.02%; P = 1.00), an increase in percent predicted FVC (0.07 ± 0.02%; P = 0.004), and a decrease in FEV1/FVC (-0.03 ± 0.01%; P = 0.02). In a large cross-section of U.S. adults, cumulative lifetime marijuana use, up to 20 joint-years, is not associated with adverse changes in spirometric measures of lung health. Although greater than 20 joint-years of cumulative marijuana exposure was associated with a twofold increased odds of a FEV1/FVC less than 70%, this was the result of an increase in FVC, rather than a disproportional decrease in FEV1 as is typically associated with obstructive lung diseases.

The influence of polycyclic aromatic hydrocarbons on lung function in a representative sample of the Canadian population.

PubMed

Cakmak, Sabit; Hebbern, Chris; Cakmak, Jasmine D; Dales, Robert E

2017-09-01

We investigated the associations between exposure to polycyclic aromatic hydrocarbons (PAHs) and selected respiratory physiologic measures in cycles 2 and 3 of the Canadian Health Measures Survey, a nationally representative population sample. Using generalized linear mixed models, we tested the association between selected PAH metabolites and 1-second forced expiratory volume (FEV 1 ), forced vital capacity (FVC), and the ratio between the two (FEV 1 /FVC) in 3531 people from 6 to 79 years of age. An interquartile change in urinary PAH metabolite was associated with significant decrements in FEV 1 and FVC for eight PAHs, 2-hydroxynapthalene, 1-, and 2-hydroxyphenanthrene, 2-, 3-, and 9-hydroxyfluorene and 3- and 4-hydroxyphenanthrene. Exposure to PAH may negatively affect lung function in the Canadian population. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

PAI-1 gain-of-function genotype, factors increasing PAI-1 levels, and airway obstruction: The GALA II Cohort.

PubMed

Sherenian, M G; Cho, S H; Levin, A; Min, J-Y; Oh, S S; Hu, D; Galanter, J; Sen, S; Huntsman, S; Eng, C; Rodriguez-Santana, J R; Serebrisky, D; Avila, P C; Kalhan, R; Smith, L J; Borrell, L N; Seibold, M A; Keoki Williams, L; Burchard, E G; Kumar, R

2017-09-01

PAI-1 gain-of-function variants promote airway fibrosis and are associated with asthma and with worse lung function in subjects with asthma. We sought to determine whether the association of a gain-of-function polymorphism in plasminogen activator inhibitor-1 (PAI-1) with airway obstruction is modified by asthma status, and whether any genotype effect persists after accounting for common exposures that increase PAI-1 level. We studied 2070 Latino children (8-21y) with genotypic and pulmonary function data from the GALA II cohort. We estimated the relationship of the PAI-1 risk allele with FEV1/FVC by multivariate linear regression, stratified by asthma status. We examined the association of the polymorphism with asthma and airway obstruction within asthmatics via multivariate logistic regression. We replicated associations in the SAPPHIRE cohort of African Americans (n=1056). Secondary analysis included the effect of the at-risk polymorphism on postbronchodilator lung function. There was an interaction between asthma status and the PAI-1 polymorphism on FEV 1 /FVC (P=.03). The gain-of-function variants, genotypes (AA/AG), were associated with lower FEV 1 /FVC in subjects with asthma (β=-1.25, CI: -2.14,-0.35, P=.006), but not in controls. Subjects with asthma and the AA/AG genotypes had a 5% decrease in FEV 1 /FVC (P<.001). In asthmatics, the risk genotype (AA/AG) was associated with a 39% increase in risk of clinically relevant airway obstruction (OR=1.39, CI: 1.01, 1.92, P=.04). These associations persisted after exclusion of factors that increase PAI-1 including tobacco exposure and obesity. The decrease in the FEV 1 /FVC ratio associated with the risk genotype was modified by asthma status. The genotype increased the odds of airway obstruction by 75% within asthmatics only. As exposures known to increase PAI-1 levels did not mitigate this association, PAI-1 may contribute to airway obstruction in the context of chronic asthmatic airway inflammation. © 2017 John Wiley & Sons Ltd.

The associations between weight-related anthropometrics during childhood and lung function in late childhood: a retrospective cohort study.

PubMed

Byberg, Kristine Kjer; Mikalsen, Ingvild Bruun; Eide, Geir Egil; Forman, Michele R; Júlíusson, Pétur Benedikt; Øymar, Knut

2018-01-19

An association between body weight in childhood and subsequent lung function and asthma has been suggested, but few longitudinal studies exist. Our aim was to explore whether weight-related anthropometric measurements through childhood were associated with lung function in late childhood. From an original nested case-control study, a cohort study was conducted, where lung function was measured in 463 children aged 12.8 years, and anthropometry was measured at several ages from birth through 12.8 years of age. Associations between anthropometrics and lung function were analysed using multiple linear and fractional polynomial regression analysis. Birthweight and body mass index (BMI; kg/m 2 ) at different ages through childhood were positively associated with forced vital capacity in percent of predicted (FVC %) and forced expiratory volume in the first second in percent of predicted (FEV 1 %) at 12.8 years of age. BMI, waist circumference, waist-to-height ratio and skinfolds at 12.8 years of age and the change in BMI from early to late childhood were positively associated with FVC % and FEV 1 % and negatively associated with FEV 1 /FVC and forced expiratory flow at 25-75% of FVC/FVC. Interaction analyses showed that positive associations between anthropometrics other than BMI and lung function were mainly found in girls. Inverse U-shaped associations were found between BMI at the ages of 10.8/11.8 (girls/boys) and 12.8 years (both genders) and FVC % and FEV 1 % at 12.8 years of age. Weight-related anthropometrics through childhood may influence lung function in late childhood. These findings may be physiological or associated with air flow limitation. Inverse U-shaped associations suggest a differential impact on lung function in normal-weight and overweight children. This study was observational without any health care intervention for the participants. Therefore, no trial registration number is available.

Impulse oscillometry at preschool age is a strong predictor of lung function by flow-volume spirometry in adolescence.

PubMed

Lauhkonen, Eero; Riikonen, Riikka; Törmänen, Sari; Koponen, Petri; Nuolivirta, Kirsi; Helminen, Merja; Toikka, Jyri; Korppi, Matti

2018-05-01

The transition from early childhood wheezing to persistent asthma is linked to lung function impairment over time. Little is known how the methods used to study lung function at different ages correlate longitudinally. Sixty-four children with a history of hospitalization for bronchiolitis before 6 months of age were prospectively studied with impulse oscillometry (IOS) at the mean age of 6.3 years and these preschool IOS results were compared with flow-volume spirometry (FVS) measurements at mean age of 11.4 years. The baseline respiratory system resistance at 5 Hz (Rrs5) showed a modest statistically significant correlation with all baseline FVS parameters except FVC. The post-bronchodilator (post-BD) Rrs5 showed a modest statistically significant correlation with post-BD FEV 1 and FEV 1 /FVC. The bronchodilator-induced decrease in Rrs5 showed a modest statistically significant correlation with the percent increase in FEV 1 . Baseline and post-BD respiratory reactance at 5 Hz (Xrs5) showed a modest statistically significant correlation with baseline and post-BD FVS parameters except post-BD FEV 1 /FVC, respectively, and post-BD Xrs5 showed a strong correlation with post-BD FVC (ρ = 0.61) and post-BD FEV 1 (ρ = 0.59). In adjusted linear regression, preschool Xrs5 remained as a statistically significant independent predictor of FVS parameters in adolescence; the one-unit decrease in the Z-score of preschool post-BD Xrs5 predicted 9.6% lower post-BD FEV 1 , 9.3% lower post-BD FVC, and 9.7% lower post-BD MEF 50 when expressed as %-predicted parameters. Persistent post-BD small airway impairment in children with a history of bronchiolitis detected with IOS at preschool age predicted FVS results measured in early adolescence. © 2018 Wiley Periodicals, Inc.

The association between anthropometric measures and lung function in a population-based study of Canadian adults.

PubMed

Rowe, A; Hernandez, P; Kuhle, S; Kirkland, S

2017-10-01

Decreased lung function has health impacts beyond diagnosable lung disease. It is therefore important to understand the factors that may influence even small changes in lung function including obesity, physical fitness and physical activity. The aim of this study was to determine the anthropometric measure most useful in examining the association with lung function and to determine how physical activity and physical fitness influence this association. The current study used cross-sectional data on 4662 adults aged 40-79 years from the Canadian Health Measures Survey Cycles 1 and 2. Linear regression models were used to examine the association between the anthropometric and lung function measures (forced expiratory volume in 1 s [FEV 1 ] and forced vital capacity [FVC]); R 2 values were compared among models. Physical fitness and physical activity terms were added to the models and potential confounding was assessed. Models using sum of 5 skinfolds and waist circumference consistently had the highest R 2 values for FEV 1 and FVC, while models using body mass index consistently had among the lowest R 2 values for FEV 1 and FVC and for men and women. Physical activity and physical fitness were confounders of the relationships between waist circumference and the lung function measures. Waist circumference remained a significant predictor of FVC but not FEV 1 after adjustment for physical activity or physical fitness. Waist circumference is an important predictor of lung function. Physical activity and physical fitness should be considered as potential confounders of the relationship between anthropometric measures and lung function. Copyright © 2017. Published by Elsevier Ltd.

Effects of a simple prototype respiratory muscle trainer on respiratory muscle strength, quality of life and dyspnea, and oxidative stress in COPD patients: a preliminary study.

PubMed

Leelarungrayub, Jirakrit; Pinkaew, Decha; Puntumetakul, Rungthip; Klaphajone, Jakkrit

2017-01-01

The aim of this study was to evaluate the efficiency of a simple prototype device for training respiratory muscles in lung function, respiratory muscle strength, walking capacity, quality of life (QOL), dyspnea, and oxidative stress in patients with COPD. Thirty COPD patients with moderate severity of the disease were randomized into three groups: control (n=10, 6 males and 4 females), standard training (n=10, 4 males and 6 females), and prototype device (n=10, 5 males and 5 females). Respiratory muscle strength (maximal inspiratory pressure [PImax] and maximal expiratory pressure [PEmax]), lung function (forced vital capacity [FVC], percentage of FVC, forced expiratory volume in 1 second [FEV 1 ], percentage of FEV 1 [FEV 1 %], and FEV 1 /FVC), 6-minute walking distance (6MWD), QOL, and oxidative stress markers (total antioxidant capacity [TAC]), glutathione (GSH), malondialdehyde (MDA), and nitric oxide (NO) were evaluated before and after 6 weeks of training. Moreover, dyspnea scores were assessed before; during week 2, 4, and 6 of training; and at rest after training. All parameters between the groups had no statistical difference before training, and no statistical change in the control group after week 6. FVC, FEV 1 /FVC, PImax, PEmax, QOL, MDA, and NO showed significant changes after 6 weeks of training with either the standard or prototype device, compared to pre-training. FEV 1 , FEV 1 %, 6MWD, TAC, and GSH data did not change statistically. Furthermore, the results of significant changes in all parameters were not statistically different between training groups using the standard and prototype device. The peak dyspnea scores increased significantly in week 4 and 6 when applying the standard or prototype device, and then lowered significantly at rest after 6 weeks of training, compared to pre-training. This study proposes that a simple prototype device can be used clinically in COPD patients as a standard device to train respiratory muscles, improving lung function and QOL, as well as involving MDA and NO levels.

Lung Function Impact from Working in the Pre-Revolution Libyan Quarry Industry

PubMed Central

Draid, Marwan M.; Ben-Elhaj, Khaled M.; Ali, Ashraf M.; Schmid, Kendra K.; Gibbs, Shawn G.

2015-01-01

The purpose of this study was to determine the lung impact from working within the Libyan quarry industry, and if the length of work impacted the degree of degradation. Eighty three workers from eight silica quarries in the Nafusa Mountains of Libya opted to participate. These quarries were working the upper cretaceous geological structure. Eighty-five individuals who lived in Gharyan City with no affiliation to quarry operations participated as controls. Spirometry variables evaluated were Forced Vital Capacity (FVC), Forced Expiratory Volume at 1.0 second (FEV1), FVC/FEV1 and Peak Expiratory Flow (PEF). Control and exposed groups had no differences in terms of height, weight, or smoking status (p = 0.18, 0.20, 0.98, respectively). Prior to adjustment for other variables, FVC, FEV1, and PEF are all significantly lower in the exposed group (p = 0.003, 0.009, 0.03, respectively). After adjustment for age, height, weight, and smoking status, there remain significant differences between the control and exposed groups for FVC, FEV1, and PEF. This analysis demonstrated that exposure to quarry dust has a detrimental effect on lung function, and that pre-revolution Libyan quarry workers were being exposed. This study shows that any exposure is harmful, as the reduction in lung function was not significantly associated with years of exposure. PMID:25961801

Acute effects of summer air pollution on respiratory function in primary school children in southern England.

PubMed Central

Scarlett, J F; Abbott, K J; Peacock, J L; Strachan, D P; Anderson, H R

1996-01-01

BACKGROUND: There is growing concern about health effects of air pollution in the UK. Studies in the USA have reported adverse effects on lung function among children but no comparable studies have been published in the UK. This study investigates the relationship between daily changes in ambient air pollution and short term variations in lung function in a panel of school children. METHODS: One hundred and fifty four children aged 7-11 attending a primary school adjacent to a major motorway in Surrey, south-east England, were studied. Bellows spirometry was performed daily on 31 schooldays between 6 June and 21 July 1994. Levels of ozone, nitrogen dioxide, and particulates of less than 10 microns in diameter (PM10) were measured continuously at the school and the pollen count was measured six miles away. Relationships between daily changes in forced expiratory volume in 0.75 seconds (FEV0.75), forced vital capacity (FVC), the FEV0.75/FVC ratio and pollutants were analysed using separate autoregressive models for each child. A weighted average of the resulting slopes was then calculated. RESULTS: There was a significant inverse relationship between daily mean PM10 levels lagged one day and FVC, with a reduction in lung function of 1% (95% CI 0.3% to 2%) across the whole range of PM10 levels (20-150 micrograms/m3). The effect on FEV0.75 was similar (-0.5%) but was not significant when weighted by 1/SE2 (95% CI -1.2% to 0.2%). There was no effect of PM10 levels on the FEV0.75/FVC ratio. No significant association was seen between FEV0.75, FVC, or the FEV0.75/FVC ratio and either ozone or nitrogen dioxide levels. There was no evidence that wheezy children were more affected than healthy children. Pollen levels on the previous day had no effect on lung function and did not change the air pollution results. CONCLUSIONS: There is a very small, but statistically significant, adverse effect of airborne respirable particulate matter, measured as PM10, on lung function in this study group. There is no evidence for an inverse association of lung function with levels of ozone or NO2 measured on the previous day. PMID:8958894

Pulmonary function in advanced uncomplicated singleton and twin pregnancy.

PubMed

Siddiqui, Anwar Hasan; Tauheed, Nazia; Ahmad, Aquil; Mohsin, Zehra

2014-01-01

Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

Improved pulmonary function in working divers breathing nitrox at shallow depths

NASA Technical Reports Server (NTRS)

Fitzpatrick, Daniel T.; Conkin, Johnny

2003-01-01

INTRODUCTION: There is limited data about the long-term pulmonary effects of nitrox use in divers at shallow depths. This study examined changes in pulmonary function in a cohort of working divers breathing a 46% oxygen enriched mixture while diving at depths less than 12 m. METHODS: A total of 43 working divers from the Neutral Buoyancy Laboratory (NBL), NASA-Johnson Space Center completed a questionnaire providing information on diving history prior to NBL employment, diving history outside the NBL since employment, and smoking history. Cumulative dive hours were obtained from the NBL dive-time database. Medical records were reviewed to obtain the diver's height, weight, and pulmonary function measurements from initial pre-dive, first year and third year annual medical examinations. RESULTS: The initial forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were greater than predicted, 104% and 102%, respectively. After 3 yr of diving at the NBL, both the FVC and FEV1 showed a significant (p < 0.01) increase of 6.3% and 5.5%, respectively. There were no significant changes in peak expiratory flow (PEF), forced mid-expiratory flow rate (FEF(25-75%)), and forced expiratory flow rates at 25%, 50%, and 75% of FVC expired (FEF25%, FEF50%, FEF75%). Cumulative NBL dive hours was the only contributing variable found to be significantly associated with both FVC and FEV1 at 1 and 3 yr. CONCLUSIONS: NBL divers initially belong to a select group with larger than predicted lung volumes. Regular diving with nitrox at shallow depths over a 3-yr period did not impair pulmonary function. Improvements in FVC and FEV1 were primarily due to a training effect.

Relationship between birth weight, maternal smoking during pregnancy and childhood and adolescent lung function: A path analysis.

PubMed

Balte, Pallavi; Karmaus, Wilfried; Roberts, Graham; Kurukulaaratchy, Ramesh; Mitchell, Frances; Arshad, Hasan

2016-12-01

Low birth weight and gestational maternal smoking have been linked with reduced lung function in children in many cross sectional studies. However, these associations have not yet been assessed with repeated measurements of lung function. Our aim was to investigate the effects of birth weight, gestational age, and gestational maternal smoking on lung function in children at age 10 and 18 years. In the Isle of Wight birth cohort spirometry was performed at age 10 and 18 years. Information on birth weight and gestational age were obtained from hospital records. Mothers were asked about smoking during pregnancy. We employed linear mixed models to estimate the effect of these risk factors on repeated measurements of lung function. We considered maternal asthma, sex, neonatal intensive care unit admission, height, socio-economic status, personal smoking in participants at age 18, body mass index and environmental tobacco smoke exposure as potential confounders. Finally, we used path analysis to determine links between birth weight, gestational age and gestational maternal smoking on lung function at age 10 and 18 years. Linear mixed models showed that with every 1 kg increase in birth weight, Forced expiratory volume in one second (FEV 1 ) increased by 42.6 ± 17.2 mL and Forced expiratory flow between 25% and 75% (FEF 25-75 ) of Forced vital capacity (FVC) increased by 95.5 ± 41.2 mL at age 18 years after adjusting for potential confounders. Path analysis suggested that birth weight had positive direct effects on FEV 1 and FEF 25-75 and positive indirect effect on FVC at 10 years which were carried forward to 18 years. Additionally, results also suggested a positive association between gestational age and FEV 1 , FVC and FEF 25-75  at ages 10 and 18 years and an inverse association between gestational smoke exposure and FEV 1 /FVC ratio and FEF 25-75  at age 18 years. Higher birth weight and gestational age were associated with higher FEV 1 , FVC and FEF 25-75 and maternal smoking during pregnancy was associated with reduced FEV 1 /FVC ratio and FEF 25-75 . The use of path analysis can improve our understanding of underlying "causal" pathways among different prenatal and childhood factors that affect lung function in both pre-adolescent and adolescent periods. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Genome‐wide linkage analysis of pulmonary function in families of children with asthma in Costa Rica

PubMed Central

Hersh, Craig P; Soto‐Quirós, Manuel E; Avila, Lydiana; Lake, Stephen L; Liang, Catherine; Fournier, Eduardo; Spesny, Mitzi; Sylvia, Jody S; Lazarus, Ross; Hudson, Thomas; Verner, Andrei; Klanderman, Barbara J; Freimer, Nelson B; Silverman, Edwin K; Celedón, Juan C

2007-01-01

Background Although asthma is highly prevalent among certain Hispanic subgroups, genetic determinants of asthma and asthma‐related traits have not been conclusively identified in Hispanic populations. A study was undertaken to identify genomic regions containing susceptibility loci for pulmonary function and bronchodilator responsiveness (BDR) in Costa Ricans. Methods Eight extended pedigrees were ascertained through schoolchildren with asthma in the Central Valley of Costa Rica. Short tandem repeat (STR) markers were genotyped throughout the genome at an average spacing of 8.2 cM. Multipoint variance component linkage analyses of forced expiratory volume in 1 second (FEV1) and FEV1/ forced vital capacity (FVC; both pre‐bronchodilator and post‐bronchodilator) and BDR were performed in these eight families (pre‐bronchodilator spirometry, n = 640; post‐bronchodilator spirometry and BDR, n = 624). Nine additional STR markers were genotyped on chromosome 7. Secondary analyses were repeated after stratification by cigarette smoking. Results Among all subjects, the highest logarithm of the odds of linkage (LOD) score for FEV1 (post‐bronchodilator) was found on chromosome 7q34–35 (LOD = 2.45, including the additional markers). The highest LOD scores for FEV1/FVC (pre‐bronchodilator) and BDR were found on chromosomes 2q (LOD = 1.53) and 9p (LOD = 1.53), respectively. Among former and current smokers there was near‐significant evidence of linkage to FEV1/FVC (post‐bronchodilator) on chromosome 5p (LOD = 3.27) and suggestive evidence of linkage to FEV1 on chromosomes 3q (pre‐bronchodilator, LOD = 2.74) and 4q (post‐bronchodilator, LOD = 2.66). Conclusions In eight families of children with asthma in Costa Rica, there is suggestive evidence of linkage to FEV1 on chromosome 7q34–35. In these families, FEV1/FVC may be influenced by an interaction between cigarette smoking and a locus (loci) on chromosome 5p. PMID:17099076

Association between high-density lipoprotein cholesterol level and pulmonary function in healthy Korean adolescents: the JS high school study.

PubMed

Park, Ji Hye; Mun, Seyeon; Choi, Dong Phil; Lee, Joo Young; Kim, Hyeon Chang

2017-12-11

Accumulating evidence suggests that high-density lipoprotein (HDL) cholesterol is associated with pulmonary function and pulmonary disorders. The aim of this study was to evaluate the association between HDL cholesterol and pulmonary function in healthy adolescents. This cross-sectional study was based on data collected for the JS High School study. The analysis included 644 adolescents (318 male and 326 female) aged 15-16 years old and free from asthma or chronic obstructive pulmonary disease. Fasting blood samples were collected for hematologic and biochemical assessment. Forced vital capacity volume (FVC) and forced expiratory volume in the 1 s (FEV1) were measured using dry-rolling-seal spirometry. The associations between HDL cholesterol and pulmonary function were analyzed using multiple linear regression models. Among male adolescents, an increase of 1.0 mg/dL in HDL cholesterol was associated with 10 mL decrease in FVC (p = 0.013) and FEV1 (p = 0.013) after adjusting for age, height, weight, alcohol drinking, smoking, physical activity, systolic blood pressure, total cholesterol, triglyceride, and monthly household income. Percent predicted values of FVC (p = 0.036) and FEV1 (p = 0.017) were also inversely associated with HDL cholesterol. However, among female adolescents, HDL cholesterol level was not significantly associated with absolute or percent predictive value of FVC and FEV1. Higher HDL cholesterol level may be associated with decreased pulmonary function among healthy male adolescents. The sex differences observed in the association between HDL cholesterol and pulmonary function need further investigation.

Obstructive Airways Disease With Air Trapping Among Firefighters Exposed to World Trade Center Dust

PubMed Central

Weiden, Michael D.; Ferrier, Natalia; Nolan, Anna; Rom, William N.; Comfort, Ashley; Gustave, Jackson; Zeig-Owens, Rachel; Zheng, Shugi; Goldring, Roberta M.; Berger, Kenneth I.; Cosenza, Kaitlyn; Lee, Roy; Webber, Mayris P.; Kelly, Kerry J.; Aldrich, Thomas K.

2010-01-01

Background: The World Trade Center (WTC) collapse produced a massive exposure to respirable particulates in New York City Fire Department (FDNY) rescue workers. This group had spirometry examinations pre-September 11, 2001, and post-September 11, 2001, demonstrating declines in lung function with parallel declines in FEV1 and FVC. To date, the underlying pathophysiologic cause for this has been open to question. Methods: Of 13,234 participants in the FDNY-WTC Monitoring Program, 1,720 (13%) were referred for pulmonary subspecialty evaluation at a single institution. Evaluation included 919 full pulmonary function tests, 1,219 methacholine challenge tests, and 982 high-resolution chest CT scans. Results: At pulmonary evaluation (median 34 months post-September 11, 2001), median values were FEV1 93% predicted (interquartile range [IQR], 83%-101%), FVC 98% predicted (IQR, 89%-106%), and FEV1/FVC 0.78 (IQR, 0.72-0.82). The residual volume (RV) was 123% predicted (IQR, 106%-147%) with nearly all participants having normal total lung capacity, functional residual capacity, and diffusing capacity of carbon monoxide. Also, 1,051/1,720 (59%) had obstructive airways disease based on at least one of the following: FEV1/FVC, bronchodilator responsiveness, hyperreactivity, or elevated RV. After adjusting for age, gender, race, height and weight, and tobacco use, the decline in FEV1 post-September 11, 2001, was significantly correlated with increased RV percent predicted (P < .0001), increased bronchodilator responsiveness (P < .0001), and increased hyperreactivity (P = .0056). CT scans demonstrated bronchial wall thickening that was significantly associated with the decline in FEV1 post-September 11, 2001 (P = .024), increases in hyperreactivity (P < .0001), and increases in RV (P < .0001). Few had evidence for interstitial disease. Conclusions: Airways obstruction was the predominant physiologic finding underlying the reduction in lung function post-September 11, 2001, in FDNY WTC rescue workers presenting for pulmonary evaluation. PMID:19820077

Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood: follow-up of a double-blind randomised controlled trial in Nepal

PubMed Central

Devakumar, D; Stocks, J; Ayres, JG; Kirkby, J; Yadav, SK; Saville, NM; Devereux, G; Wells, JCK; Manandhar, DS; Costello, A; Osrin, D

2015-01-01

A randomised trial of prenatal multiple micronutrient supplementation in Nepalese women increased birthweight and weight at two years of age in offspring, compared with those born to mothers who only received iron and folic acid supplements. Further follow-up of this cohort provided an opportunity to investigate the effect of antenatal multiple micronutrients on subsequent lung function, by measuring spirometry at 7-9 years of age in children born in the trial. 841 children (80% of the cohort) were seen at mean (SD) 8.5 (0.4) years. Technically successful spirometry results were obtained in 793 children (94.3%), 50% of whom had been randomised to micronutrient supplementation. Background characteristics, including anthropometry, were similar in the two allocation groups. Lung function was also similar, mean (95%CI) difference in z-scores (supplementation – control) being −0.08 (−0.19, 0.04) for FEV1; −0.05 (−0.17, 0.06) for FVC and −0.04 (−0.15, 0.07) for FEV1/FVC. Compared with healthy White children, FEV1 and FVC in the ‘healthy’ Nepalese children were ~1 z-score (~13%) lower, with no difference in FEV1/FVC. We conclude that, compared with routine iron and folic acid, multiple micronutrient supplementation during pregnancy has no effect on spirometric lung function in Nepalese children at 8.5 years of age. PMID:25700386

Drillers and mill operators in an open-pit gold mine are at risk for impaired lung function.

PubMed

Vinnikov, Denis

2016-01-01

Occupational studies of associations of exposures with impaired lung function in mining settings are built on exposure assessment and far less often on workplace approach, so the aim of this study was to identify vulnerable occupational groups for early lung function reduction in a cohort of healthy young miners. Data from annual screening lung function tests in gold mining company in Kyrgyzstan were linked to occupations. We compared per cent predicted forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC between occupational groups and tested selected occupations in multivariate regression adjusted for smoking and work duration for the following outcomes: FEV1 < 80 %, FEV1/FVC < 70 % and both. 1550 tests of permanent workers of 41 occupations (mean age 40.5 ± 9.2 years, 29.8 % never smokers) were included in the analysis. The mean overall VC was 103.0 ± 12.9 %; FVC 109.1 ± 13.0 % and FEV1 100.2 ± 25.9 %. Drillers and smoking food handlers had the lowest FEV1%. In non-smokers, the lowest FEV1 was in drillers (94.9 ± 11.3 % compared to 115.2 ± 17.7 % in engineers). Drillers (adjusted odds ratio (OR) 1.53 (95 % confidence interval (CI) 1.11-2.09)) and mill operators (OR 2.01 (1.13-3.57)) were at greater risk of obstructive ventilation pattern (FEV1/FVC < 70 %). Drilling and mill operations are the highest risk jobs in an open-pit mine for reduced lung function. Occupational medical clinic at site should follow-up workers in these occupations with depth and strongly recommend smoking cessation.

An implication of the short physical performance battery (SPPB) as a predictor of abnormal pulmonary function in aging people.

PubMed

Choi, Ho-Chun; Son, Ki Young; Cho, Belong; Park, Sang Min; Cho, Sung-Il

2012-01-01

If association between the decline in physical performance and the decline in pulmonary function is confirmed, the SPPB could be used as a predictor for pulmonary functional declines in aging people because of its convenient use. This study aimed to elucidate the association of the SPPB with the pulmonary function test (PFT) to determine the usefulness of the SPPB as a predictor of PFT decline. The SPPB and PFT were performed on random sample nested in the Korean Longitudinal Study of Aging (KLoSA) panel, a national representative sample of aging people in Korea. Comparisons of adjusted means of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory ratio (FER) defined as FEV1/FVC between normal and abnormal SPPB groups were performed using the t-test. The association between PFT and SPPB abnormality was examined using multiple logistic regression analysis. Additionally, the associations of gait speed and chair stand time with FEV1 and FVC were examined using multiple linear regression analysis. Five hundred and eighteen subjects were included in analysis. Approximately 43% (222/518) of the subjects were male and 65% (338/518) were 60 years or older. Adjusted means of FEV1 and FER were significantly or marginally lower when SPPB score was abnormal in both overall and non-smoking men (p=0.009 and 0.053 for overall, p<0.001 and p<0.080 for non-smokers), but FVC was lower only in non-smoking men (p=0.024). Abnormal SPPB score was significantly associated with abnormal PFT regardless of sex. (adjusted odds ratio=OR=3.76, 95%CI=1.96-7.22 for men, adjusted OR=2.11, 95%CI 1.28-3.47 for women). Gait speed was significantly or marginally associated with FEV1 and FVC in participants 60 years or older, regardless of sex. We conclude that abnormal SPPB score was associated with abnormal pulmonary function. Thus, the SPPB has the potential to be used as an early predictor of abnormal pulmonary function in clinical settings and epidemiological study. Copyright © 2011. Published by Elsevier Ireland Ltd.

A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria.

PubMed

Dilektasli, Asli Gorek; Porszasz, Janos; Casaburi, Richard; Stringer, William W; Bhatt, Surya P; Pak, Youngju; Rossiter, Harry B; Washko, George; Castaldi, Peter J; Estepar, Raul San Jose; Hansen, James E

2016-11-01

In chronic obstructive pulmonary disease, both smaller and larger airways are affected. FEV 1 mainly reflects large airways obstruction, while the later fraction of forced exhalation reflects reduction in terminal expiratory flow. In this study, the objective was to evaluate the relationship between spirometric ratios, including the ratio of forced expiratory volume in 3 and 6 seconds (FEV 3 /FEV 6 ), and small airways measures and gas trapping at quantitative chest CT scanning, and clinical outcomes in the Genetic Epidemiology of COPD (COPDGene) cohort. Seven thousand eight hundred fifty-three current and ex-smokers were evaluated for airflow obstruction by using recently defined linear iteratively derived equations of Hansen et al to determine lower limit of normal (LLN) equations for prebronchodilator FEV 1 /FVC, FEV 1 /FEV 6 , FEV 3 /FEV 6 , and FEV 3 /FVC. General linear and ordinal regression models were applied to the relationship between prebronchodilator spirometric and radiologic and clinical data. Of the 10,311 participants included in the COPDGene phase I study, participants with incomplete quantitative CT scanning or relevant spirometric data were excluded, resulting in 7,853 participants in the present study. Of 4,386 participants with FEV 1 /FVC greater than or equal to the LLN, 15.4% had abnormal FEV 3 /FEV 6 . Compared with normal FEV 3 /FEV 6 and FEV 1 /FVC, abnormal FEV 3 /FEV 6 was associated with significantly greater gas trapping; St. George's Respiratory Questionnaire score; modified Medical Research Council dyspnea score; and BMI, airflow obstruction, dyspnea, and exercise index and with shorter 6-min walking distance (all P < .0001) but not with CT scanning evidence of emphysema. Current and ex-smokers with prebronchodilator FEV 3 /FEV 6 less than the LLN as the sole abnormality identifies a distinct population with evidence of small airways disease in quantitative CT scanning, impaired indexes of physical function and quality of life otherwise deemed normal by using the current spirometric definition. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Native American ancestry, lung function, and COPD in Costa Ricans.

PubMed

Chen, Wei; Brehm, John M; Boutaoui, Nadia; Soto-Quiros, Manuel; Avila, Lydiana; Celli, Bartolome R; Bruse, Shannon; Tesfaigzi, Yohannes; Celedón, Juan C

2014-04-01

Whether Native American ancestry (NAA) is associated with COPD or lung function in a racially admixed Hispanic population is unknown. We recruited 578 Costa Ricans with and without COPD into a hybrid case-control/family-based cohort, including 316 members of families of index case subjects. All participants completed questionnaires and spirometry and gave a blood sample for DNA extraction. Genome-wide genotyping was conducted with the Illumina Human610-Quad and HumanOmniExpress BeadChip kits (Illumina Inc), and individual ancestral proportions were estimated from these genotypic data and reference panels. For unrelated individuals, linear or logistic regression was used for the analysis of NAA and COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stage II or greater) or lung function. For extended families, linear mixed models and generalized estimating equations were used for the analysis. All models were adjusted for age, sex, educational level, and smoking behavior; models for FEV1 were also adjusted for height. The average proportion of European, Native American, and African ancestry among participants was 62%, 35%, and 3%, respectively. After adjustment for current smoking and other covariates, NAA was inversely associated with COPD (OR per 10% increment, 0.55; 95% CI, 0.41-0.75) but positively associated with FEV1, FVC, and FEV1/FVC. After additional adjustment for pack-years of smoking, the association between NAA and COPD or lung function measures was slightly attenuated. We found that about 31% of the estimated effect of NAA on COPD is mediated by pack-years of smoking. NAA is inversely associated with COPD but positively associated with FEV1 or FVC in Costa Ricans. Ancestral effects on smoking behavior partly explain the findings for COPD but not for FEV1 or FVC.

Native American Ancestry, Lung Function, and COPD in Costa Ricans

PubMed Central

Chen, Wei; Brehm, John M.; Boutaoui, Nadia; Soto-Quiros, Manuel; Avila, Lydiana; Celli, Bartolome R.; Bruse, Shannon; Tesfaigzi, Yohannes

2014-01-01

Background: Whether Native American ancestry (NAA) is associated with COPD or lung function in a racially admixed Hispanic population is unknown. Methods: We recruited 578 Costa Ricans with and without COPD into a hybrid case-control/family-based cohort, including 316 members of families of index case subjects. All participants completed questionnaires and spirometry and gave a blood sample for DNA extraction. Genome-wide genotyping was conducted with the Illumina Human610-Quad and HumanOmniExpress BeadChip kits (Illumina Inc), and individual ancestral proportions were estimated from these genotypic data and reference panels. For unrelated individuals, linear or logistic regression was used for the analysis of NAA and COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stage II or greater) or lung function. For extended families, linear mixed models and generalized estimating equations were used for the analysis. All models were adjusted for age, sex, educational level, and smoking behavior; models for FEV1 were also adjusted for height. Results: The average proportion of European, Native American, and African ancestry among participants was 62%, 35%, and 3%, respectively. After adjustment for current smoking and other covariates, NAA was inversely associated with COPD (OR per 10% increment, 0.55; 95% CI, 0.41-0.75) but positively associated with FEV1, FVC, and FEV1/FVC. After additional adjustment for pack-years of smoking, the association between NAA and COPD or lung function measures was slightly attenuated. We found that about 31% of the estimated effect of NAA on COPD is mediated by pack-years of smoking. Conclusions: NAA is inversely associated with COPD but positively associated with FEV1 or FVC in Costa Ricans. Ancestral effects on smoking behavior partly explain the findings for COPD but not for FEV1 or FVC. PMID:24306962

Pulmonary function and adverse cardiovascular outcomes: Can cardiac function explain the link?

PubMed

Burroughs Peña, Melissa S; Dunning, Allison; Schulte, Phillip J; Durheim, Michael T; Kussin, Peter; Checkley, William; Velazquez, Eric J

2016-12-01

The complex interaction between pulmonary function, cardiac function and adverse cardiovascular events has only been partially described. We sought to describe the association between pulmonary function with left heart structure and function, all-cause mortality and incident cardiovascular hospitalization. This study is a retrospective analysis of patients evaluated in a single tertiary care medical center. We used multivariable linear regression analyses to examine the relationship between FVC and FEV1 with left ventricular ejection fraction (LVEF), left ventricular internal dimension in systole and diastole (LVIDS, LVIDD) and left atrial diameter, adjusting for baseline characteristics, right ventricular function and lung hyperinflation. We also used Cox proportional hazards models to examine the relationship between FVC and FEV1 with all-cause mortality and cardiac hospitalization. A total of 1807 patients were included in this analysis with a median age of 61 years and 50% were female. Decreased FVC and FEV1 were both associated with decreased LVEF. In individuals with FVC less than 2.75 L, decreased FVC was associated with increased all-cause mortality after adjusting for left and right heart echocardiographic variables (hazard ratio [HR] 0.49, 95% CI 0.29, 0.82, respectively). Decreased FVC was associated with increased cardiac hospitalization after adjusting for left heart size (HR 0.80, 95% CI 0.67, 0.96), even in patients with normal LVEF (HR 0.75, 95% CI 0.57, 0.97). In a tertiary care center reduced pulmonary function was associated with adverse cardiovascular events, a relationship that is not fully explained by left heart remodeling or right heart dysfunction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Air pollution and environmental risk factors for altered lung function among adult women of an urban slum area of Delhi: A prevalence study.

PubMed

Arora, Shweta; Rasania, S K; Bachani, D; Gandhi, Asha; Chhabra, S K

2018-01-01

Household and ambient air pollution are jointly responsible for about 7 million premature deaths annually. Women living in slums, with unhealthy environment, both indoors and outdoors, particularly those living close to industrial and/or vehicular pollution zones due to multiple sources of air pollution, are at the higher risk of having impaired lung function tests. The aim of this study was to estimate the prevalence of abnormal lung functions and to identify the environmental risk factors associated with them among adult women of 18-59 years. A total of 550 women aged 18-59 years were approached in a representative urban slum. Five hundred consented to participate and 299 had prebronchodilator spirometry satisfying ATS standards. House visits to assess environmental conditions were conducted to determine their association with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Chi-square test was used to test the association of risk factors with lung functions. ANOVA was used to test the association of mean values of FEV1 and FVC with age. Out of 299 participants with acceptable spirometric curves, 5% had reduced FEV1/FVC ratio than the normal and 26.8% and 17.4% had lower values than predicted for FVC and FEV1, respectively. Altered lung function was related to age, tobacco smoking, and history of respiratory disease. Both ambient and household air pollution have a deleterious pulmonary effect on long-term women residents of a representative urban slum in Delhi.

Air pollution and respiratory health among diabetic and non-diabetic subjects in Pune, India-results from the Wellcome Trust Genetic Study.

PubMed

Khafaie, Morteza Abdullatif; Salvi, Sundeep Santosh; Yajnik, Chittaranjan Sakerlal; Ojha, Ajay; Khafaie, Behzad; Gore, Sharad Damodar

2017-06-01

Diabetics may be more vulnerable to the harmful effects of ambient air pollutants than healthy individuals. But, the risk factors that lead to susceptibility to air pollution in diabetics have not yet been identified. We examined the effect of exposure to ambient PM 10 on chronic symptoms and the pulmonary function tests (PFT) in diabetic and non-diabetic subjects. Also, to investigate possible determinants of susceptibility, we recruited 400 type 2 diabetic and 465 healthy subjects who were investigated for chronic respiratory symptoms (CRSs) and then underwent measurement of forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) according to standard protocol. Percent predicted FEV1 and FVC (FEV1% and FVC%, respectively) for each subject were calculated. Particulate matter (PM 10 ) concentrations at residence place of subjects were estimated using AERMOD dispersion model. The association between PM 10 and CRSs was explored using logistic regression. We also used linear regression models controlling for potential confounders to study the association between chronic exposure to PM 10 and FEV1% and FVC%. Prevalence of current wheezing, allergy symptom, chest tightness, FEV1/FVC <70%, and physician-diagnosed asthma and COPD was significantly higher among diabetic subjects than non-diabetics. There was no significant difference between percent predicted value of PFT among diabetic and non-diabetic subjects (P < 0.05). We estimated that 1 SD increase in PM 10 concentration was associated with a greater risk of having dyspnea by 1.50-fold (95% CI, 1.12-2.01). Higher exposure to PM 10 concentration was also significantly associated with lower FVC%. The size of effect for 1 SD μg/m 3 (=98.38) increase in PM 10 concentration was 3.71% (95% CI, 0.48-4.99) decrease in FVC%. In addition, we indicated that strength of these associations was higher in overweight, smoker, and aged persons. We demonstrated a possible contribution of air pollution to reduced lung function independent of diabetes status. This study suggests that decline in exposure may significantly reduce disease manifestation as dyspnea and impaired lung function. We conduct that higher BMI, smoking, and older age were associated with higher levels of air pollution effects.

Ventilatory function in rubber processing workers: acute changes over the workshift.

PubMed

Governa, M; Comai, M; Valentino, M; Antonicelli, L; Rinaldi, F; Pisani, E

1987-02-01

When considering rubber tyre manufacturing from an occupational health viewpoint, three areas may be identified in which exposure to respirable materials are potentially harmful: the processing, curing, and talc areas. A study of the ventilatory function of the entire work force employed in the processing area in a rubber tyre manufacturing plant was undertaken to determine whether an acute reduction in lung function occurs over the course of their working shift (the plant worked a three shift system) and whether a chronic exposure to the occupational airborne contaminants causes permanent changes in lung function. The ventilatory function was measured at the worksite at the beginning and immediately after the end of the workshift. No evidence of chronic obstructive pulmonary disease was found and in most cases no significant decline in FEV1 was observed. Only one of the 79 individuals showed a moderate obstruction, measured by the ratio FEV1/FVC which gave the value of 0.55, with no variation over the shift. For non-smokers, the FVC, FEV1, and FEF25-75% were lower in those exposed for more than five years than in those exposed for five years or less. A similar pattern was also observed in the FVC and FEV1 of the smokers. None of these differences was statistically significant. Within each exposure group the pulmonary function of the smokers was lower than that of the non-smokers, but the only significant difference was found in the values of FEF25-75%. Only one man showed a decline in the FEV1/FVC ratio over the shift, but during each shift, a decrease in all the lung function tests was observed. The decrease was smallest during the first of the three shifts. These results are thought to support the hypothesis that there are acute adverse effects over an eight hour shift. Further investigations are needed to discover whether these acute changes in lung function result from a chemical stimulation or irritant receptors in the airways.

Lung function status of some Nigerian men and women chronically exposed to fish drying using burning firewood.

PubMed

Peters, E J; Esin, R A; Immananagha, K K; Siziya, S; Osim, E E

1999-05-01

To determine the lung function status of some Nigerian men and women chronically exposed to fish drying using burning firewood. Case control study. Ibaka, Utaewa and Ikanga fishing settlements. 183 males and 192 females engaged in fishing, aged 20 to 45 years who have been exposed for a minimum of five years as cases. The control group comprised sex matched male (142) and female (152) Nigerians from the same area who were not exposed to any known air pollutant. Lung function indices: FVC, FEV1, FEV1% and PEFR. Lung function indices were significantly lower in men engaged in fishing than in their controls: FVC [mean (SD): 2.98 (0.20) vs 3.52 (0.29), p < 0.001]; FEV1 [2.08 (0.18) vs 2.82 (0.25), p < 0.001]; FEV1% [69.8 (3.1) vs 80.2 (6.7), p < 0.001]; and PEFR [335 (22) vs 592 (99), p < 0.001], respectively. Similarly, lung function indices were lower in females in the fishing industry than in their controls; FVC [2.42 (0.17) vs 3.02 (0.24), p < 0.001]; FEV1 [1.70 (0.19) vs 2.55 (0.21), p < 0.001]; FEV1% [72.9 (3.2) vs 84.4 (6.7), p < 0.001]; and PEFR [298 (22) vs 418 (34), p < 0.001]. All the lung function indices (except FEV1%) of the fishermen and women declined significantly (p < 0.001) with their duration of exposure. The results showed a predominantly mixed pattern (restrictive and obstructive) of respiratory defect. There were higher prevalences of respiratory and other symptoms among the cases than the controls. The respiratory symptoms included cough with sputum, chest pain, dyspnoea catarrh and sneezing and unproductive cough. Other symptoms were eye and skin irritation, internal heat and headache. Chronic exposure to fish drying using burning firewood can impair lung function and cause respiratory and other symptoms.

Pulmonary function improvement after vertebral column resection for severe spinal deformity.

PubMed

Bumpass, David B; Lenke, Lawrence G; Bridwell, Keith H; Stallbaumer, Jeremy J; Kim, Yongjung J; Wallendorf, Michael J; Min, Woo-Kie; Sides, Brenda A

2014-04-01

Retrospective review of prospectively accrued cohorts. We hypothesized that posterior-only vertebral column resection (PVCR) would result in improved postoperative pulmonary function, avoiding pulmonary insults from combined anterior/posterior approaches. Pulmonary function after PVCR for severe spinal deformity has not been previously studied. Previous studies have demonstrated impaired pulmonary performance after combined anterior/posterior fusions. Serial pulmonary function testing (PFTs) in 49 patients (27 pediatric, 22 adult) who underwent PVCR at a single institution was reviewed. Mean age at surgery was 28.7 years (range, 8-74 yr), and mean follow-up was 32 months (range, 23-64 mo). Thoracic PVCRs (T5-T11) were performed in 31 patients and thoracolumbar PVCRs (T12-L5) in 18 patients. Pediatric patients who underwent PVCR experienced both increased mean forced vital capacity (FVC) (2.10-2.43 L, P = 0.0005) and forced expiratory volume in 1 second (FEV1) (1.71-1.98 L, P = 0.001). There were no significant differences in percent-predicted values for FVC (69%-66%, P = 0.51) or FEV1 (64%-63%, P = 0.77). In adult patients, there were no significant changes in FVC (2.73-2.61 L, P = 0.35) or FEV1 (2.22-2.07 L, P = 0.51) after PVCR; also, changes in adult percent-predicted values for FVC (79%-76%, P = 0.47) and FEV1 (78%-74%, P = 0.40) were not significant. In pediatric patients who underwent PVCR, improved PFTs were correlated with younger age (P = 0.02), diagnosis of angular kyphosis (P ≤ 0.0001), no previous spine surgery (P = 0.04), and preoperative halo-gravity traction (P = 0.02). Comparison of PFT changes between patients who underwent PVCR and a control group who underwent combined anterior/posterior approaches revealed no significant differences. In pediatric patients, PVCR resulted in small but significant improvements in postoperative FVC and FEV1. In adult patients, no significant increases in PFTs were found. Patients who have the greatest potential for lung and thoracic cage growth after spinal correction are most likely to have improved pulmonary function after PVCR.

Effect of isoprenaline and cigarette smoking on airways.

PubMed

Mahajan, K K; Reghunandan, V; Maini, B K; Mahajan, S K

1983-01-01

After two hours of abstinence from smoking pulmonary functions were assessed in twenty-seven asymptomatic male smokers by spirometry and Wright Peak Flow Meter, recording FVC, FEV1, FEV1%, FEF25-75%, and FEF75-85% of FVC, MVV and PEFR. These tests were repeated immediately after smoking and again after one hr. Only PEFR decreased significantly (P less than 0.01) and returned to nearly basal level after one hr. Sixteen of these smokers were subjected to further study. Isoprenaline inhalation in these smokers caused a significant improvement in most of the flow rates. Smoking of cigarettes at this stage decreased flow rates. After one hr the effect of smoking was over and most of the parameters were between basal and post-isoprenaline levels. Smoking affects the flow rates more than other parameters. An improvement in FEV1, FEV1%, FEF25-75% and FEF75-85% of FVC, after bronchodilator inhalation suggests the presence of some reversible bronchoconstriction specially of smaller airways basically present in chronic smokers.

Influence of stapling the intersegmental planes on lung volume and function after segmentectomy.

PubMed

Tao, Hiroyuki; Tanaka, Toshiki; Hayashi, Tatsuro; Yoshida, Kumiko; Furukawa, Masashi; Yoshiyama, Koichi; Okabe, Kazunori

2016-10-01

Dividing the intersegmental planes with a stapler during pulmonary segmentectomy leads to volume loss in the remnant segment. The aim of this study was to assess the influence of segment division methods on preserved lung volume and pulmonary function after segmentectomy. Using image analysis software on computed tomography (CT) images of 41 patients, the ratio of remnant segment and ipsilateral lung volume to their preoperative values (R-seg and R-ips) was calculated. The ratio of postoperative actual forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) per those predicted values based on three-dimensional volumetry (R-FEV1 and R-FVC) was also calculated. Differences in actual/predicted ratios of lung volume and pulmonary function for each of the division methods were analysed. We also investigated the correlations of the actual/predicted ratio of remnant lung volume with that of postoperative pulmonary function. The intersegmental planes were divided by either electrocautery or with a stapler in 22 patients and with a stapler alone in 19 patients. Mean values of R-seg and R-ips were 82.7 (37.9-140.2) and 104.9 (77.5-129.2)%, respectively. The mean values of R-FEV1 and R-FVC were 103.9 (83.7-135.1) and 103.4 (82.2-125.1)%, respectively. There were no correlations between the actual/predicted ratio of remnant lung volume and pulmonary function based on the division method. Both R-FEV1 and R-FVC were correlated not with R-seg, but with R-ips. Stapling does not lead to less preserved volume or function than electrocautery in the division of the intersegmental planes. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Acute respiratory effects on workers exposed to metalworking fluid aerosols in an automotive transmission plant.

PubMed

Robins, T; Seixas, N; Franzblau, A; Abrams, L; Minick, S; Burge, H; Schork, M A

1997-05-01

Exposure to metalworking fluids has been linked to modest cross-shift reductions in FEV1 and occupational asthma. To identify responsible agents, we measured personal exposures to thoracic particulate (TP), viable plus nonviable thoracic bacteria (BAC), and vapor phase nicotine (VPN) (as a surrogate for tobacco particulate) among 83 machinists exposed to soluble oils and 46 dry assemblers working in an automotive transmission machining plant using biocides infrequently. The participants completed interviews and performed pre- and postshift spirometry on Monday and Thursday of the same week in each of three rounds of data collection (June 1992, January 1993, June 1993). Generalized estimating equations were used to combine information across rounds in multiple regression models of cross-shift and cross-week changes in forced expiratory volume, I second (FEV1) and forced vital capacity (FVC). Mean seniority was 19 years among machinists. Mean personal TP levels were 0.41 mg/m3 in machinists and 0.13 mg/m3 in assemblers. Six of the 83 machinists and none of the 46 assemblers experienced a greater than 19% cross-shift decrement in FEV1 or FVC at least once (p = .07). In regression models using either TP or BAC, among subjects with lower baseline (Monday preshift) FEV1/FVC ratios, increasing exposure was significantly associated with increasing cross-shift decrements in FEV1 and FVC in linear models, and with increased likelihood of a 10% or greater cross-shift decrement in FEV1 or FVC in logistic models. Adjustment of TP for VPN did not affect models significantly. We conclude that clinically important cross-shift decrements in pulmonary function are associated with exposure to metalworking fluid aerosols within a high-seniority population.

Pulmonary functions in tannery workers--a cross sectional study.

PubMed

Chandrasekaran, Vasanthi; Dilara, K; Padmavathi, R

2014-01-01

Tannery workers are at potential exposure to detrimental agents rendering them vulnerable to respiratory and dermal problems. Thus by performing pulmonary functions among leather tannery workers, we can decipher the effect of chromium and leather dust on lung functions and also the decline of respiratory functions with increasing years of exposure to leather dust. Pulmonary functions were assessed for 130 tannery workers and compared with the 130 unexposed office workers. Pulmonary function measurements namely FVC, FEV1, FEF25-75% and PEFR were measured using portable data logging Spirometer (KOKO Spirometer). The observed pulmonary functions of Tannery-workers in this study showed a reduction in FEV1, FVC, FEV1/FVC ratio, FEF25-75 and PEFR in relation to their predicted values and also compared to the unexposed. Smokers showed a decline in pulmonary functions compared to the non smokers because smoking acts as an additional risk factor in the development of respiratory illnesses. It is worthy to mention that the pulmonary function values correlate negatively with the duration of exposure to leather dust. So this study could provide base line information based upon which legal implementation of preventive measures could be undertaken.

[Impaired lung function in patients with moderate chronic obstructive bronchitis].

PubMed

Nefedov, V B; Popova, L A; Shergina, E A

2004-01-01

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, RV, Raw, Rin, Rex, DLCO-SS, paO2 and paCO2 were determined in 22 patients with moderate chronic obstructive bronchitis (FEV1, 79-50% of the normal value). All the patients were found to have impaired bronchial patency, 90.9% of the patients had lung volume and capacity changes; pulmonary gas exchange dysfunction was present in 72.7%. Bronchial patency impairments were manifested by a decrease in FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, and an increase in Raw, Rin, Rex. Changes in the lung volumes and capacities appeared as higher RV, TGV, TLC, lower VC and FVC. Pulmonary gas exchange dysfunction showed up as a reduction in pO2 and DLCO-SS a reduction and an increase in paCO2. The magnitude of the functional changes observed in most patients was low. Significant and pronounced disorders were seen in one third of the patients.

African ancestry and lung function in Puerto Rican children.

PubMed

Brehm, John M; Acosta-Pérez, Edna; Klei, Lambertus; Roeder, Kathryn; Barmada, Michael M; Boutaoui, Nadia; Forno, Erick; Cloutier, Michelle M; Datta, Soma; Kelly, Roxanne; Paul, Kathryn; Sylvia, Jody; Calvert, Deanna; Thornton-Thompson, Sherell; Wakefield, Dorothy; Litonjua, Augusto A; Alvarez, María; Colón-Semidey, Angel; Canino, Glorisa; Celedón, Juan C

2012-06-01

Puerto Rican and African American subjects share a significant proportion of African ancestry. Recent findings suggest that African ancestry influences lung function in African American adults. We sought to examine whether a greater proportion of African ancestry is associated with lower FEV(1) and forced vital capacity (FVC) in Puerto Rican children independently of socioeconomic status, health care access, or key environmental/lifestyle factors. We performed a cross-sectional case-control study of 943 Puerto Rican children aged 6 to 14 years with (n= 520) and without (n= 423) asthma (defined as physician-diagnosed asthma and wheeze in the prior year) living in Hartford, Connecticut (n= 383), and San Juan, Puerto Rico (n= 560). We estimated the percentage of African racial ancestry in study participants using genome-wide genotypic data. We tested whether African ancestry is associated with FEV(1) and FVC using linear regression. Multivariate models were adjusted for indicators of socioeconomic status and health care and selected environmental/lifestyle exposures. After adjustment for household income and other covariates, each 20% increment in African ancestry was significantly associated with lower prebronchodilator FEV(1) (-105 mL; 95% CI, -159 to -51 mL; P< .001) and FVC (-133 mL; 95% CI, -197 to -69 mL; P< .001) and postbronchodilator FEV(1) (-152 mL; 95% CI, -210 to -94 mL; P< .001) and FVC (-145 mL; 95% CI, -211 to -79 mL; P< .001) in children with asthma. Similar but weaker associations were found for prebronchodilator and postbronchodilator FEV(1) (change for each 20% increment in African ancestry, -78 mL; 95% CI, -131 to -25 mL; P= .004) and for postbronchodilator FVC among children without asthma. Genetic factors, environmental/lifestyle factors, or both correlated with African ancestry might influence childhood lung function in Puerto Rican subjects. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

African Ancestry and Lung Function in Puerto Rican Children

PubMed Central

Brehm, John M.; Acosta-Pérez, Edna; Klei, Lambertus; Roeder, Kathryn; Barmada, Michael; Boutaoui, Nadia; Forno, Erick; Cloutier, Michelle; Datta, Soma; Kelly, Roxanne; Paul, Kathryn; Sylvia, Jody; Calvert, Deanna; Thornton-Thompson, Sherell; Wakefield, Dorothy; Litonjua, Augusto A.; Alvarez, María; Colón-Semidey, Angel; Canino, Glorisa; Celedón, Juan C.

2012-01-01

Background Puerto Ricans and African Americans share a significant proportion of African ancestry. Recent findings suggest that African ancestry influences lung function in African American adults. Objective To examine whether a greater proportion of African ancestry is associated with lower FEV1 and FVC in Puerto Rican children, independently of socioeconomic status (SES), healthcare access or key environmental/lifestyle (EL) factors. Methods Cross-sectional case-control study of 943 Puerto Rican children ages 6 to 14 years with (n=520) and without (n=423) asthma (defined as physician-diagnosed asthma and wheeze in the prior year) living in Hartford (CT, n=383) and San Juan (PR, n=560). We estimated the percentage of African racial ancestry in study participants using genome-wide genotypic data. We tested whether African ancestry is associated with FEV1 and FVC using linear regression. Multivariate models were adjusted for indicators of SES and healthcare, and selected EL exposures. Results After adjustment for household income and other covariates, each 20% increment in African ancestry was significantly associated with lower pre-bronchodilator(BD) FEV1 (−105 ml, 95% confidence interval [CI] = −159 ml to −51 ml, P <0.001) and FVC (−133 ml, 95% CI −197 ml to −69 ml, P <0.001), and post-BD FEV1 (−152 ml, 95% CI=−210 ml to −94 ml, P <0.001) and FVC (−145 ml, 95% CI= −211 to −79 ml, P <0.001) in children with asthma. Similar but weaker associations were found for pre- and post-BD FEV1 (change for each 20% increment in African ancestry= −78 ml, 95% CI= −131 to −25 ml, P=0.004), and for post-BD FVC among children without asthma. Conclusions Genetic and/or EL factors correlated with African ancestry may influence childhood lung function in Puerto Ricans. PMID:22560959

Post-tuberculous lung function impairment in a tuberculosis reference clinic in Cameroon.

PubMed

Mbatchou Ngahane, Bertrand Hugo; Nouyep, Junior; Nganda Motto, Malea; Mapoure Njankouo, Yacouba; Wandji, Adeline; Endale, Mireille; Afane Ze, Emmanuel

2016-05-01

After completion of treatment, a proportion of pulmonary TB (pTB) patients experience lung function impairment which can influence their quality of life. This study aimed to determine the prevalence of lung function impairment in patients treated for pTB and investigate its associated factors. A cross-sectional study was conducted in TB clinic of the Douala Laquintinie Hospital in Cameroon. Patients aged 15 and above who were treated for pTB between 2008 and 2012 were included in the study. Demographic data, respiratory symptoms prior TB diagnosis, comorbidities and chest radiography findings prior to TB treatment were collected. All participants underwent spirometric measurements. Airflow obstruction was defined as a post-bronchodilation FEV1/FVC <70% with FVC >80%, restrictive defects as an FEV1/FVC ratio of ≥70% with an FVC <80% predicted, and mixed defects as FVC of <80% predicted and an FEV1/FVC ratio of <70%. Lung function impairment was defined by the presence of at least one of these three abnormalities. Logistic regression analysis was employed to investigate risk factors of lung function impairment. Of a total of 269 participants included in the study, 146 (54.3%) were male. The median age of participants was 33 years. The median duration of symptoms before diagnosis of TB was 4 weeks [interquartile range (IQR) 3-8]. The prevalence of lung function impairment was 45.4% (95% CI 39-51). The multivariate analysis identified duration of symptoms [OR 1.08; 95% CI (1.01-1.15)] and fibrotic pattern [OR 3.54; 95% CI (1.40-8.95)] as independent risk factors for lung function impairment. Post-tuberculous pulmonary function impairment is frequent in Douala. Sensitization of patient with symptoms of pulmonary TB for an earlier visit to healthcare facilities could reduce the impact of pTB on lung function of patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pulmonary effects of active smoking and secondhand smoke exposure among adolescent students in Juárez, Mexico.

PubMed

Bird, Yelena; Staines-Orozco, Hugo

2016-01-01

Youth smoking trends among Latin American countries, including Mexico, are on the rise. Notably, although the high prevalence of smoking in teens has been well documented in the literature, few studies have evaluated the impact of smoking and secondhand smoke (SHS) exposure on their respiratory system. To investigate the effects of smoking and SHS exposure on the respiratory health and lung function among eighth-grade students in Juárez, Mexico. A cross-sectional study was undertaken on a sample of convenience. The study outcomes centered on evaluating 300 students' lung function by spirometry (forced expiratory volume in 1 second [FEV1], forced expiratory volume in 1 second/forced vital capacity ratio [FEV1/FVC], and forced mid-expiratory flow rate [FEF25%-75%]) and their respiratory health (smoking behavior and SHS exposure) by their self-reported responses to a standardized respiratory questionnaire. The study outcomes were compared among three distinct groups: 1) nonsmokers/nonexposed to SHS; 2) nonsmokers/exposed to SHS; and 3) smokers. The majority of the study participants were 14 years old (85%), females (54%), who attended eighth grade in a public school setting (56%). Approximately, half reported being of low socioeconomic status (49%) and nonsmokers/exposed to SHS (49%). The lung function parameters of smokers were found to be lower (FEV1 =62.88±10.25; FEV1/FVC =83.50±14.15; and FEF25%-75% =66.35±12.55) than those recorded for the nonsmokers/exposed to SHS (FEV1 =69.41±11.35; FEV1/FVC =88.75±15.75; and FEF25%-75% =78.90±14.65) and significantly reduced when compared to the nonsmokers/nonexposed to SHS (FEV1 =79.14±13.61; FEV1/FVC =94.88±21.88; and FEF25%-75% =87.36±17.02) (P<0.001). Similarly, respiratory complaints were more prevalent among smokers and those exposed to SHS when compared to nonsmokers/nonexposed to SHS. Our findings suggest that initiation of cigarette smoking and, to a lesser extent, exposure to SHS in adolescence leads to increased respiratory symptoms and reduction of pulmonary function test values. Public health initiatives that aim to prevent smoking initiation, assist in cessation, and lessen SHS exposure of adolescents need to be school-based and employed as early as middle school.

Cotton dust and endotoxin exposure-response relationships in cotton textile workers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kennedy, S.M.; Christiani, D.C.; Eisen, E.A.

Endotoxin exposure has been implicated in the etiology of lung disease in cotton workers. We investigated this potential relationship in 443 cotton workers from 2 factories in Shanghai and 439 control subjects from a nearby silk mill. A respiratory questionnaire was administered and pre- and postshift forced expiratory volume (FVC) and flow in one second (FEV1) were determined for each worker. Multiple area air samples were analyzed for total elutriated dust concentration (range: 0.15 to 2.5 mg/m3) and endotoxin (range: 0.002 to 0.55 microgram U.S. Reference Endotoxin/m3). The cotton worker population was stratified by current and cumulative dust or endotoxinmore » exposure. Groups were compared for FEV1, FVC, FEV1/FVC%, % change in FEV1 over the shift (delta FEV1%), and prevalences of chronic bronchitis and byssinosis, and linear and logistic regression models were constructed. No dose-response relationships were demonstrated comparing dust concentration to any pulmonary function or symptom variable. A dose-response trend was seen with the current endotoxin level and FEV1, delta FEV1%, and the prevalence of byssinosis and chronic bronchitis, except for the highest exposure level group in which a reversal of the trend was seen. The regression coefficients for current endotoxin exposure were significant (p less than 0.05) in the models for FEV1 and chronic bronchitis but not in the models for delta FEV1% (i.e., acute change in FEV1) or byssinosis prevalence. The coefficient for dust level was never significant in the models.« less

Spirometry in 3-5-year-old children with asthma.

PubMed

Nève, Véronique; Edmé, Jean-Louis; Devos, Patrick; Deschildre, Antoine; Thumerelle, Caroline; Santos, Clarisse; Methlin, Catherine-Marie; Matran, Murielle; Matran, Régis

2006-08-01

Spirometry with incentive games was applied to 207 2-5-year-old preschool children (PSC) with asthma in order to refine the quality-control criteria proposed by Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159). The data set in our study was much larger compared to that in Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159), where 42 children with cystic fibrosis and 37 healthy control were studied. At least two acceptable maneuvers were obtained in 178 (86%) children. Data were focused on 3-5-year-old children (n = 171). The proportion of children achieving a larger number of thresholds for each quality-control criterion (backward-extrapolated volume (Vbe), Vbe in percent of forced vital capacity (FVC, Vbe/FVC), time-to-peak expiratory flow (time-to-PEF), and difference (Delta) between the two FVCs (DeltaFVC), forced expiratory volume in 1 sec (DeltaFEV(1)), and forced expiratory volume in 0.5 sec (DeltaFEV(0.5)) from the two "best" curves) was calculated, and cumulative plots were obtained. The optimal threshold was determined for all ages by derivative function of rate of success-threshold curves, close to the inflexion point. The following thresholds were defined for acceptability: Vbe

FEV1/FVC and FEV1 for the assessment of chronic airflow obstruction in prevalence studies: do prediction equations need revision?

PubMed

Roche, Nicolas; Dalmay, François; Perez, Thierry; Kuntz, Claude; Vergnenègre, Alain; Neukirch, Françoise; Giordanella, Jean-Pierre; Huchon, Gérard

2008-11-01

Little is known on the long-term validity of reference equations used in the calculation of FEV(1) and FEV(1)/FVC predicted values. This survey assessed the prevalence of chronic airflow obstruction in a population-based sample and how it is influenced by: (i) the definition of airflow obstruction; and (ii) equations used to calculate predicted values. Subjects aged 45 or more were recruited in health prevention centers, performed spirometry and fulfilled a standardized ECRHS-derived questionnaire. Previously diagnosed cases and risk factors were identified. Prevalence of airflow obstruction was calculated using: (i) ATS-GOLD definition (FEV(1)/FVC<0.70); and (ii) ERS definition (FEV(1)/FVC

Lung function among 9- to 10-year-old Tibetan and Han Chinese schoolchildren living at different altitudes in Tibet.

PubMed

Yangzong; Berntsen, Sveinung; Bjertness, Espen; Stigum, Hein; Gonggalanzi; Bianba; Nafstad, Per

2013-03-01

Tibetans have lived at high altitude longer than any other high-altitude population. Still little is known about their lung function and especially among children. This study compared lung function values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory flow at 50% of FVC (FEF50) in children living at various altitudes in Tibet and with different ancestries. A cross-sectional study of lung function was performed among 9-10-year-old native Tibetan and Han Chinese children living at 3700 meters above sea level, and among native Tibetan children living at 4300 meters above sea level. The adjusted FVC and FEV1 were significantly higher in Tibetan children living at 4300 m above sea level as compared to Tibetans living at 3700 m. Tibetans living at 3700 m had higher FVC and FEV1 than Han Chinese living at the same altitude. All Tibetan children had on average higher FEF50 than Han Chinese. Tibetan children living at an altitude of 4300 m had relatively higher lung function than those living at 3700 m, and there were differences in lung function between Tibetans and Han Chinese who live at the same altitude. It seems likely that genetic factors involved in long-term adaptation to high altitude and cultural attributes could have contributed to the study findings.

Association between Traffic Air Pollution and Reduced Forced Vital Capacity: A Study Using Personal Monitors for Outdoor Workers.

PubMed

Santos, Ubiratan Paula; Garcia, Maria Lúcia Siqueira Bueno; Braga, Alfésio Luís Ferreira; Pereira, Luiz Alberto Amador; Lin, Chin An; de André, Paulo Afonso; de André, Carmen Diva Saldiva; Singer, Julio da Motta; Saldiva, Paulo Hilário Nascimento

2016-01-01

The effects of outdoor air pollution on lung function in adults are still controversial. Evaluate the effects of exposure to different levels of traffic-generated PM2.5 on workers' lung functions in São Paulo, Brazil. To cover a wide range of exposures, 101 non-smoking workers from three occupations (taxi drivers, traffic controllers, and forest rangers) were selected for the study. After clinical evaluation, the participants were scheduled to attend four consecutive weekly visits in which they received a 24-hour personal PM2.5 sampler and had lung function tests measured on the following day. The association between the spirometric variables and the averaged PM2.5 levels was assessed using robust regression models adjusted for age, waist circumference, time at the job, daily work hours, diabetes or hypertension and former smoking habits. Relative to workers in the lowest exposed group (all measures < 25 μg/m3), those with the highest level of exposure (all measures > 39.6 μg/m3) showed a reduction of predicted FVC (-12.2%; CI 95%: [-20.0% to -4.4%]), a marginal reduction of predicted FEV1 (-9.1%; CI 95%: [-19.1% to 0.9%]) and an increase of predicted FEF25-75%/FVC (14.9%; CI 95%: [2.9% to 26.8%]) without changes of FEV1/FVC. Exposure to vehicular traffic air pollution is associated with a small but significant reduction of FVC without a reduction of FEV1/FVC.

[Lung dysfunction in patients with severe chronic obstructive bronchitis].

PubMed

Nefedov, V B; Popova, L A; Shergina, E A

2005-01-01

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, TCL, TGV, RV, Raw, Rin, Rex, DLCO-SS, PaO2, and PaCO2 were determined in 36 patients with severe chronic obstructive lung disease (FEV1 < 50% of the normal value). All the patients were found to have impaired bronchial patency and changes in lung volumes and capacities; 83.3% of the patients had pulmonary gas exchange dysfunction. Impaired bronchial patency mainly appeared as decreased FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, Raw, Rin, Rex; altered lung volumes and capacities manifested by increased RV, TGV, and TLC, and by decreased VC and FVC; pulmonary gas exchange dysfunction showed up as lowered PaO2 and DLCO-SS, as decreased or increased PaCO2. The observed bronchial patency disorders varied from significant to severe; functional changes in lung volumes and capacities were mild to severe.

Bronchodilator Response in FVC Is Larger and More Relevant Than in FEV1 in Severe Airflow Obstruction.

PubMed

Quanjer, Philip H; Ruppel, Gregg L; Langhammer, Arnulf; Krishna, Abhishek; Mertens, Frans; Johannessen, Ane; Menezes, Ana M B; Wehrmeister, Fernando C; Perez-Padilla, Rogelio; Swanney, Maureen P; Tan, Wan C; Bourbeau, Jean

2017-05-01

Recommendations on interpreting tests of bronchodilator responsiveness (BDR) are conflicting. We investigated the dependence of BDR criteria on sex, age, height, ethnicity, and severity of respiratory impairment. BDR test data were available from clinical patients in the Netherlands, New Zealand, and the United States (n = 15,278; female subjects, 51.7%) and from surveys in Canada, Norway, and five Latin-American countries (n = 16,250; female subjects, 54.7%). BDR calculated according to FEV 1 , FVC, and FEV 1 /FVC was expressed as absolute change, a percentage of the baseline level (% baseline), a percentage of the predicted value (% predicted), and z score. Change (Δ) in FEV 1 and FVC, in milliliters, was unrelated to the baseline value but was biased toward age, height, sex, and level of airways obstruction; ΔFEV 1 was significantly lower in African Americans. In 1,106 subjects with low FEV 1 (200-1,621 mL) the FEV 1 increased by 12% to 44.7% relative to baseline but < 200 mL. Expressing BDR as a percentage of the predicted value or as a z score attenuated the bias and made the 200-mL criterion redundant, but reduced positive responses by half. ΔFEV 1 % baseline increased with the level of airflow obstruction but decreased with severe obstruction when expressed as z scores or % predicted; ΔFVC, however expressed, increased with the level of airflow obstruction. Expressing FEV 1 responsiveness as % baseline spuriously suggests that responsiveness increases with the severity of respiratory impairment. Expressing change in FEV 1 or FVC as % predicted or as z scores eliminates this artifact and renders the required 200-mL minimum increase redundant. In severe airways obstruction ΔFVC should be critically evaluated as an index of clinically important relief of hyperinflation, with implications for bronchodilator drug trials. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

[Cohort study of effects on lung function of coke oven workers exposured to coke oven emissions].

PubMed

Zhi, Yongfen; Zhang, Hongming; Li, Weixing; Hu, Zhipeng; Liu, Weihua; Li, Yangfan; Zheng, Jinpin

2015-07-01

Through comparative study on pulmonary function damage of coke oven workers exposed to coke oven emissions with the same group before and after five years, and further explore the relationship between the coke oven emissions and injury in pulmonary function of coke oven worker. Select a coking plant in Shanxi 165 coke oven workers (exposed group) and 52 auxiliary workers (control group) for the study, using a uniform questionnaire to collect workers' personal information. Fixed workplace air samples collected periodically. Air samples of benzo (a) pyrene concentrations was measured by high pressure liquid chromatograph. Pulmonary function of research object was measured by portable spirometer respectively in 2009 and 2013, and comparative analysis on it. The concentration of B(a)P was no significant difference in the same area between 5 years in 2009-2013. Compared with 2009, 2013 control workers lung function index and the abnormal rate had no significant difference (P > 0.05). But FVC%, FEV1.0%, MVV%, VC% and FEF25% of exposed workers in 2013 was significantly lower than in 2009, FVC%, FEV1.0%, VC% and FEF25% pulmonary dysfunction rate in 2013 was also significantly higher than in 2009, difference was statistically significant (P < 0.05). Workers emerging pulmonary function abnormalities mainly distributed in furnace roof and side. furnace roof group FVC%, FEV1.0%, VC% additional abnormal number (rate) was significantly higher than furnace floor and the control group (P < 0.05), and furnace side groop was significantly higher than the control group, the difference was statistically significant (P < 0.05). Multivariate Logistic regression analysis showed that after 5 years FVC%, FEV1% and VC% of abnormal lung function emerging adjusted OR of furnace roof workers were 7.939, 5.966 and 4.956. For abnormal of FVC%, FEV1%, VC% and MVV%, the contacting coke seniority is a risk factor. There is a positive interaction between contacting coke seniority and furnace roof (P < 0.05). Coke oven workers lung function damage associated with exposureing to coke oven emissions, coke oven emissions exposure level and exposure time are the main factors of coke oven workers in lung function damage, there is a positive interaction between the two factors.

[The importance of lung volumes in the investigation of heavy smokers].

PubMed

Ben Saad, H; Ben Amor, L; Ben Mdalla, S; Ghannouchi, I; Ben Essghair, M; Sfaxi, R; Garrouche, A; Rouatbi, N; Rouatbi, S

2014-01-01

Lung hyperinflation (LH) has become a major concern in the management of chronic obstructive pulmonary disease (COPD). To evaluate the role of lung volumes in the positive diagnosis of COPD and in the assessment of airway obstruction reversibility. Three hundred and sixty-six male smokers over the age of 35 with more than 40 pack-years exposure were included in the study. Plethysmographic data were determined before/after taking a bronchodilator (BBD, ABD). Applied definitions: airflow obstruction: BBD FEV1/FVC<0.70. LH: BBD residual volume (RV)>upper limit of normal. Expressions of reversibility: Δvariable=(ABD-BBD) values; Δinit%=Δvariable/BBD value and Δref%=Δvariable/reference value. A 12%init and a 0.2L increase in either FEV1 or FVC or a 10%ref or - 300 mL decrease in RV were considered as clinically significant. Over the 85 smokers without airflow obstruction, 68% had LH. In the hyperinflated group (n=314), and compared to changes in FEV1 and FVC, these RV changes detected more respondents (54% for FEV1 and FVC vs. 65% for RV, P=0.002). This was not the case for the group free from LH (n=52) (23% for FEV1 and FVC vs. 35% for RV, P=0.09). In the 58 hyperinflated groups free from airflow obstruction, and compared to changes in FEV1 and FVC, changes in RV detected more respondents (24% for FEV1 and FVC vs. 71% for RV, P=0.0001). In heavy smokers, it seems essential to include LH as a criterion for a positive diagnosis of COPD and of reversibility evaluation. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Modulation of Lung Function by Increased Nitric Oxide Production

PubMed Central

Yadav, Ram Lochan; Yadav, Prakash Kumar

2017-01-01

Introduction Cigarette smoking reduces endogenous Nitric Oxide (NO) production by reducing Nitric Oxide Synthase (NOS) activity, which is one of the probable reason for increased rate of pulmonary diseases in smokers. Nitric oxide/oxygen blends are used in critical care to promote capillary and pulmonary dilation to treat several pulmonary vascular diseases. Among several supplements, the highest NOS activation has been proved for garlic with its unique mechanism of action. Aim To investigate the effect of dietary supplementation of NO producing garlic on pulmonary function of smokers. Materials and Methods The study was conducted on 40 healthy non-smoker (Group A) and 40 chronic smoker (Group B) males with matched age, height and weight. The pulmonary function tests- Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), FEV1/FVC ratio and Peak Expiratory Flow Rate (PEFR) were performed in non-smokers (Group A), smokers (Group B) and smokers after supplementation of approximately 4 gm of raw garlic (2 garlic cloves) per day for three months (Group C). Endogenous NO production was studied in smokers before and after garlic supplementation and in non-smokers without supplementation. The data obtained were compared between the groups using unpaired student’s t-test. The p-value considered significant at <0.05. Results Our results showed that FVC, FEV1, FEV1/FVC ratio and PEFR were reduced significantly along with a significant decreased NOS activity among smokers (Group B) when compared with non-smokers (Group A). Garlic supplementation significantly improved the pulmonary function tests in Group C in comparison to Group B by increasing NOS activity. Conclusion Dietary supplementation of garlic, which might be by increasing NOS activity, has significantly improved pulmonary functions in smokers. PMID:28764150

Respiratory symptoms and ventilatory functions among quarry workers in Edo state, Nigeria

PubMed Central

Isara, Alphonsus Rukevwe; Adam, Vincent Yakubu; Aigbokhaode, Adesuwa Queen; Alenoghena, Innocent Osi

2016-01-01

Introduction Workers in the quarry industries are exposed to hazards resulting from the inhalation of air borne particulates. The study determined the prevalence of respiratory symptoms and assessed ventilatory functions among quarry workers in Edo state, Nigeria. Methods Quarry workers (site workers and office workers) were interviewed using structured questionnaire. FEV1, FVC, FEV1/FVC and PEFR were measured using a KoKo Legend spirometer. Results A total of 113 quarry workers (76 exposure and 37 controls) were studied. The exposure group had significantly higher occurrence of chest tightness (35.5%) compared with 16.2% of the controls (p < 0.05). The occurrence of cough (23.7% versus 13.5%), sputum (21.1% versus 16.2%), and dyspnoea (7.9% versus 5.4%), were higher in exposure groups while wheeze (10.8% versus 10.5%) and nasal congestion (27.0% and 25.0%) were higher in the control groups. The mean (SD) FEV1, and FVC were significantly lower among the exposure compared with the control group; 2.77L (0.73) versus 3.14L (0.78), p < 0.05, and 3.48L (0.84) versus 3.89L (0.92), p < 0.05. In both groups, smokers had significantly lower mean (SD) FEV1, FVC and PEFR compared with non-smokers; 2.91L (0.77) versus 3.39L (0.69), p = 0.01, 3.61L (0.91) versus 4.26L (0.74), p < 0.05 and 6.56L (2.43) versus 7.98L (1.67), p < 0.05. Conclusion Chronic exposure to quarry dust is associated with respiratory symptoms and reduced lung function indices among quarry workers. The enforcement of the use of PPEs and periodic evaluation the lung function status of quarry workers is advocated. PMID:27347301

Respiratory symptoms and ventilatory functions among quarry workers in Edo state, Nigeria.

PubMed

Isara, Alphonsus Rukevwe; Adam, Vincent Yakubu; Aigbokhaode, Adesuwa Queen; Alenoghena, Innocent Osi

2016-01-01

Workers in the quarry industries are exposed to hazards resulting from the inhalation of air borne particulates. The study determined the prevalence of respiratory symptoms and assessed ventilatory functions among quarry workers in Edo state, Nigeria. Quarry workers (site workers and office workers) were interviewed using structured questionnaire. FEV1, FVC, FEV1/FVC and PEFR were measured using a KoKo Legend spirometer. A total of 113 quarry workers (76 exposure and 37 controls) were studied. The exposure group had significantly higher occurrence of chest tightness (35.5%) compared with 16.2% of the controls (p < 0.05). The occurrence of cough (23.7% versus 13.5%), sputum (21.1% versus 16.2%), and dyspnoea (7.9% versus 5.4%), were higher in exposure groups while wheeze (10.8% versus 10.5%) and nasal congestion (27.0% and 25.0%) were higher in the control groups. The mean (SD) FEV1, and FVC were significantly lower among the exposure compared with the control group; 2.77L (0.73) versus 3.14L (0.78), p < 0.05, and 3.48L (0.84) versus 3.89L (0.92), p < 0.05. In both groups, smokers had significantly lower mean (SD) FEV1, FVC and PEFR compared with non-smokers; 2.91L (0.77) versus 3.39L (0.69), p = 0.01, 3.61L (0.91) versus 4.26L (0.74), p < 0.05 and 6.56L (2.43) versus 7.98L (1.67), p < 0.05. Chronic exposure to quarry dust is associated with respiratory symptoms and reduced lung function indices among quarry workers. The enforcement of the use of PPEs and periodic evaluation the lung function status of quarry workers is advocated.

Characteristics and self-rated health of overlap syndrome.

PubMed

Chung, Jung Wha; Kong, Kyoung Ae; Lee, Jin Hwa; Lee, Seok Jeong; Ryu, Yon Ju; Chang, Jung Hyun

2014-01-01

Overlap syndrome shares features of both asthma and chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate characteristics of overlap syndrome and their effect on self-rated health (SRH). We analyzed data from the Fourth Korea National Health and Nutrition Examination Survey of 2007-2009. Subjects with acceptable spirometry and available wheezing history were included. Subjects were classified into four groups based on forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) results and the presence or absence of self-reported wheezing for the previous 12 months: 1) COPD group, defined as having FEV1/FVC <0.7 without self-reported wheezing history; 2) asthma group, defined as having self-reported wheezing history without FEV1/FVC <0.7; 3) overlap syndrome group, having both FEV1/FVC <0.7 and wheezing history; and 4) non-obstructive disease (NOD) group, having neither FEV1/FVC <0.7 nor self-reported wheezing. SRH was categorized as better or lower based on responses to a questionnaire. From a total 9,104 subjects, 700 were assigned to the COPD group, 560 to the asthma group, 210 to the overlap syndrome group, and 7,634 to the NOD group. Compared to the other groups, subjects in the overlap syndrome group were more likely to have low lung function, a high proportion of smokers, low socioeconomic status, short education duration, lower SRH, and past diagnosis of pulmonary tuberculosis or bronchiectasis. Multiple logistic regression analysis revealed that both overlap syndrome and asthma groups were independently associated with lower SRH after adjustment for age, sex, socioeconomic status, education level, smoking status, comorbidities, and lung function. Female, old age, low education level, low economic status, smoker and other comorbidities were also associated with lower SRH. Overlap syndrome was accompanied by high morbidity and was associated with lower SRH, which needs more appropriate care.

Lung function indices of children exposed to wood smoke in a fishing port in South-South Nigeria.

PubMed

Oloyede, Iso P; Ekrikpo, Udeme E; Ekanem, Emmanuel E

2013-10-01

Children in the warm rain forest are at risk of having their lung function compromised by a variety of factors, including smoke from wood fires. A total of 358 children from a fishing port and 400 children living in a farm settlement were tested to determine their peak expiratory flow rate (PEFR), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory volume in 1 s per cent and forced expiratory flow between 25 and 75%. The values for the PEFR, FVC, FEV1, forced expiratory volume in 1 s per cent and forced expiratory flow between 25 and 75% of the subjects were significantly lower than those of the controls (P value for males = <0.001, 0.01, 0.002, 0.01 and <0.001, respectively, whereas for their female counterparts = <0.001, 0.003, 0.001, 0.04 and <0.001, respectively). These deficits were observed to be more with increasing duration of exposure to wood smoke for PEFR, FVC and FEV1. Chronic exposure to fish drying using firewood can impair lung function in children. There is a need for alternative methods of fish preservation for those engaged in fish drying.

Correlation of 68Ga Ventilation-Perfusion PET/CT with Pulmonary Function Test Indices for Assessing Lung Function.

PubMed

Le Roux, Pierre-Yves; Siva, Shankar; Steinfort, Daniel P; Callahan, Jason; Eu, Peter; Irving, Lou B; Hicks, Rodney J; Hofman, Michael S

2015-11-01

Pulmonary function tests (PFTs) are routinely used to assess lung function, but they do not provide information about regional pulmonary dysfunction. We aimed to assess correlation of quantitative ventilation-perfusion (V/Q) PET/CT with PFT indices. Thirty patients underwent V/Q PET/CT and PFT. Respiration-gated images were acquired after inhalation of (68)Ga-carbon nanoparticles and administration of (68)Ga-macroaggregated albumin. Functional volumes were calculated by dividing the volume of normal ventilated and perfused (%NVQ), unmatched and matched defects by the total lung volume. These functional volumes were correlated with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and diffusing capacity for carbon monoxide (DLCO). All functional volumes were significantly different in patients with chronic obstructive pulmonary disease (P < 0.05). FEV1/FVC and %NVQ had the highest correlation (r = 0.82). FEV1 was also best correlated with %NVQ (r = 0.64). DLCO was best correlated with the volume of unmatched defects (r = -0.55). Considering %NVQ only, a cutoff value of 90% correctly categorized 28 of 30 patients with or without significant pulmonary function impairment. Our study demonstrates strong correlations between V/Q PET/CT functional volumes and PFT parameters. Because V/Q PET/CT is able to assess regional lung function, these data support the feasibility of its use in radiation therapy and preoperative planning and assessing pulmonary dysfunction in a variety of respiratory diseases. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Is insufficient pulmonary air support the cause of dysphonia in chronic obstructive pulmonary disease?

PubMed

Hassan, Megahed M; Hussein, Mona T; Emam, Ahmed Mamdouh; Rashad, Usama M; Rezk, Ibrahim; Awad, Al Hussein

2018-08-01

Optimal pulmonary air support is essential pre-requisite for efficient phonation. The objective is to correlate pulmonary and vocal functions in chronic obstructive pulmonary disease (COPD) to find out whether the reduced pulmonary function per se could induce dysphonia. In this prospective case-control study, sixty subjects with stable COPD underwent evaluation of pulmonary and vocal functions. The pulmonary functions measured include {Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF)}. The vocal functions were {jitter, shimmer, noise-to-harmonic ratio, pitch perturbation quotient, amplitude perturbation quotient, maximum phonation time (MPT), sound pressure level, phonatory efficiency, resistance and power. A control group (n=35) underwent the same measurements. These functions were compared between subjects and controls. Also, correlation of the vocal and pulmonary functions was conducted. Thirty five (58.3%) of COPD subjects have dysphonia. The pulmonary functions were lower in all COPD group than in the control group (P<0.001 for all parameters). Also, the FVC, FEV1, PEF and MMEF % of predicted values were significantly lower in subjects with dysphonia (n=35) than those without dysphonia (n=25) with P values 0.0018, <0.001, 0.0011 and 0.0026 respectively. In addition, the MPT in all subjects showed positive correlations to the 5 pulmonary functions (P=0.004 for FEV1/FVC ratio and P<0.001 for the rest). Also, the phonatory efficiency showed significant positive correlations with the pulmonary functions FVC, FEV1, PEF and MMEF (P=0.001, 0.001, 0.002 and 0.001 respectively). Unlike efficiency, the phonatory resistance revealed significant negative correlations with these pulmonary functions in the same order (P=0.001, 0.003, 0.002, 0.001 respectively). Dysphonia is a common comorbidity with COPD which attributed to multifactorial etiologies. The lower the pulmonary function in COPD patients is the more likely to have dysphonia. Decreased pulmonary function was associated with reduced MPT and phonatory efficiency but with increased phonatory resistance. The reduced pulmonary functions in COPD can be the underlying cause of the altered vocal function and dysphonia. Great part of this dysphonia is functional, and hence, can be corrected by voice therapy in compensated subjects. Further researches are needed to evaluate the efficacy of voice therapy in these patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Correlation analysis between pulmonary function test parameters and CT image parameters of emphysema

NASA Astrophysics Data System (ADS)

Liu, Cheng-Pei; Li, Chia-Chen; Yu, Chong-Jen; Chang, Yeun-Chung; Wang, Cheng-Yi; Yu, Wen-Kuang; Chen, Chung-Ming

2016-03-01

Conventionally, diagnosis and severity classification of Chronic Obstructive Pulmonary Disease (COPD) are usually based on the pulmonary function tests (PFTs). To reduce the need of PFT for the diagnosis of COPD, this paper proposes a correlation model between the lung CT images and the crucial index of the PFT, FEV1/FVC, a severity index of COPD distinguishing a normal subject from a COPD patient. A new lung CT image index, Mirage Index (MI), has been developed to describe the severity of COPD primarily with emphysema disease. Unlike conventional Pixel Index (PI) which takes into account all voxels with HU values less than -950, the proposed approach modeled these voxels by different sizes of bullae balls and defines MI as a weighted sum of the percentages of the bullae balls of different size classes and locations in a lung. For evaluation of the efficacy of the proposed model, 45 emphysema subjects of different severity were involved in this study. In comparison with the conventional index, PI, the correlation between MI and FEV1/FVC is -0.75+/-0.08, which substantially outperforms the correlation between PI and FEV1/FVC, i.e., -0.63+/-0.11. Moreover, we have shown that the emphysematous lesion areas constituted by small bullae balls are basically irrelevant to FEV1/FVC. The statistical analysis and special case study results show that MI can offer better assessment in different analyses.

Ventilatory function in rubber processing workers: acute changes over the workshift.

PubMed Central

Governa, M; Comai, M; Valentino, M; Antonicelli, L; Rinaldi, F; Pisani, E

1987-01-01

When considering rubber tyre manufacturing from an occupational health viewpoint, three areas may be identified in which exposure to respirable materials are potentially harmful: the processing, curing, and talc areas. A study of the ventilatory function of the entire work force employed in the processing area in a rubber tyre manufacturing plant was undertaken to determine whether an acute reduction in lung function occurs over the course of their working shift (the plant worked a three shift system) and whether a chronic exposure to the occupational airborne contaminants causes permanent changes in lung function. The ventilatory function was measured at the worksite at the beginning and immediately after the end of the workshift. No evidence of chronic obstructive pulmonary disease was found and in most cases no significant decline in FEV1 was observed. Only one of the 79 individuals showed a moderate obstruction, measured by the ratio FEV1/FVC which gave the value of 0.55, with no variation over the shift. For non-smokers, the FVC, FEV1, and FEF25-75% were lower in those exposed for more than five years than in those exposed for five years or less. A similar pattern was also observed in the FVC and FEV1 of the smokers. None of these differences was statistically significant. Within each exposure group the pulmonary function of the smokers was lower than that of the non-smokers, but the only significant difference was found in the values of FEF25-75%. Only one man showed a decline in the FEV1/FVC ratio over the shift, but during each shift, a decrease in all the lung function tests was observed. The decrease was smallest during the first of the three shifts. These results are thought to support the hypothesis that there are acute adverse effects over an eight hour shift. Further investigations are needed to discover whether these acute changes in lung function result from a chemical stimulation or irritant receptors in the airways. PMID:3814549

Association between marijuana exposure and pulmonary function over 20 years.

PubMed

Pletcher, Mark J; Vittinghoff, Eric; Kalhan, Ravi; Richman, Joshua; Safford, Monika; Sidney, Stephen; Lin, Feng; Kertesz, Stefan

2012-01-11

Marijuana smoke contains many of the same constituents as tobacco smoke, but whether it has similar adverse effects on pulmonary function is unclear. To analyze associations between marijuana (both current and lifetime exposure) and pulmonary function. The Coronary Artery Risk Development in Young Adults (CARDIA) study, a longitudinal study collecting repeated measurements of pulmonary function and smoking over 20 years (March 26, 1985-August 19, 2006) in a cohort of 5115 men and women in 4 US cities. Mixed linear modeling was used to account for individual age-based trajectories of pulmonary function and other covariates including tobacco use, which was analyzed in parallel as a positive control. Lifetime exposure to marijuana joints was expressed in joint-years, with 1 joint-year of exposure equivalent to smoking 365 joints or filled pipe bowls. Forced expiratory volume in the first second of expiration (FEV(1)) and forced vital capacity (FVC). Marijuana exposure was nearly as common as tobacco exposure but was mostly light (median, 2-3 episodes per month). Tobacco exposure, both current and lifetime, was linearly associated with lower FEV(1) and FVC. In contrast, the association between marijuana exposure and pulmonary function was nonlinear (P < .001): at low levels of exposure, FEV(1) increased by 13 mL/joint-year (95% CI, 6.4 to 20; P < .001) and FVC by 20 mL/joint-year (95% CI, 12 to 27; P < .001), but at higher levels of exposure, these associations leveled or even reversed. The slope for FEV(1) was -2.2 mL/joint-year (95% CI, -4.6 to 0.3; P = .08) at more than 10 joint-years and -3.2 mL per marijuana smoking episode/mo (95% CI, -5.8 to -0.6; P = .02) at more than 20 episodes/mo. With very heavy marijuana use, the net association with FEV(1) was not significantly different from baseline, and the net association with FVC remained significantly greater than baseline (eg, at 20 joint-years, 76 mL [95% CI, 34 to 117]; P < .001). Occasional and low cumulative marijuana use was not associated with adverse effects on pulmonary function.

Effects of Exposure to Welding Fume on Lung Function: Results from the German WELDOX Study.

PubMed

Lehnert, M; Hoffmeyer, F; Gawrych, K; Lotz, A; Heinze, E; Berresheim, H; Merget, R; Harth, V; Van Gelder, R; Hahn, J-U; Hartwig, A; Weiß, T; Pesch, B; Brüning, T

2015-01-01

The association between exposure to welding fume and chronic obstructive pulmonary disease (COPD) has been insufficiently clarified. In this study we assessed the influence of exposure to welding fume on lung function parameters. We investigated forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and expiratory flow rates in 219 welders. We measured current exposure to respirable particles and estimated a worker's lifetime exposure considering welding techniques, working conditions and protective measures at current and former workplaces. Multiple regression models were applied to estimate the influence of exposure to welding fume, age, and smoking on lung function. We additionally investigated the duration of working as a welder and the predominant welding technique. The findings were that age- and smoking-adjusted lung function parameters showed no decline with increasing duration, current exposure level, and lifetime exposure to welding fume. However, 15% of the welders had FEV1/FVC below the lower limit of normal, but we could not substantiate the presence of an association with the measures of exposure. Adverse effects of cigarette smoking were confirmed. In conclusion, the study did not support the notion of a possible detrimental effect of exposure to welding fume on lung function in welders.

Chest wall mobility is related to respiratory muscle strength and lung volumes in healthy subjects.

PubMed

Lanza, Fernanda de Cordoba; de Camargo, Anderson Alves; Archija, Lilian Rocha Ferraz; Selman, Jessyca Pachi Rodrigues; Malaguti, Carla; Dal Corso, Simone

2013-12-01

Chest wall mobility is often measured in clinical practice, but the correlations between chest wall mobility and respiratory muscle strength and lung volumes are unknown. We investigate the associations between chest wall mobility, axillary and thoracic cirtometry values, respiratory muscle strength (maximum inspiratory pressure and maximum expiratory pressure), and lung volumes (expiratory reserve volume, FEV(1), inspiratory capacity, FEV(1)/FVC), and the determinants of chest mobility in healthy subjects. In 64 healthy subjects we measured inspiratory capacity, FVC, FEV(1), expiratory reserve volume, maximum inspiratory pressure, and maximum expiratory pressure, and chest wall mobility via axillary and thoracic cirtometry. We used linear regression to evaluate the influence of the measured variables on chest wall mobility. The subjects' mean ± SD values were: age 24 ± 3 years, axillary cirtometry 6.3 ± 2.0 cm, thoracic cirtometry 7.5 ± 2.3 cm; maximum inspiratory pressure 90.4 ± 10.6% of predicted, maximum expiratory pressure 92.8 ± 13.5% of predicted, inspiratory capacity 99.7 ± 8.6% of predicted, FVC 101.9 ± 10.6% of predicted, FEV(1) 98.2 ± 10.3% of predicted, expiratory reserve volume 90.9 ± 19.9% of predicted. There were significant correlations between axillary cirtometry and FVC (r = 0.32), FEV(1) (r = 0.30), maximum inspiratory pressure (r = 0.48), maximum expiratory pressure (r = 0.25), and inspiratory capacity (r = 0.24), and between thoracic cirtometry and FVC (r = 0.50), FEV(1) (r = 0.48), maximum inspiratory pressure (r = 0.46), maximum expiratory pressure (r = 0.37), inspiratory capacity (r = 0.39), and expiratory reserve volume (r = 0.47). In multiple regression analysis the variable that best explained the axillary cirtometry variation was maximum inspiratory pressure (R(2) 0.23), and for thoracic cirtometry it was FVC and maximum inspiratory pressure (R(2) 0.32). Chest mobility in healthy subjects is related to respiratory muscle strength and lung function; the higher the axillary cirtometry and thoracic cirtometry values, the greater the maximum inspiratory pressure, maximum expiratory pressure, and lung volumes in healthy subjects.

Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60–84 Years

PubMed Central

Tian, Xin-Yu; Liu, Chun-Hong; Wang, De-Xiang; Ji, Xiu-Li; Shi, Hui; Zheng, Chun-Yan; Xie, Meng-Shuang; Xiao, Wei

2018-01-01

Background: The interpretation of spirometry varies on different reference values. Older people are usually underrepresented in published predictive values. This study aimed at developing spirometric reference equations for elderly Chinese in Jinan aged 60–84 years and to compare them to previous equations. Methods: The project covered all of Jinan city, and the recruitment period lasted 9 months from January 1, 2017 to September 30, 2017, 434 healthy people aged 60–84 years who had never smoked (226 females and 208 males) were recruited to undergo spirometry. Vital capacity (VC), forced VC (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, FEV1/VC, FEV6, peak expiratory flow, and forced expiratory flow at 25%, 50%, 75%, and 25–75% of FVC exhaled (FEF25%, FEF50%, FEF75%, and FEF25–75%) were analyzed. Reference equations for mean and the lower limit of normal (LLN) were derived using the lambda-mu-sigma method. Comparisons between new and previous equations were performed by paired t-test. Results: New reference equations were developed from the sample. The LLN of FEV1/FVC, FEF25–75% computed using the 2012-Global Lung Function Initiative (GLI) and 2006-Hong Kong equations were both lower than the new equations. The biggest degree of difference for FEV1/FVC was 19% (70.46% vs. 59.29%, t = 33.954, P < 0.01) and for maximal midexpiratory flow (MMEF, equals to FEF25–75%) was 22% (0.82 vs. 0.67, t = 21.303, P < 0.01). The 1990-North China and 2009-North China equations predicted higher mean values of FEV1/FVC and FEF25–75% than the present model. The biggest degrees of difference were −4% (78.31% vs. 81.27%, t = −85.359, P < 0.01) and −60% (2.11 vs. 4.68, t = −170.287, P < 0.01), respectively. Conclusions: The newly developed spirometric reference equations are applicable to elderly Chinese in Jinan. The 2012-GLI and 2006-Hong Kong equations may lead to missed diagnoses of obstructive ventilatory defects and the small airway dysfunction, while traditional linear equations for all ages may lead to overdiagnosis. PMID:29553052

Airway wall thickness of allergic asthma caused by weed pollen or house dust mite assessed by computed tomography.

PubMed

Liu, Liping; Li, Guangrun; Sun, Yuemei; Li, Jian; Tang, Ningbo; Dong, Liang

2015-03-01

Little was known about Airway wall thickness of asthma patients with different allergen allergy. So we explored the possible difference of Airway wall thickness of asthma patients mono-sensitized to weed pollen or HDM using high-resolution computed tomography. 85 severe asthma patients were divided into weed pollen group and HDM group according to relevant allergen. 20 healthy donors served as controls. Airway wall area, percentage wall area and luminal area at the trunk of the apical bronchus of the right upper lobe were quantified using HRCT and compared. The values of pulmonary function were assessed as well. There were differences between HDM group and weed pollen group in WA/BSA,WA% and FEF25-75% pred, and no significant difference in FEV1%pred, FEV1/FVC and LA/BSA. In weed pollen group, WA/BSA was observed to correlate with the duration of rhinitis, whereas in HDM group, WA/BSA and LA/BSA was observed to correlate with the duration of asthma. In weed pollen group, FEV1/FVC showed a weak but significant negative correlation with WA%, but in HDM group FEV1/FVC showed a significant positive correlation with WA% and a statistical negative correlation with LA/BSA. FEV1/FVC and FEF25-75% pred were higher and WA/BSA and LA/BSA were lower in healthy control group than asthma group. FEV1%pred and WA% was no significant difference between asthma patients and healthy subjects. There are differences between HDM mono-sensitized subjects and weed pollen mono-sensitized subjects, not only in airway wall thickness, but also small airway obstruction. Copyright © 2014 Elsevier Ltd. All rights reserved.

Lung function in asphalt pavers: a longitudinal study.

PubMed

Ulvestad, Bente; Randem, Britt Grethe; Skare, Øivind; Aaløkken, Trond Mogens; Myranek, Georg Karl; Elihn, Karine; Lund, May Brit

2017-01-01

To study longitudinal changes in lung function in asphalt pavers and a reference group of road maintenance workers, and to detect possible signs of lung disease by high-resolution computed tomography (HRCT) scans. Seventy-five asphalt pavers and 71 road maintenance workers were followed up with questionnaires and measurements of lung function. Not every worker was tested every year, but most of them had four or more measurement points. The 75 asphalt pavers were also invited to have HRCT scans of the lungs at the end of the follow-up period. Mean annual decline in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV 1 ) of the asphalt pavers was 58 and 35 ml, respectively. Adjusted for age at baseline, packyears of smoking and BMI, the asphalt pavers had a significant excess annual decline in FVC and FEV 1 compared to the references. The screedmen, the most exposed group of the asphalt pavers, showed a significantly larger decline in FVC than the other asphalt pavers (P = 0.029). Fine intralobular fibrosis without evident cysts was identified with HRCT in three subjects (4 %). We conclude that our findings may indicate an excess annual decline in FVC and FEV 1 related to exposure to asphalt fumes. The screedmen, who carry out their work behind and close to the paving machine, had the largest decline in lung function. The finding of adverse pulmonary effects in asphalt pavers calls for better technological solutions to prevent exposure.

Agricultural work exposures and pulmonary function among hired farm workers in California (the MICASA study).

PubMed

Rodriquez, Erik J; Stoecklin-Marois, Maria T; Bennett, Deborah H; Tancredi, Daniel J; Schenker, Marc B

2014-01-01

Despite California's dependence on hired farm labor, scarce research has been conducted on the respiratory health of hired farm workers. Agricultural exposures to inorganic and organic dusts can adversely affect an individual's respiratory health and differ by farm type and job task. The purpose of the present analysis was to examine associations between agricultural work exposures and pulmonary function among 450 California farm workers. Data were collected as part of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study, a prospective cohort study examining occupational risk factors and health of hired farm worker families in Mendota, California. Time-weighted self-reported average (TWSRA) dust scores were calculated from assessments of past-12-month agricultural work history. Other dust exposure indicator variables included months worked in agriculture in the past 12 months and years worked in agriculture. Multiple linear regression modeled FEV1 (forced expiratory volume in 1 second), FEF(25-75%) (forced midexpiratory flow rate), FVC (forced vital capacity), FEV6, FEV1/FVC, and FEV1/FEV6 separately. Seventy-six percent of participants had worked in agriculture in the past year. In models conducted for crops and tasks separately, high TWSRA dust score was associated with better FEV6. Crop and task models showed associations between greater months worked in agriculture in the past year and better FEV1, FEF(25-75%), and FEV6. Both models also found greater years worked in agriculture to be associated with worse FEV1/FEV6. Results were generally in the opposite direction as expected given past research but not uncommon. Future research should investigate relationships between pulmonary function and agricultural dust exposure over a lifetime and changes in pulmonary function over time.

Validation of the portable Air-Smart Spirometer

PubMed Central

Núñez Fernández, Marta; Pallares Sanmartín, Abel; Mouronte Roibas, Cecilia; Cerdeira Domínguez, Luz; Botana Rial, Maria Isabel; Blanco Cid, Nagore; Fernández Villar, Alberto

2018-01-01

Background The Air-Smart Spirometer is the first portable device accepted by the European Community (EC) that performs spirometric measurements by a turbine mechanism and displays the results on a smartphone or a tablet. Methods In this multicenter, descriptive and cross-sectional prospective study carried out in 2 hospital centers, we compare FEV1, FVC, FEV1/FVC ratio measured with the Air Smart-Spirometer device and a conventional spirometer, and analyze the ability of this new portable device to detect obstructions. Patients were included for 2 consecutive months. We calculate sensitivity, specificity, positive and negative predictive value (PPV and NPV) and likelihood ratio (LR +, LR-) as well as the Kappa Index to evaluate the concordance between the two devices for the detection of obstruction. The agreement and relation between the values of FEV1 and FVC in absolute value and the FEV1/FVC ratio measured by both devices were analyzed by calculating the intraclass correlation coefficient (ICC) and the Pearson correlation coefficient (r) respectively. Results 200 patients (100 from each center) were included with a mean age of 57 (± 14) years, 110 were men (55%). Obstruction was detected by conventional spirometry in 73 patients (40.1%). Using a FEV1/FVC ratio smaller than 0.7 to detect obstruction with the Air Smart-Spirometer, the kappa index was 0.88, sensitivity (90.4%), specificity (97.2%), PPV (95.7%), NPV (93.7%), positive likelihood ratio (32.29), and negative likelihood ratio (0.10). The ICC and r between FEV1, FVC, and FEV1 / FVC ratio measured by the Air Smart Spirometer and the conventional spirometer were all higher than 0.94. Conclusion The Air-Smart Spirometer is a simple and very precise instrument for detecting obstructive airway diseases. It is easy to use, which could make it especially useful non-specialized care and in other areas. PMID:29474502

[Preliminary study of clinical significance of decreased D(L)CO in patients with left ventricular heart failure].

PubMed

Tan, Xiao-yue; Sun, Xing-guo; Hu, Sheng-shou; Zhang, Jian; Huang, Jie; Chen, Zhi-gao; Ma, Li

2015-07-01

This study aimed to investigate the feature of D(L)CO (Diffusion Lung Capacity for Carbon Monoxide) in CHF (left ventricular heart failure) patients, underlying pathophysiological mechanism and clinical significance. We retrospectively studied the D(L)CO, pulmonary ventilation function, cardiopulmonary exercise testing and related clinical information in severer HF patients. Peak VO2 severely decreased to 34 ± 7 percentage of predicted(%pred) and anaerobic threshold to 48 ± 11%pred in all patients. D(L)CO moderately decreased to 63 ± 12%pred and there were 25 patients lower than 80%pred. FVC, FEV1, FEV1/FVC and TLC were 75 ± 14%pred, 71 ± 17%pred, 97 ± 11%pred, and 79 ± 13%pred, which indicated borderline or mild restrictive ventilatory dysfunction. The decrease of D(L)CO was more severe than those of TLC, FEV1 and FVC. For patients with severe CHF, cardiopulmonary exercise function is extremely limited, D(L)CO generally moderately declines and ventilation function is merely mildly limited. D(L)CO is the parameter for cardiopulmonary coupling, reflecting limitation of the cardiovascular dysfunction while without ventilatory limit.

Impact of varying physical activity levels on airway sensitivity and bronchodilation in healthy humans.

PubMed

Smith, Joshua R; Kurti, Stephanie P; Johnson, Ariel M; Kolmer, Sarah A; Harms, Craig

2015-12-01

The purpose of this study was to determine if the amount of physical activity influences airway sensitivity and bronchodilation in healthy subjects across a range of physical activity levels. Thirty healthy subjects (age, 21.9 ± 2.6 years; 13 men/17 women) with normal pulmonary function reported to the laboratory on 2 separate occasions where they were randomized to breathe either hypertonic saline (HS) (nebulized hypertonic saline (25%) for 20 min) or HS followed by 5 deep inspirations (DIs), which has been reported to bronchodilate the airways. Pulmonary function tests (PFTs) were performed prior to both conditions and following the HS breathing or 5 DIs. Moderate to vigorous physical activity (MVPA) level was measured via accelerometer worn for 7 days. Following the HS breathing, forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) significantly decreased from baseline by -11.8% ± 8.4% and -9.3% ± 6.7%, respectively. A 2-segment linear model determined significant relationships between MVPA and percent change in FEV1 (r = 0.50) and FVC (r = 0.55). MVPA above ∼497 and ∼500 min/week for FEV1 and FVC, respectively, resulted in minor additional improvements (p > 0.05) in PFTs following the HS breathing. Following the DIs, FEV1 and FVC decreased (p < 0.05) by -7.3% ± 8.6% and -5.7% ± 5.7%, respectively, from baseline, but were not related (p > 0.05) to MVPA. In conclusion, these data demonstrate that higher MVPA levels attenuated airway sensitivity but not bronchodilation in healthy subjects.

Declining Pulmonary Function in Populations with Long-term Exposure to Polycyclic Aromatic Hydrocarbons-Enriched PM2.5.

PubMed

Shen, Meili; Xing, Jie; Ji, Qianpeng; Li, Zhihui; Wang, Yanhua; Zhao, Hongwei; Wang, Qingrong; Wang, Ting; Yu, Liwei; Zhang, Xiuchuan; Sun, Yaxin; Zhang, Zhihu; Niu, Yong; Wang, Huanqiang; Chen, Wen; Dai, Yufei; Su, Wenge; Duan, Huawei

2018-06-05

This study assesses the effects of long-term exposure to ambient air pollutants on inflammatory response and lung function. We selected 390 male coke oven workers with exposure to polycyclic aromatic hydrocarbons (PAHs) and fine particulate matter (PM 2.5 ) and 115 control workers. The average duration in the exposed group was 9.10 years. The total amount of PAHs was more enriched in PM 2.5 which collected from the coke oven workshops compared with the control areas. Correspondingly, the internal PAHs exposure indicated by urinary 1-hydroxypyrene (1-OHP) in the exposure group increased 25.7-fold compared to that of the control group. Moreover, the increasing level of urinary 1-OHP was associated with the decrease of forced expiratory volume in 1 s to forced vital capacity ratio (FEV 1 /FVC). In non-current smokers of exposure group, inverse correlation of 1-OHP with FEV 1 /FVC was also found. Particularly, an exposure duration-dependent decline in FEV 1 /FVC and mean forced expiratory flow between 25% and 75% of forced vital capacity (FEF 25-75% ) indicated that small airways were functionally obstructed. Furthermore, the increasing serum high-sensitivity C-reactive protein (hs-CRP) was correlated with the decline in pulmonary function in all subjects. These findings provide a clue that long-term exposure to PAHs-enriched PM 2.5 impairs pulmonary function in occupational population.

Non-atopic males with adult onset asthma are at risk of persistent airflow limitation.

PubMed

Amelink, M; de Nijs, S B; Berger, M; Weersink, E J; ten Brinke, A; Sterk, P J; Bel, E H

2012-05-01

Patients with asthma have on average a more rapid decline in FEV (1) as compared with the general population. Recent cluster analysis has revealed different asthma phenotypes that can be distinguished by age of onset and reversibility of airflow limitation. This study aimed at detecting risk factors associated with persistent airflow limitation in patients with the adult onset asthma phenotype. We recruited 88 patients with adult onset (≥ 18 years) asthma from an academic pulmonary outpatient clinic in the Netherlands. The associations of age, age of asthma onset, asthma duration, gender, race, atopy, smoking pack-years, BMI, use of oral corticosteroids with post-bronchodilator FEV (1) /FVC were investigated. Multiple linear regression analysis showed an association of absence of atopy (r = -0.27, B = -0.26, P = 0.01) and male gender (r = 0.31, B = 0.30, P = 0.004) with post-bronchodilator FEV (1) /FVC. Multiple logistic regression analysis showed that male patients were 10.8 (CI: 2.6-45.2) times the odds than women to have an FEV (1) /FVC < 0.7, and non-atopic patients were 5.2 (CI: 1.3-20.3) times the odds to have an FEV (1) /FVC < 0.7 than atopic patients. We conclude that in patients with adult onset asthma, male gender and absence of atopy are associated with persistent airflow limitation. This might suggest that amongst patients with adult onset asthma, non-atopic male patients are at increased risk of accelerated decline in lung function. © 2012 Blackwell Publishing Ltd.

The effect of flexible body armour on pulmonary function.

PubMed

Armstrong, Nicola C; Gay, Louise A

2016-05-01

The additional mass and fit of current military in-service body armour (ISBA) can reduce pulmonary function in a way that is characteristic of a restrictive respiratory impairment. This could ultimately impair exercise capacity and military performance. This study compared pulmonary function (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV1]) in UK ISBA (15.3 kg) and three flexible body armours (BAs) (FA1: 10 kg; FA2: 7.8 kg; FA3: 10 kg) in eight male soldiers. The design of the ballistic plates differed between the BAs to improve the flexibility. FVC and FEV1 were reduced by 4-6%, without reduction in FEV1/FVC for ISBA, FA2 and FA3, when compared to NoBA (p < 0.05). No difference was observed between FA1 and NoBA. As expected, wearing BA caused a mild restrictive ventilatory impairment; however, modifications to BA design can reduce the degree of this impairment. Practitioner Summary: This study showed that wearing body armour caused a mild restrictive ventilatory impairment. However, the design of the armour can be modified to reduce the degree of this impairment. This may lead to improvements in soldier performance during tasks that require body armour.

Lung function association with outdoor temperature and relative humidity and its interaction with air pollution in the elderly.

PubMed

Lepeule, Johanna; Litonjua, Augusto A; Gasparrini, Antonio; Koutrakis, Petros; Sparrow, David; Vokonas, Pantel S; Schwartz, Joel

2018-04-21

While the effects of weather variability on cardio-respiratory mortality are well described, research examining the effects on morbidity, especially for vulnerable populations, is warranted. We investigated the associations between lung function and outdoor temperature (T in Celsius degrees (°C)) and relative humidity (RH), in a cohort of elderly men, the Normative Aging Study. Our study included 1103 participants whose forced vital capacity (FVC), forced expiratory volume in one second (FEV 1 ), and weather exposures were assessed one to five times during the period 1995-2011 (i.e. 3162 observations). Temperature and relative humidity were measured at one location 4 h to 7 days before lung function tests. We used linear mixed-effects models to examine the associations with outdoor T and RH. A 5-degree increase in the 3-day moving average T was associated with a significant 0.7% decrease (95%CI: -1.24, -0.20) in FVC and a 5% increase in the 7-day moving average RH was associated with a significant 0.2% decrease (95%CI: -0.40, -0.02) in FVC and FEV 1 . The associations with T were greater when combined with higher exposures of black carbon with a 1.6% decrease (95%CI -2.2; -0.9) in FVC and a 1% decrease (95%CI -1.7; -0.4) in FEV 1 . The relationships between T and RH and lung function were linear. No synergistic effect of T and RH was found. Heat and lung function are two predictors of mortality. Our findings suggest that increases in temperature and relative humidity are related to decreases in lung function, and such observations might be amplified by high black carbon levels. Copyright © 2018 Elsevier Inc. All rights reserved.

Effects of bronchoscopy on lung function in asthmatics.

PubMed

Bellinger, Christina; Bleecker, Eugene R; Peters, Stephen; Pascual, Rodolfo; Krings, Jeffrey; Smith, Regina; Hastie, Annette T; Moore, Wendy C

2017-10-01

To better understand the changes in pulmonary physiology related to asthma severity following bronchoscopy, we performed scheduled pre- and post-procedure spirometry on subjects undergoing bronchoscopy in our research program. Control subjects and asthma subjects were recruited for bronchoscopy. On the day of bronchoscopy, subjects underwent spirometry pre-bronchoscopy and then up to three sets within 2 hour following the completion of bronchoscopy. A subset of patients had a second bronchoscopy after 2 weeks of treatment with oral prednisolone (40mg daily). A total of 92 subjects had at least one bronchoscopy (12 control subjects, 56 nonsevere asthma (NSA), 24 severe asthma (SA)). The SA and NSA groups had similar decreases in forced expiratory volume in 1 second (FEV1) (-20±13% vs.-19±16%, p = 0.92) and forced vital capacity (FVC) (-20±12% vs.-20±14%, p = 0.80), but no change in FEV1/FVC ratio. The control and NSA group had more rapid recovery of both FEV1 and FVC by 2 hour compared to the SA group (p = 0.01). In the subset of 36 subjects (22 NSA, 14 SA) who underwent a second bronchoscopy following the administration of oral prednisolone for 14 days, steroids resulted in more rapid recovery of lung function (p < 0.04). Following bronchoscopy the lung function of NSA subjects recovered more quickly than SA subjects. Treatment with oral corticosteroids was associated with a quicker recovery of FEV1 which suggests an inflammatory mechanism for these changes in lung compliance.

Lower lung function associates with cessation of menstruation: UK Biobank data.

PubMed

Amaral, André F S; Strachan, David P; Gómez Real, Francisco; Burney, Peter G J; Jarvis, Deborah L

2016-11-01

Little is known about the effect of cessation of menstruation on lung function. The aims of the study were to examine the association of lung function with natural and surgical cessation of menstruation, and assess whether lower lung function is associated with earlier age at cessation of menstruation.The study was performed in 141 076 women from the UK Biobank, who had provided acceptable and reproducible spirometry measurements and information on menstrual status. The associations of lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1 ), spirometric restriction (FVC < lower limit of normal (LLN)), airflow obstruction (FEV 1 /FVC

[Analysis of correlation between pulmonary function and expression levels of matrix metalloproteinases-9 and tissue inhibitor of metalloproteinase-1 among toluene diisocyanate exposed workers].

PubMed

Miao, P P; Meng, T; Jia, Q; Niu, Y; Ye, M; Ji, Y Q; Ju, R; Chen, X L; Shao, H; Zheng, Y X; Dai, Y F

2016-05-01

To investigate the effect of occupational toluene diisocyanate(TDI) exposure on matrix metalloproteinases-9 (MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1), and analysis of the correlation of MMP-9,TIMP-1,MMP-9/TIMP-1 and lung function. In October 2014, based on cluster sampling, we conducted a cross-sectional study in a TDI production factory located in China's western region. 61 exposed workers were recruited from workers engaged in packing, operating and checking. Based on different levels of the external exposure, the packers were classified as high exposed group, while operators and checkers as low exposed group. 58 factory managers, matching age and agent, were selected as controls, having same work intense and not contacting the TDI or other allergens. The questionnaire surveys were used to obtain the agent, age, work age, smoking and drinking, personal and family allergic history, occupational history, and the recent health conditions. The levels of MMP-9 and TIMP-1 in serum of subjects were determind by ELISA. The time weighted average concentrations (8h-TWA) were used to describe the levels of TDI air exposure in working environment. Spearman correlation assay was used to investigate the correlation of MMP-9, TIMP-1, MMP-9/TIMP-1 and lung function, exposure time. 8-hour TWA means of TDI air levels in exposed group, packers, operators and checkers were 0.39, 0.76, 0.25 mg/m(3), respectively . According to the external exposure concentration, the packers were classified as high exposed group, and the operators and checkers were classified as low exposed group. In controls, low exposed group and high exposed group, the levels of MMP-9, respectively, were (807.21±347.70),(586.91±317.50),(388.94±312.01) ng/ml (χ(2)=16.69, P<0.001), respectively, and the P50(P25-P75) of MMP-9/TIMP-1 were 4.67(2.87-6.68), 2.3(1.44-3.48), 1.11(0.59-1.48) (χ(2)=39.42, P<0.001), respectively, and the concentrations of TIMP-1, were (173.44±72.67), (236.12±51.98), (302.81±44.39) ng/ml (F=20.09, P< 0.001), respectively. The levels P50(P25-P75) of FVC, FEV1.0 and FEV1.0/FVC in exposed group were, 92.8% (86.0%-101.8%), 85.5%(76.7%-92.8%), 112.5(108.2-118.5), respectively, which were lower than that in control group (124.3%(107.9%-144.2%), 142.7%(119.1%-155.7%), 129.2(123.5-134))(Z values were 7.70, 8.97, 8.62, and all P<0.001). Spearman rank correlation analysis showed that levels of MMP-9 were positively associated with FEV1.0, and FEV1.0/FVC (r values were 0.27, 0.25, respectively, all P<0.05), and The levels of TIMP-1 were negatively associated with FVC, FEV1.0, and FEV1.0/FVC (r valuse were -0.33, -0.39, -0.39, all P<0.05).The levels of MMP-9 were negatively correlated with exposure time(r=-0.26, P=0.040). The positive correlations of MMP-9/TIMP-1 with FVC, FEV1.0, and FEV1.0/FVC were also found (r valuse were 0.34, 0.44, 0.40, all P<0.05). TDI exposure could induce the downs of MMP-9 and MMP-9/TIMP-1 associated with lung functions. The MMP-9 and MMP-9/TIMP-1,in a way, could reflect the respiratory inflammatory injury caused by TDI exposure.

Lung function gain in preterm infants with and without bronchopulmonary dysplasia.

PubMed

Sanchez-Solis, Manuel; Perez-Fernandez, Virginia; Bosch-Gimenez, Vicente; Quesada, Juan J; Garcia-Marcos, Luis

2016-09-01

The aim of our study was to determine whether the development of lung function, during the first 2 years of life, is different in preterm infants who suffered or did not suffer from Bronchopulmonary dysplasia (BPD). We also assessed the role of nutritional status and growth in that development. Lung function tests were performed in 71 preterm infants at two time points: 6 months of corrected age and 1 year after. FVC, FEV0.5, FEF75 , and FEF25-75 were obtained from maximal expiratory volume curves by means of the raised volume rapid thoraco-abdominal compression technique. When comparing lung function measurements, we found that FVC (P = 0.033) FEV0.5 (P = 0.044), FEF75 (P = 0.014), and FEF25-75 (P = 0.036) were significantly lower in BPD infants. We did not find any catch-up of lung function during the study time, in neither the whole group of children nor within the BPD or non-BPD groups. The increase in lung function was directly proportional to the increase in weight and length. The multivariate analysis showed that the increase in z-score of FVC (P = 0.043), FEV0.5 (P = 0.015), and FEF75 (P = 0.042), was related with the height velocity during the study period. Infants who suffered from BPD have lower lung function (FVC, FEV0.5 , FEF75 , and FEF25-75 ), than those non-BPD, at two different time points 1 year apart. During the study period, there was no lung function catch-up in either BPD or non-BPD infants. The increase in length is closely associated to the increase in lung function. Pediatr Pulmonol. 2016; 51:936-942. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Effects of ozone and other pollutants on the pulmonary function of adult hikers.

PubMed Central

Korrick, S A; Neas, L M; Dockery, D W; Gold, D R; Allen, G A; Hill, L B; Kimball, K D; Rosner, B A; Speizer, F E

1998-01-01

This study evaluated the acute effects of ambient ozone (O3), fine particulate matter (PM2.5), and strong aerosol acidity on the pulmonary function of exercising adults. During the summers of 1991 and 1992, volunteers (18-64 years of age) were solicited from hikers on Mt. Washington, New Hampshire. Volunteer nonsmokers with complete covariates (n = 530) had pulmonary function measured before and after their hikes. We calculated each hiker's posthike percentage change in forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), the ratio of these two (FEV1/FVC), forced expiratory flow between 25 and 75% of FVC(FEF25-75%), and peak expiratory flow rate (PEFR). Average O3 exposures ranged from 21 to 74 ppb. After adjustment for age,sex, smoking status (former versus never), history of asthma or wheeze, hours hiked, ambient temperature, and other covariates, there was a 2.6% decline in FEV1 [95% confidence interval (CI), 0.4-4.7; p = 0.02] and a 2.2% decline in FVC (CI, 0.8-3.5; p =0.003) for each 50 ppb increment in mean O3. There were consistent associations of decrements in both FVC (0.4% decline; CI,0.2-0.6, p = 0.001) and PEFR (0.8% decline; CI, 0.01-1.6; p = 0.05) with PM2.5 and of decrements in PEFR (0.4% decline; CI, 0.1-0.7; p = 0.02) with strong aerosol acidity across the interquartile range of these exposures. Hikers with asthma or a history of wheeze (n = 40) had fourfold greater responsiveness to ozone than others. With prolonged outdoor exercise, low-level exposures to O3, PM2.5, and strong aerosol acidity were associated with significant effects on pulmonary function among adults. Hikers with a history of asthma or wheeze had significantly greater air pollution-related changes in pulmonary function. Images Figure 1 Figure 2 PMID:9435151

Myelodysplastic syndrome patients present more severe respiratory muscle impairment and reduced forced vital capacity: Is disordered inflammatory signaling the culprit?

PubMed

Okubo, Bruno Memória; Matos, Anacélia Gomes de; Ribeiro Junior, Howard Lopes; Borges, Daniela de Paula; Oliveira, Roberta Taiane Germano de; de Castro, Marilena Facundo; Martins, Manoel Ricardo Alves; Gonçalves, Romélia Pinheiro; Bruin, Pedro Felipe Carvalhedo; Pinheiro, Ronald Feitosa; Magalhães, Silvia Maria Meira

2017-01-01

The ageing process is associated with gradual decline in respiratory system performance. Anemia is highly prevalent among older adults and usually associated with adverse outcomes. Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic malignancies with increasing incidence with age and characterized by anemia and other cytopenias. The main objectives of this study were to evaluate respiratory muscle strength and lung function in elderly patients with anemia, compare data between myelodysplastic syndromes and non-clonal anemias and evaluate the influence of serum IL-8 level and NF-kB activity on deteriorate pulmonary function in this specific population. Individuals aged 60 and older with anemia secondary to MDS, non-clonal anemia and healthy elderly individuals. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/ FVC ratio were measured by spirometry. Respiratory muscle strength was evaluated by maximal static respiratory pressures measurement. IL-8 analysis was performed by ELISA and activity of NF-kB by chemiluminescent assay. Mean Hb concentration was comparable between patients with anemia. Significant differences were detected between all patients with anemia and controls for maximum-effort inspiratory mouth pressure (PImax) and also for maximum-effort expiratory mouth pressure (PEmax). The MDS group recorded a significantly lower PImax and PEmax percent predicted when compared to non-clonal anemia group. For FVC and FEV1, a significant difference was found in anemic patients, with even significantly lower values for FVC and FEV1 in MDS group. No significant differences were detected for PImax and PEmax and spirometry parameters when anemic patients were stratified according to the degree of anemia. A significant negative impact in FVC (% pred), PImax (% pred) and PEmax (% pred) was observed in patients with MDS and higher levels of IL-8 or increased activity of NF-kB. A negative impact of anemia, independent of its degree, was demonstrated in respiratory muscle strength and lung function particularly in MDS. The well known elevated proinflammatory cytokines in MDS patients were proposed to play a role as was demonstrated by detrimental effect of higher IL-8 and NF-kB in pulmonary function tests in this population.

[Clinical and functional characteristics of patients prior to lung transplantation: report of experience at the Clínica Puerta de Hierro].

PubMed

Laporta, Rosalía; Ussetti, Piedad; Mora, Gema; López, Cristina; Gómez, David; de Pablo, Alicia; Lázaro, M Teresa; Carreño, M Cruz; Ferreiro, M José

2008-08-01

The time at which lung transplantation is indicated is determined by clinical and functional criteria that vary according to the particular disease. The aim of our study was to present the criteria according to which patients were placed on waiting lists for lung transplantation in our hospital. We analyzed retrospectively the clinical characteristics, lung function, heart function, and 6-minute walk test results of patients who had received a lung transplant in our hospital from January 2002 through September 2005. During the study period 100 lung transplants were performed. The mean age of the patients was 45 years (range, 15-67 years) and 57% were men. The diseases that most often led to a lung transplant were chronic obstructive pulmonary disease (COPD) (35%), pulmonary fibrosis (29%), and bronchiectasis (21%). Lung function values differed by disease: mean (SD) forced expiratory volume in 1 second (FEV1) was 20% (11%) and forced vital capacity (FVC) was 37% (15%) in patients with COPD; FEV1 was 41% (15%) and FVC, 40% (17%) in patients with pulmonary fibrosis; and FEV1 was 23% (7%) and FVC, 37% (10%) in patients with bronchiectasis. The patients who received lung transplants in our hospital were in advanced phases of their disease and met the inclusion criteria accepted by the various medical associations when they were placed on the waiting list.

No mediating effects of glycemic control and inflammation on the association between vitamin D and lung function in the general population.

PubMed

Kaul, Anne; Gläser, Sven; Hannemann, Anke; Stubbe, Beate; Felix, Stefan B; Nauck, Matthias; Ewert, Ralf; Friedrich, Nele

2017-04-01

Vitamin D deficiency is discussed to be associated with lung health. While former studies focused on subjects suffering from pulmonary diseases, we aimed to investigate the association of 25-hydroxy vitamin D [25(OH)D] with lung function in the general population and examined whether mediating effects of inflammation, glycemic control or renal function exist. 1404 participants from the Study of Health in Pomerania with pulmonary function testing assessed by expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), total lung capacity and Krogh index were used. Adjusted analysis of variance, linear regression models and mediation analyses were performed. Significant positive associations between 25(OH)D levels and FEV 1 , FVC and Krogh index were found. Mediator analyses revealed no mediating effect of inflammation (fibrinogen), glycemic control (HbA1c) or renal function (eGFR) on associations with FEV 1 or FVC. With respect to Krogh-Index, the association to 25(OH)D was slightly mediated by fibrinogen with a proportion mediated of 9.7%. Significant positive associations of 25(OH)D with lung function were revealed in a general population. The proposed mediating effects of inflammation, glycemic control and renal function on these relations were not confirmed. Further studies examining the causality of the association between 25(OH)D and lung function are necessary. Copyright © 2017 Elsevier Ltd. All rights reserved.

Spirometric reference values for Hopi Native American children ages 4-13 years.

PubMed

Arnall, David A; Nelson, Arnold G; Hearon, Christopher M; Interpreter, Christina; Kanuho, Verdell

2016-04-01

Spirometry is the most important tool in diagnosing pulmonary disease and is the most frequently performed pulmonary function test. Respiratory disease is also one of the greatest causes for morbidity and mortality on the Hopi Nation, but no specific reference equations exist for this unique population. The purpose of this study was to determine if population reference equations were necessary for these children and, if needed, to create new age and race-specific pulmonary nomograms for Hopi children. Two hundred and ninety-two healthy children, ages 4-13 years, attending Hopi Nation elementary schools in Arizona, were asked to perform spirometry for a full battery of pulmonary volumes and capacities of which the following were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1 ), FEV1 % (FEV1 /FVC), FEF25-75% and peak expiratory flow rate (PEFR). Spirometric data from Navajo children living in the same geographical region as the Hopi children were compared as well as spirometric data from common reference values used for other ethnic groups in the USA. Spirometry tests from 165 girls and 127 boys met American Thoracic Society quality control standards. We found that the natural log of height, body mass and age were significant predictors of FEV1 , FVC, and FEF25-75% in the gender-specific models and that lung function values all increased with height and age as expected. The predictions using the equations derived for Navajo, Caucasian, Mexican-American, African-American youth were significantly different (P ≤ 0.05) from the predictions derived from the Hopi equations for all of the variables across both genders, with the exceptions of Hopi versus Navajo FEV1 /FVC in the males and Hopi versus Caucasians FEF25-75% in the females. Thus it would appear for this population important to have specific formulae to provide more accurate reference values. © 2015 Wiley Periodicals, Inc.

The effect of habitual waterpipe tobacco smoking on pulmonary function and exercise capacity in young healthy males: A pilot study.

PubMed

Hawari, F I; Obeidat, N A; Ghonimat, I M; Ayub, H S; Dawahreh, S S

2017-01-01

Evidence regarding the health effects of habitual waterpipe smoking is limited, particularly in young smokers. Respiratory health and cardiopulmonary exercise tests were compared in young male habitual waterpipe smokers (WPS) versus non-smokers. 69 WPS (≥3 times/week for three years) and 69 non-smokers were studied. Respiratory health was assessed through the American Thoracic Society and the Division of Lung Diseases (ATS-DLD-78) adult questionnaire. Pulmonary function and cardiopulmonary exercise tests were performed. Self-reported respiratory symptoms, forced expiratory volume in first second (FEV 1 ), forced vital capacity (FVC), FEV 1 /FVC ratio, forced expiratory flow between 25 and 75% of FVC (FEF 25-75% ), peak expiratory flow (PEF), exercise time, peak end-tidal CO 2 tension (PetCO 2 ), subject-reported leg fatigue and dyspnea; peak O 2 uptake (VO 2 max), and end-expiratory lung volume (EELV) change from baseline (at peak exercise) were measured. WPS were more likely than non-smokers to report respiratory symptoms. WPS also demonstrated: shorter exercise time; lower peak VO 2 ; higher perceived dyspnea at mid-exercise; lower values of the following: FEV 1 , FVC, PEF, and EELV change. Habitual waterpipe tobacco smoking in young seemingly healthy individuals is associated with a greater burden of respiratory symptoms and impaired exercise capacity. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effects of Ramadan Intermittent Fasting (RIF) on Spirometric Data of Stable COPD Patients: A Pilot Study.

PubMed

Zouari, Hajer; Latiri, Imed; Mahjoub, Mohamed; Boussarsar, Mohamed; Benzarti, Mohamed; Abdelghani, Ahmed; Ben Saad, Helmi

2018-03-01

No previous study has raised the effects of RIF on lung function data of chronic obstructive pulmonary disease (COPD) patients. The objective of the present study was to assess the effects of RIF on spirometric data measured in male patients with a stable COPD. Sixteen patients with stable COPD (mean ± SD of age: 64 ± 7 years) who fasted during Ramadan volunteered to the study. Three sessions (Before-R, End-R, and After-R) were selected for spirometry tests that were consistently performed 2.5-4.5 hr before fasting break. Assessment sessions comprised: forced vital capacity (FVC), 1st s forced expiratory volume (FEV 1 ), FEV 1 /FVC, peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), and forced expiratory flow rate at the x% of FVC to be exhaled (FEFx%). A reversibility test was performed only during the Before-Ramadan session. Spirometric data were expressed in percentages of local reference values. Findings were analyzed by applying repeated measures analysis of variance. The mean ± SD of the postbronchodilator FEV 1 /FVC ratio and the FEV 1 were, respectively, 0.52 ± 0.14 and 48 ± 19%. The mean ± SD of FEV 1 (Before-R: 47 ± 19, End-R: 45 ± 18, After-R: 44 ± 19%), FVC (Before-R: 73 ± 18, End-R: 71 ± 16, After-R: 69 ± 17%), FEV 1 /FVC (Before-R: 67 ± 16, End-R: 66 ± 16, After-R: 65 ± 16%), PEF (Before-R: 46 ± 19, End-R: 47 ± 22, After-R: 45 ± 21%), MMEF (Before-R: 19 ± 10, End-R: 18 ± 8, After-R: 18 ± 9%), FEF 25% (Before-R: 16 ± 6, End-R: 16 ± 5, After-R: 15 ± 5%), FEF 50% (Before-R: 21 ± 14, End-R: 20 ± 12, After-R: 20 ± 12%) and FEF 75% (Before-R: 27 ± 19, End-R: 27 ± 19, After-R: 27 ± 19%) were not significantly influenced by RIF. RIF did not bring about any significant changes in the spirometric data of stable COPD male patients fasting the 2016 holy month of Ramadan.

Decreased response to inhaled steroids in overweight and obese asthmatic children.

PubMed

Forno, Erick; Lescher, Rachel; Strunk, Robert; Weiss, Scott; Fuhlbrigge, Anne; Celedón, Juan C

2011-03-01

The mechanisms and consequences of the observed association between obesity and childhood asthma are unclear. We sought to determine the effect of obesity on treatment responses to inhaled corticosteroids in asthmatic children. We performed a post hoc analysis to evaluate the interaction between body mass index (BMI) and treatment with inhaled budesonide on lung function in the Childhood Asthma Management Program trial. Participants were then stratified into overweight/obese and nonoverweight groups, and their response to inhaled budesonide was analyzed longitudinally over the 4 years of the trial. There was a significant interaction between BMI and budesonide for prebronchodilator FEV(1)/forced vital capacity (FVC) ratio (P = .0007) and bronchodilator response (BDR; P = .049) and a nonsignificant trend for an interaction between BMI and budesonide on prebronchodilator FEV(1) (P = .15). Nonoverweight children showed significant improvement with inhaled budesonide in lung function (FEV(1), FEV(1)/FVC ratio, and BDR) during the early (years 1-2) and late (years 3-4) stages of the trial. Overweight/obese children had improved FEV(1) and BDR during the early but not the late stage of the trial and showed no improvement in FEV(1)/FVC ratio. When comparing time points at which both groups showed a significant response, the degree of improvement among nonoverweight children was significantly greater than in overweight/obese children at most visits. Nonoverweight children had a 44% reduction in the risk of emergency department visits or hospitalizations throughout the trial (P = .001); there was no reduction in risk among overweight/obese children (P = .97). Compared with children of normal weight, overweight/obese children in the Childhood Asthma Management Program showed a decreased response to inhaled budesonide on measures of lung function and emergency department visits/hospitalizations for asthma. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Effect of backpack carrying on forced vital capacity in cystic fibrosis: A randomized crossover-controlled trial.

PubMed

Combret, Yann; Medrinal, Clement; Prieur, Guillaume; Robledo Quesada, Aurora; Le Roux, Pascal; Reychler, Grégory

2018-01-01

Backpack carrying impacts lung function in healthy children but the effect in children with cystic fibrosis (CF) is unknown. Three backpack positions were tested: no backpack (NB), a 12.5% body-weight backpack carried bilaterally (BB) or unilaterally (UB), at rest and during a 10 minute walk. Primary outcome was forced vital capacity (FVC). Secondary outcomes included comparison of cardio-respiratory variables within and between groups. Nine children with CF (13.3±2.6 years; FEV1 66±22%) and 18 healthy children (13.8±1.8 years; FEV1 107±30%) were included. FVC was reduced with UB compared to NB (68.5±23.3% vs 72.1±24.3%, p = 0.024) in children with CF. FEV1, MIP and MEP decreased more with UB in children with CF than in healthy peers. Increases in VO2, VCO2 and minute ventilation with UB were greater in the CF group during walking. Unilateral backpack wearing affects FVC in children with CF and requires greater cardio-respiratory adjustments compared to healthy peers.

Impact of backpack load on ventilatory function among 9-12 year old Saudi girls.

PubMed

Al-Katheri, Abeer E

2013-12-01

To explore the backpack load as a percentile of body weight (BW) and its impact on ventilatory function including tidal volume (Vt), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow (PEF), and maximum voluntary ventilation (MVV) among 9-12 year old Saudi girls. This is a prospective, experimental study of 91 Saudi girls aged between 9-12 years from primary schools in Riyadh, Saudi Arabia. The study took place in King Saud University, Riyadh, Saudi Arabia between April 2012 and May 2012. Ventilatory function was measured under 2 conditions: a free standing position without carrying a backpack, and while carrying a backpack. The backpack load observed was 13.8% of the BW, which is greater than the recommended limit (10% BW). All values of ventilatory function were significantly reduced after carrying the backpack (p<0.001) with the exception of FEV1/FVC (p>0.178). The reduction was observed even with the lowest backpack load (7.4% BW). A significant reduction was reported for most of the ventilatory function parameters while carrying the backpack. This reduction was apparent even with the least backpack load (7.4% BW) carried by the participants. This study recommends that the upper safe limit of backpack load carried by Saudi girls aged 9-12 years should be less than 7.4% of BW.

Air pollution and fuel vapour induced changes in lung functions: are fuel handlers safe?

PubMed

Chawla, Anuj; Lavania, A K

2008-01-01

Automobile exhaust derived air pollutants have become a major health hazard. Coupled with the inhalation of fuel vapour, as occurs in petrol station workers, this may lead to significant impairment of lung function. Spirometric lung functions were studied in 58 petrol station workers to examine this possibility. The forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory flow 25%-75% (FEF25-75) and peak expiratory flow (PEF) were recorded and analysed separately for smokers and non-smokers. The workers were divided into 5 groups for analysis of data based on the number of years of work in the petrol pumps. Outdoor air analysis was also carried out. The FVC, FEV1 and PEF declined significantly with increasing years of work in petrol stations in both smokers and non-smokers. Smoking as an independent variable was found to affect the FEV1 significantly but not FVC or PEF. The FEF25-75 was found to be the most affected spirometric value with a significant reduction with increasing years of work. Smoking as such did not affect it. Oxides of nitrogen (NOx), suspended particulate matter (SPM) and particulate matter less than 10 microns (PM10) in outdoor air were higher than the national ambient air quality standards. Exposure to automobile exhaust and fuel vapour impairs lung function in a time-dependent manner. Cigarette smoking appears to accelerate the decline.

Infection, inflammation, and lung function decline in infants with cystic fibrosis.

PubMed

Pillarisetti, Naveen; Williamson, Elizabeth; Linnane, Barry; Skoric, Billy; Robertson, Colin F; Robinson, Phil; Massie, John; Hall, Graham L; Sly, Peter; Stick, Stephen; Ranganathan, Sarath

2011-07-01

Better understanding of evolution of lung function in infants with cystic fibrosis (CF) and its association with pulmonary inflammation and infection is crucial in informing both early intervention studies aimed at limiting lung damage and the role of lung function as outcomes in such studies. To describe longitudinal change in lung function in infants with CF and its association with pulmonary infection and inflammation. Infants diagnosed after newborn screening or clinical presentation were recruited prospectively. FVC, forced expiratory volume in 0.5 seconds (FEV(0.5)), and forced expiratory flows at 75% of exhaled vital capacity (FEF(75)) were measured using the raised-volume technique, and z-scores were calculated from published reference equations. Pulmonary infection and inflammation were measured in bronchoalveolar lavage within 48 hours of lung function testing. Thirty-seven infants had at least two successful repeat lung function measurements. Mean (SD) z-scores for FVC were -0.8 (1.0), -0.9 (1.1), and -1.7 (1.2) when measured at the first visit, 1-year visit, or 2-year visit, respectively. Mean (SD) z-scores for FEV(0.5) were -1.4 (1.2), -2.4 (1.1), and -4.3 (1.6), respectively. In those infants in whom free neutrophil elastase was detected, FVC z-scores were 0.81 lower (P=0.003), and FEV(0.5) z-scores 0.96 lower (P=0.001), respectively. Significantly greater decline in FEV(0.5) z-scores occurred in those infected with Staphylococcus aureus (P=0.018) or Pseudomonas aeruginosa (P=0.021). In infants with CF, pulmonary inflammation is associated with lower lung function, whereas pulmonary infection is associated with a greater rate of decline in lung function. Strategies targeting pulmonary inflammation and infection are required to prevent early decline in lung function in infants with CF.

Association Between ADRB2 Genetic Polymorphisms and the Risk of Chronic Obstructive Pulmonary Disease: A Case-Control Study in a Chinese Population.

PubMed

Zhao, Hui; Wu, Xuan; Dong, Chun-Ling; Wang, Bi-Ying; Zhao, Jiao; Cao, Xian-E

2017-08-01

This study was designed to investigate the association between single nucleotide polymorphisms (SNPs) of the β2-adrenergic receptor (ADRB2) gene and the risk of chronic obstructive pulmonary disease (COPD) in a Chinese population. From January 2010 to October 2014, 261 COPD patients were selected as the case group and 239 healthy subjects were selected as the control group. Pulmonary function tests were performed to detect forced vital capacity (FVC), 1-s forced expiratory volume (FEV 1 ), and FEV 1 /FVC (%). rs1042711, rs1042714, and rs1042718 were selected as tagSNPs of the ADRB2 gene from the HapMap database in accordance with previous studies. The ADRB2 genotypes were established by real-time polymerase chain reaction assays using TaqMan-labeled probes. The relationships between the ADRB2 polymorphisms and COPD risk were estimated using logistic regression analyses. The frequency of the genotypes and alleles of rs1042711 in ADRB2 showed a significant difference between the COPD and control groups (p < 0.05); compared with the CC genotype, the non-CC genotypes showed an increased COPD risk (p = 0.002). Compared with the CC haplotype, the TG haplotype increased COPD risk, while the CG haplotype reduced COPD risk for normal individuals. Compared with the CC genotype, the TT genotype showed significantly lower FEV 1 and FEV 1 /FVC (p = 0.022, p = 0.0191, respectively). Both the TC and TG haplotypes showed lower FEV 1 and FEV 1 /FVC in comparison with the CC haplotype (both p < 0.05). The results of logistic regression analysis showed that rs1042711 of ADRB2 and smoking history were associated with COPD risk (both p < 0.05). It is indicated that the TT genotype of rs1042711 and smoking pack years are both risk factors for COPD.

Relationship between blood levels of heavy metals and lung function based on the Korean National Health and Nutrition Examination Survey IV–V

PubMed Central

Leem, Ah Young; Kim, Se Kyu; Chang, Joon; Kang, Young Ae; Kim, Young Sam; Park, Moo Suk; Kim, Song Yee; Kim, Eun Young; Chung, Kyung Soo; Jung, Ji Ye

2015-01-01

Background Heavy metal exposure may contribute to inflammation in the lungs via increased oxidative stress, resulting in tissue destruction and obstructive lung function (OLF). In this study, we evaluated the relationship between lead and cadmium levels in blood, and lung function in the Korean population. Methods Pooled cross-sectional data from 5,972 subjects who participated in the Korean National Health and Nutrition Examination Survey 2008–2012 were used for this study. OLF was defined as forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) <0.7. Graphite-furnace atomic absorption spectrometry was used to measure levels of lead and cadmium in blood. Results Adjusted means for age, sex, body mass index, and smoking status in blood lead and cadmium levels were increased with age and were higher in men and current smokers. The FEV1/FVC ratio was lower in the highest quartile group of lead (78.4% vs 79.0%; P=0.025) and cadmium (78.3% vs 79.2%; P<0.001) concentrations, compared with those in the lowest quartile groups. Multiple linear regression demonstrated an inverse relationship between the FEV1/FVC ratio and concentrations of lead (estimated −0.002; P=0.007) and cadmium (estimated −0.005; P=0.001). Of the 5,972 subjects, 674 (11.3%) were classified into the OLF group. Among current smokers, the risk of OLF was higher in subjects in the highest quartile group of cadmium concentration than in those in the lowest quartile group (odds ratio 1.94; 95% confidence interval 1.06–3.57). Conclusion We demonstrated a significant association between the FEV1/FVC ratio and blood concentrations of lead and cadmium in the Korean population. The risk for OLF was elevated with increasing concentrations of cadmium among current smokers. PMID:26345298

Lifetime Exposure to Ambient Pollution and Lung Function in Children

PubMed Central

Rifas-Shiman, Sheryl L.; Litonjua, Augusto A.; Oken, Emily; Gillman, Matthew W.; Kloog, Itai; Luttmann-Gibson, Heike; Zanobetti, Antonella; Coull, Brent A.; Schwartz, Joel; Koutrakis, Petros; Mittleman, Murray A.; Gold, Diane R.

2016-01-01

Rationale: Few studies have examined associations between exposure to air pollution and childhood lung function after implementation of strict air quality regulations in the 1990s. Objectives: To assess traffic-related pollution exposure and childhood lung function. Methods: We geocoded addresses for 614 mother–child pairs enrolled during pregnancy in the Boston area 1999–2002 and followed them until a mid-childhood visit (median age, 7.7). We calculated the proximity of the home to the nearest major roadway. We estimated first year of life, lifetime, and prior-year exposure to particulate matter with a diameter smaller than 2.5 μm (PM2.5) by a hybrid model using satellite-derived aerosol optical depth, and to black carbon (BC) by a land-use regression model. Measurements and Main Results: Residential proximity to roadway and prior-year and lifetime PM2.5 and BC exposure were all associated with lower FVC. Associations with FEV1 were also negative and proportionally similar. Pollution exposures were not associated with the FEV1/FVC ratio or bronchodilator response. Compared with distances greater than or equal to 400 m, living less than 100 m from a major roadway was associated with lower FVC (−98.6 ml; −176.3 to −21.0). Each 2 μg/m3 increment in prior-year PM2.5 was associated with lower FVC (−21.8 ml; −43.9 to 0.2) and higher odds of FEV1 less than 80% predicted (1.41; 1.03–1.93). Each 0.2 μg/m3 increment in prior-year BC was associated with a 38.9 ml (−70.4 to −7.3) lower FVC. Conclusions: Estimates of long-term exposure to ambient pollution, including proximity to major roadway, PM2.5, and BC (a traffic-related PM2.5 constituent), were associated with lower lung function in this Boston-area cohort of children with relatively low pollution exposures. PMID:26575800

Lifetime Exposure to Ambient Pollution and Lung Function in Children.

PubMed

Rice, Mary B; Rifas-Shiman, Sheryl L; Litonjua, Augusto A; Oken, Emily; Gillman, Matthew W; Kloog, Itai; Luttmann-Gibson, Heike; Zanobetti, Antonella; Coull, Brent A; Schwartz, Joel; Koutrakis, Petros; Mittleman, Murray A; Gold, Diane R

2016-04-15

Few studies have examined associations between exposure to air pollution and childhood lung function after implementation of strict air quality regulations in the 1990s. To assess traffic-related pollution exposure and childhood lung function. We geocoded addresses for 614 mother-child pairs enrolled during pregnancy in the Boston area 1999-2002 and followed them until a mid-childhood visit (median age, 7.7). We calculated the proximity of the home to the nearest major roadway. We estimated first year of life, lifetime, and prior-year exposure to particulate matter with a diameter smaller than 2.5 μm (PM2.5) by a hybrid model using satellite-derived aerosol optical depth, and to black carbon (BC) by a land-use regression model. Residential proximity to roadway and prior-year and lifetime PM2.5 and BC exposure were all associated with lower FVC. Associations with FEV1 were also negative and proportionally similar. Pollution exposures were not associated with the FEV1/FVC ratio or bronchodilator response. Compared with distances greater than or equal to 400 m, living less than 100 m from a major roadway was associated with lower FVC (-98.6 ml; -176.3 to -21.0). Each 2 μg/m(3) increment in prior-year PM2.5 was associated with lower FVC (-21.8 ml; -43.9 to 0.2) and higher odds of FEV1 less than 80% predicted (1.41; 1.03-1.93). Each 0.2 μg/m(3) increment in prior-year BC was associated with a 38.9 ml (-70.4 to -7.3) lower FVC. Estimates of long-term exposure to ambient pollution, including proximity to major roadway, PM2.5, and BC (a traffic-related PM2.5 constituent), were associated with lower lung function in this Boston-area cohort of children with relatively low pollution exposures.

Exercise-induced bronchoconstriction alters airway nitric oxide exchange in a pattern distinct from spirometry.

PubMed

Shin, Hye-Won; Schwindt, Christina D; Aledia, Anna S; Rose-Gottron, Christine M; Larson, Jennifer K; Newcomb, Robert L; Cooper, Dan M; George, Steven C

2006-12-01

Exhaled nitric oxide (NO) is altered in asthmatic subjects with exercise-induced bronchoconstriction (EIB). However, the physiological interpretation of exhaled NO is limited because of its dependence on exhalation flow and the inability to distinguish completely proximal (large airway) from peripheral (small airway and alveolar) contributions. We estimated flow-independent NO exchange parameters that partition exhaled NO into proximal and peripheral contributions at baseline, postexercise challenge, and postbronchodilator administration in steroid-naive mild-intermittent asthmatic subjects with EIB (24-43 yr old, n = 9) and healthy controls (20-31 yr old, n = 9). The mean +/- SD maximum airway wall flux and airway diffusing capacity were elevated and forced expiratory flow, midexpiratory phase (FEF(25-75)), forced expiratory volume in 1 s (FEV(1)), and FEV(1)/forced vital capacity (FVC) were reduced at baseline in subjects with EIB compared with healthy controls, whereas the steady-state alveolar concentration of NO and FVC were not different. Compared with the response of healthy controls, exercise challenge significantly reduced FEV(1) (-23 +/- 15%), FEF(25-75) (-37 +/- 18%), FVC (-12 +/- 12%), FEV(1)/FVC (-13 +/- 8%), and maximum airway wall flux (-35 +/- 11%) relative to baseline in subjects with EIB, whereas bronchodilator administration only increased FEV(1) (+20 +/- 21%), FEF(25-75) (+56 +/- 41%), and FEV(1)/FVC (+13 +/- 9%). We conclude that mild-intermittent steroid-naive asthmatic subjects with EIB have altered airway NO exchange dynamics at baseline and after exercise challenge but that these changes occur by distinct mechanisms and are not correlated with alterations in spirometry.

Effect of heliox- and air-driven nebulized bronchodilator therapy on lung function in patients with asthma.

PubMed

El-Khatib, Mohamad F; Jamaleddine, Ghassan; Kanj, Nadim; Zeineddine, Salah; Chami, Hassan; Bou-Akl, Imad; Husari, Ahmad; Alawieh, Marwan; Bou-Khalil, Pierre

2014-06-01

This study compares the effect of heliox-driven to that of air-driven bronchodilator therapy on the pulmonary function test (PFT) in patients with different levels of asthma severity. One-hundred thirty-two participants were included in the study. Participants underwent spirometry twice with bronchodilator testing on two consecutive days. Air-driven nebulization was used one day and heliox-driven nebulization the other day in random order crossover design. After a baseline PFT, each participant received 2.5 mg of albuterol sulfate nebulized with the randomized driving gas. Post bronchodilator PFT was repeated after 30 min. The next day, the exact same protocol was repeated, except that the other driving gas was used to nebulize the drug. Participants were subgrouped and analyzed according to their baseline FEV(1) on day 1: Group I, FEV(1) ≥80 %; Group II, 80 % > FEV(1) > 50 %; Group III, FEV(1) ≤50 %. The proportion of participants with greater than 12 % and 200-mL increases from their baseline FEV(1) and the changes from baseline in PFT variables were compared between heliox-driven versus air-driven bronchodilation therapy. The proportion of participants with >12 % and 200-mL increases from their baseline FEV(1) with air- or heliox-driven bronchodilation was not different with respect to the proportion of participants with baseline FEV(1) ≥80 % (20 vs. 18 %, respectively) and 80 % > FEV(1) > 50 % (36 vs. 43 %, respectively), but it was significantly greater with heliox-driven bronchodilation in participants with FEV(1) ≤50 % (43 vs. 73 %, respectively; p = 0.01). Changes from baseline FVC, FEV(1), FEV(1)/FVC, FEF(25-75) %, FEF(max), FEF(25) %, FEF(50) %, and FEF(75) % were significantly larger with heliox-driven versus air-driven bronchodilation in participants with baseline FEV(1) ≤50 %. Improvements in PFT variables are more frequent and profound with heliox-driven compared to air-driven bronchodilator therapy only in asthmatic patients with baseline FEV(1) ≤50 %.

Analysis of spirometry results in hospitalized patients aged over 65 years.

PubMed

Wróblewska, Izabela; Oleśniewicz, Piotr; Kurpas, Donata; Sołtysik, Mariusz; Błaszczuk, Jerzy

2015-01-01

The growing population of the elderly, as well as the occurrence of coexisting diseases and polypharmacy, is the reason why diseases of patients aged $65 years belong to the major issues of the contemporary medicine. Among the most frequent diseases of the elderly, there are respiratory system diseases. They are difficult to diagnose because of the patient group specificity, which is the reason for increased mortality among seniors, caused by underdiagnosis. The study objective was to assess the factors influencing spirometry results in hospitalized patients aged ≥65 years with respiratory system disorders. In the research, 217 (100%) patients aged ≥65 years who underwent spirometry at the Regional Medical Center of the Jelenia Góra Valley Hospital in Poland were analyzed. In the statistical analysis, the STATISTICA 9.1 program, the t-test, the Shapiro-Wilk test, the ANOVA test, and the Scheffé's test were applied. The majority of the patients (59.4%) were treated in the hospital. The most frequent diagnosis was malignant neoplasm (18%). The study showed a statistically significant dependence between the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC parameters and the time of hospitalization, as well as between the FVC and FEV1 parameters and the age of patients. The FVC parameter values turned out to be dependent on the main diagnosis. Highest results were noted in patients with the diagnosis of sleep apnea or benign neoplasm. A low FVC index can reflect restrictive ventilation defects, which was supported by the performed analyses. Highest FEV1/FVC values were observed in nonsmokers, which confirms the influence of nicotine addiction on the incidence of respiratory system diseases. The respondents' sex and the established diagnosis statistically significantly influenced the FVC index result, and the diet influenced the FEV1/FVC parameter result.

Analysis of spirometry results in hospitalized patients aged over 65 years

PubMed Central

Wróblewska, Izabela; Oleśniewicz, Piotr; Kurpas, Donata; Sołtysik, Mariusz; Błaszczuk, Jerzy

2015-01-01

Introduction and objective The growing population of the elderly, as well as the occurrence of coexisting diseases and polypharmacy, is the reason why diseases of patients aged $65 years belong to the major issues of the contemporary medicine. Among the most frequent diseases of the elderly, there are respiratory system diseases. They are difficult to diagnose because of the patient group specificity, which is the reason for increased mortality among seniors, caused by underdiagnosis. The study objective was to assess the factors influencing spirometry results in hospitalized patients aged ≥65 years with respiratory system disorders. Material and methods In the research, 217 (100%) patients aged ≥65 years who underwent spirometry at the Regional Medical Center of the Jelenia Góra Valley Hospital in Poland were analyzed. In the statistical analysis, the STATISTICA 9.1 program, the t-test, the Shapiro–Wilk test, the ANOVA test, and the Scheffé’s test were applied. Results The majority of the patients (59.4%) were treated in the hospital. The most frequent diagnosis was malignant neoplasm (18%). The study showed a statistically significant dependence between the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC parameters and the time of hospitalization, as well as between the FVC and FEV1 parameters and the age of patients. The FVC parameter values turned out to be dependent on the main diagnosis. Highest results were noted in patients with the diagnosis of sleep apnea or benign neoplasm. A low FVC index can reflect restrictive ventilation defects, which was supported by the performed analyses. Highest FEV1/FVC values were observed in nonsmokers, which confirms the influence of nicotine addiction on the incidence of respiratory system diseases. Conclusion The respondents’ sex and the established diagnosis statistically significantly influenced the FVC index result, and the diet influenced the FEV1/FVC parameter result. PMID:26170646

Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control.

PubMed

Heijkenskjöld Rentzhog, C; Janson, C; Berglund, L; Borres, M P; Nordvall, L; Alving, K; Malinovschi, A

2017-12-01

Classic spirometry is effort dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multifrequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control. Spirometry measures, resistance at 5 (R5) and 19 Hz (R19), reactance at 5 Hz (X5), resonant frequency (f res ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years). We used standardized lung function variables in logistic regression analyses, unadjusted and adjusted for age, height, gender and weight. Lower FEV 1 /FVC (OR [95% CI] 0.47 [0.32, 0.69]) and FEF 50 (0.62 [0.46, 0.85]) per standard deviation increase, and higher R5 (3.31 [1.95, 5.62]) and R19 (2.54 [1.65, 3.91]) were associated with asthma diagnosis. Independent predictive effects of FEV 1 /FVC and R5 or R19, respectively, were found for asthma diagnosis. Lower FEV 1 /FVC and altered peripheral FOT measures (X5, f res and R5-R19) were associated with uncontrolled asthma (P-values < .05). Resistance FOT measures were equally informative as spirometry, related to asthma diagnosis, and, furthermore, offered additive information to FEV 1 /FVC, supporting a complementary role for FOT. Asthma control was related to FOT measures of peripheral airways, suggesting a potential use in identifying such involvement. Further studies are needed to determine a clinical value and relevant reference values in children, for the multifrequency FOT measurements. © 2017 John Wiley & Sons Ltd.

Early detection of lung function decrements in children and adolescents with cystic fibrosis using new reference values.

PubMed

Zacharasiewicz, Angela; Renner, Sabine; Haderer, Flora; Weber, Michael; Dehlink, Eleonore; Szepfalusi, Zsolt; Frischer, Thomas

2017-08-01

Interpretation of lung function values in children with cystic fibrosis (CF) depends on the applied reference values. We hypothesize that differences between the new global lung function initiative (GLI) values and the formerly used Zapletal et al. values produce significantly different clinical results. We analyzed 3719 lung function measurements of 108 children and adolescents (n = 54 male; aged 6-18 years) with CF treated between September 1991 and July 2009. Data were analyzed in milliliters (ml) and % predicted (pred.) and interpreted using Zapletal and GLI reference values. Applying GLI compared to Zapletal resulted in significantly lower mean forced expiratory volume in 1s (FEV1)% pred. Zapletal 86.6% (SD 20.6), GLI 79.9% (SD 20.3) and 32% (n = 497/1543) were misclassified as normal when using Zapletal. Despite showing no overall differences in FEV1 and forced vital capacity (FVC) between concomitant Pseudomonas detection (PA+) in n = 938 and Pseudomonas negative (PA-) (n = 2781) using either reference PA+ resulted in lower FEV1 and FVC values with increasing age; however, measurement of small airway obstruction with forced expiratory flow at 75% of FVC (FEF75) values - available for Zapletal -showed significant differences. Reassurance regarding lung function when using old reference values may occur with potential clinical significance. Discrepancies in lung function interpretation underline the importance of using uniform and best available reference values.

Low-grade systemic inflammation: a partial mediator of the relationship between diabetes and lung function.

PubMed

Giovannelli, Jonathan; Trouiller, Philippe; Hulo, Sébastien; Chérot-Kornobis, Natalie; Ciuchete, Alina; Edmé, Jean-Louis; Matran, Régis; Amouyel, Philippe; Meirhaeghe, Aline; Dauchet, Luc

2018-01-01

An association has been consistently found between diabetes mellitus and decreased lung function. We evaluated to what extent low-grade inflammation (as measured by the level of high-sensitivity C-reactive protein [hs-CRP]) could explain this relationship. A sample of 1878 middle-aged adults from the cross-sectional Enquête Littoral Souffle Air Biologie Environnement survey without self-reported pulmonary and atherosclerosis disease was included. A mediation analysis was performed to assess and quantify the hs-CRP level as a mediator of the relationship between diabetes and lung function. Diabetes was associated with higher hs-CRP level (+22.9%, 95% confidence interval = [5.1, 43.6]). The hs-CRP (>4 vs. ≤1 mg/L) was associated with lower percentage predicted values for the forced expiratory volume in the first second (FEV1) (-4% [-6.1, -1.9]) and forced vital capacity (FVC) (-4.4% [-6.5, -2.3]). Diabetes was associated with FEV1 (-3.5% [-5.8, -1.3]) and FVC (-3.6% [-5.9, -1.3]). The proportion of the effect that is mediated by hs-CRP was 12% [2.4, 37] and 13% [3.7, 39.4] for FEV1 and FVC, respectively. Our results suggest that low-grade systemic inflammation could only explain a small part of the relationship between diabetes and lung function. Copyright © 2017 Elsevier Inc. All rights reserved.

[Spirometric and radiographic profile of patients with pulmonary tuberculosis treated and cured at the Department of Pulmonology of Brazzaville University Hospital].

PubMed

Bemba, E L P; Moyikoua, R; Ouedraogo, A R; Bopaka, R G; Koumeka, P P; Ossale Abacka, K B; Mboussa, J

2017-10-01

Tuberculosis is a real public health problem in Congo. Pulmonary localization can lead to sequelae of respiratory functional repercussions. Describe the spirometric and radiographic profile of patients treated with pulmonary tuberculosis treated and cured. This was a cross-sectional study that included 150 patients with previous pulmonary tuberculosis with positive microscopy treated and cured in the Pulmonary Department of Brazzaville University Hospital. In which we performed a functional exploration (Spirometry) and a chest X-ray. The study took place from 1st January 2016 to 31st August 2016. The spirometry performed in all patients was pathological in 68.67% (103 cases/150) of the cases. Among them 74.76% (77 cases/103) had a restrictive profile (FEV1/FVC >70% and CVF <80%), 9.71% (10 cases/103) an obstructive syndrome (FEV1/FVC ≤70% and CVF >80%) and 15.53% (16 cases/103) a mixed syndrome (FVC <80% and FEV1/FVC <70%). Of the 150 chest radiographs performed, 120 or 80% were pathological; the degree of parenchymal stage III destruction represented 28.33%. There was a significant correlation between the degree of parenchymal destruction and the delay in treatment on the one hand and between the degree of parenchymal destruction and the different pulmonary volumes and volumes on the other hand. The prevention of these respiratory functional disorders is based on the prophylaxis of tuberculosis on early diagnosis of the disease. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Lung function in insulation workers.

PubMed Central

Clausen, J; Netterstrøm, B; Wolff, C

1993-01-01

To evaluate the effects of working with modern insulation materials (rock and glass wool), the members of the Copenhagen Union of Insulation Workers were invited to participate in a study based on a health examination that included lung function tests. Three hundred and forty men (74%) agreed to participate, and 166 bus drivers served as the control group. Age distribution, height, and smoking habits were similar in the two groups. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were used as tests for lung function. There were no differences in FVC between the study and control groups, but the insulation workers had significantly lower values of FEV1 (mean 2.51) compared with the controls (mean 3.4 1), independent of smoking habits. Six years before the present study, 114 of the insulation workers participated in a similar study, and eight years after the initial study, the lung function of 59 of the bus drivers was tested. The decline in FVC in insulation workers who smoked was significantly higher (7.7 cl/year) than in bus drivers who smoked (3.1 cl/year); the decline in FEV1 was significantly higher in insulation workers independent of smoking habits (17.0 cl/year v 2.9 cl/year). Self assessed former exposure to asbestos was not associated with lung function in insulation workers. The study concludes that working with modern insulation materials is associated with increased risk of developing obstructive lung disease. PMID:8457492

Pulmonary function of U.S. coal miners related to dust exposure estimates.

PubMed

Attfield, M D; Hodous, T K

1992-03-01

This study of 7,139 U.S. coal miners used linear regression analysis to relate estimates of cumulative dust exposure to several pulmonary function variables measured during medical examinations undertaken between 1969 and 1971. The exposure data included newly derived cumulative dust exposure estimates for the period up to time of examination based on large data bases of underground airborne dust sampling measurements. Negative associations were found between measures of cumulative exposure and FEV1, FVC, and the FEV1/FVC ratio (p less than 0.001). In general, the relationships were similar to those reported for British coal miners. Overall, the results demonstrate an adverse effect of coal mine dust exposure on pulmonary function that occurs even in the absence of radiographically detected pneumoconiosis.

Comparison of the fixed ratio and the Z-score of FEV1/FVC in the elderly population: a long-term mortality analysis from the Third National Health and Nutritional Examination Survey.

PubMed

Oh, Dong Kyu; Baek, Seunghee; Lee, Sei Won; Lee, Jae Seung; Lee, Sang-Do; Oh, Yeon-Mok

2018-01-01

Despite the ongoing intense debate on the definition of airflow limitation by spirometry in the elderly population, there have only been few studies comparing the fixed ratio and the Z -score of forced expiratory volume in 1 second (FEV 1 )/forced vital capacity (FVC) in terms of long-term mortalities. In this study, we aimed to identify the proper method for accurately defining the airflow limitation in terms of long-term mortality prediction in the elderly population. Data were collected from the Third National Health and Nutrition Examination Survey in the US. Non-Hispanic Caucasians aged 65-80 years were included. The receiver operating characteristic (ROC) curves of both methods were plotted and compared for 10-year all-cause, respiratory, and COPD mortalities. Of 1,331 subjects, the mean age was 71.7 years and 805 (60.5%) were males. For the 10-year all-cause mortality, the area under the curve (AUC) of the fixed ratio was significantly greater than that of the Z -score of FEV 1 /FVC, but both showed poor prediction performance (0.633 vs 0.616, p <0.001). For the 10-year respiratory and COPD mortalities, both the fixed ratio and the Z -score of FEV 1 /FVC showed comparable prediction performance with greater AUCs (0.784 vs 0.778, p =0.160, and 0.896 vs 0.896, p =0.971, respectively). Interestingly, the conventional cutoff of 0.7 in the fixed ratio was consistently higher than the optimal for the 10-year all-cause, respiratory, and COPD mortalities (0.70 vs 0.69, 0.62, and 0.61, respectively), whereas that of -1.64 in the Z -score of FEV 1 /FVC was consistently lower than the optimal cutoff (-1.64 vs -1.31, -1.47, and -1.41, respectively). In the elderly population, both the fixed ratio and the Z -score of FEV 1 /FVC showed comparable prediction performance for the 10-year respiratory and COPD mortalities. However, the conventional cutoff of neither 0.70 in the fixed ratio nor -1.64 in the Z -score of FEV 1 /FVC was optimal for predicting the long-term mortalities.

Longitudinal Lung Function Growth of Mexican Children Compared with International Studies

PubMed Central

Martínez-Briseño, David; Fernández-Plata, Rosario; Gochicoa-Rangel, Laura; Torre-Bouscoulet, Luis; Rojas-Martínez, Rosalba; Mendoza, Laura; García-Sancho, Cecilia; Pérez-Padilla, Rogelio

2013-01-01

Introduction Our aim was to compare the longitudinal lung function growth of Mexican children and adolescents with the collated spirometric reference proposed for international use and with that of Mexican-Americans from the National Health State Examination Survey III (NHANES) III study. Materials and Methods A cohort of Mexican children in third year of primary school was followed with spirometry twice a year through secondary school. Multilevel mixed-effects lineal models separated by gender were fit for the spirometric variables of 2,641 respiratory-healthy Mexican children expressed as Z-scores of tested reference equations. Impact of adjustment by sitting height on differences with Mexican-American children was observed in a subsample of 1,987 children. Results At same gender, age, and height, Mexican children had increasingly higher forced expiratory volume in 1 s (FEV1) and Forced vital capacity (FVC) than the children from the collated reference study (mean Z-score, 0.68 for FEV1 and 0.51 for FVC) and than Mexican-American children (Z-score, 0.23 for FEV1 and 0.21 for FVC) respectively. Differences with Mexican-Americans were not reduced by adjusting by sitting height. Conclusions For reasons that remain unclear, the gender-, age-, and height-adjusted lung function of children from Mexico City is higher than that reported by several international studies. PMID:24143231

Spirometric evaluation of ventilatory function in adult male cigarette smokers in Sokoto metropolis.

PubMed

Isah, Muhammad D; Makusidi, Muhammad A; Abbas, Aminu; Okpapi, Juliana U; Njoku, Chibueze H; Abba, Abdullahi A

2017-01-01

Cigarette smoking is a widespread social habit in Nigeria with extensive deleterious multisystemic effect. Ventilatory dysfunction is one of the cigarette smoking-related illnesses that affect the respiratory system. Spirometry is an investigative method that can be used for the early detection of ventilatory dysfunction even before the onset of the symptoms. A questionnaire adapted from the European Community Respiratory Health Survey was administered to collect demographic, clinical, and cigarette smoking data. Ventilatory function test was conducted using Clement Clarke (One Flow) Spirometer, version 1.3. The highest value of each ventilatory function index was chosen for analysis, and individual(s) with ventilatory dysfunction were subjected to post bronchodilator spirometry. For the purpose of this research, 150 participants who were currently cigarette smokers were enrolled, and 50 apparently healthy, age-matched individuals who were never smokers served as controls in the ratio of 3:1. Eighty percent of participants and 68% of controls were aged 40 years or below. The mean age of participants (34.27 ± 8.91 years) and the controls (35.08 ± 10.35 years) was not significantly different (P = 0.592). Similarly, there were no statistically significant differences between the mean anthropometric indices (weight: P = 0.663, height: P = 0.084, and body mass index: P = 0.099) of both participants and controls. The mean values of FEV1 (forced expiratory flow in one second) and FEV1/FVC (FVC=forced vital capacity) were lower in the participants compared to the controls, and this difference was statistically significant (P < 0.001). There was a weak negative correlation between pack-years of cigarette smoking and FEV1 (r = -0.237 and P = 0.004). Obstructive ventilatory defect was found among six study participants (4%) and two controls (4%). Cigarette smoking is associated with decline in ventilatory function test indices (FEV1 and FEV1/FVC) in adult males. Decline in FEV1 is directly related to pack-years of cigarette smoking.

Lung function, respiratory symptoms and venous thromboembolism risk: the Atherosclerosis Risk in Communities Study.

PubMed

Kubota, Y; London, S J; Cushman, M; Chamberlain, A M; Rosamond, W D; Heckbert, S R; Zakai, N; Folsom, A R

2016-12-01

Essentials The association of lung function with venous thromboembolism (VTE) is unclear. Chronic obstructive pulmonary disease (COPD) patterns were associated with a higher risk of VTE. Symptoms were also associated with a higher risk of VTE, but a restrictive pattern was not. COPD may increase the risk of VTE and respiratory symptoms may be a novel risk marker for VTE. Background The evidence for the association between chronic obstructive pulmonary disease (COPD) and venous thromboembolism (VTE) is limited. There is no study investigating the association between restrictive lung disease (RLD) and respiratory symptoms with VTE. Objectives To investigate prospectively the association of lung function and respiratory symptoms with VTE. Patients/Methods In 1987-1989, we assessed lung function by using spirometry, and obtained information on respiratory symptoms (cough, phlegm, and dyspnea) in 14 654 participants aged 45-64 years, without a history of VTE or anticoagulant use, and followed them through 2011. Participants were classified into four mutually exclusive groups: 'COPD' (forced expiratory volume in 1 s [FEV 1 ]/forced vital capacity [FVC] below the lower limit of normal [LLN]), 'RLD' (FEV 1 /FVC ≥ LLN and FVC < LLN), 'respiratory symptoms with normal spirometic results' (without RLD or COPD), and 'normal' (without respiratory symptoms, RLD, or COPD). Results We documented 639 VTEs (238 unprovoked and 401 provoked VTEs). After adjustment for VTE risk factors, VTE risk was increased for individuals with either respiratory symptoms with normal spirometric results (hazard ratio [HR] 1.40, 95% confidence interval [CI] 1.12-1.73) or COPD (HR 1.33, 95% CI 1.07-1.67) but not for those with RLD (HR 1.15, 95% CI 0.82-1.60). These elevated risks of VTE were derived from both unprovoked and provoked VTE. Moreover, FEV 1 and FEV 1 /FVC showed dose-response relationships with VTE. COPD was more strongly associated with pulmonary embolism than with deep vein thrombosis. Conclusions Obstructive spirometric patterns were associated with an increased risk of VTE, suggesting that COPD may increase the risk of VTE. Respiratory symptoms may represent a novel risk marker for VTE. © 2016 International Society on Thrombosis and Haemostasis.

Pulmonary Impairment and Risk Assessment in a Diacetyl-Exposed Population: Microwave Popcorn Workers.

PubMed

Park, Robert M; Gilbert, Stephen J

2018-06-01

The butter flavoring additive, diacetyl (DA), can cause bronchiolitis obliterans (BO) by inhalation. A risk assessment was performed using data from a microwave popcorn manufacturing plant. Current employees' medical history and pulmonary function tests together with air sampling over a 2.7-year period were used to analyze forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC). The exposure responses for declining pulmonary function and for possible early onset of BO were estimated using multiple regression methods. Several exposure metrics were investigated; benchmark dose and excess lifetime risk of impairment were calculated. Forty-six percent of the population had less than 6 months exposure to DA. Percent-of-predicted FEV1 declined with cumulative exposure (0.40 per ppm-yr, P < 10) as did percent FEV1/FVC (0.13 per ppm-yr, P = 0.0004). Lifetime respiratory impairment prevalence of one per thousand resulted from 0.005 ppm DA and one per thousand lifetime incidence of impairment was predicted for 0.002 ppm DA. DA exposures, often exceeding 1 ppm in the past, place workers at high risk of pulmonary impairment.

Work-related symptoms and dose-response relationships for personal exposures and pulmonary function among woodworkers.

PubMed

Mandryk, J; Alwis, K U; Hocking, A D

1999-05-01

Four sawmills, a wood chipping mill, and five joineries in New South Wales, Australia, were studied for the effects of personal exposure to wood dust, endotoxins. (1-->3)-beta-D-glucans, Gram-negative bacteria, and fungi on lung function among woodworkers. Personal inhalable and respirable dust sampling was carried out. The lung function tests of workers were conducted before and after a workshift. The mean percentage cross-shift decrease in lung function was markedly high for woodworkers compared with the controls. Dose-response relationships among personal exposures and percentage cross-shift decrease in lung function and percentage predicted lung function were more pronounced among joinery workers compared with sawmill and chip mill workers. Woodworkers had markedly high prevalence of regular cough, phlegm, and chronic bronchitis compared with controls. Significant associations were found between percentage cross-shift decrease in FVC and regular phlegm and blocked nose among sawmill and chip mill workers. Both joinery workers and sawmill and chip mill workers showed significant relationships between percentage predicted lung function (FVC, FEV1, FEV1/FVC, FEF25-75%) and respiratory symptoms. Wood dust and biohazards associated with wood dust are potential health hazards and should be controlled.

Forskolin compared with beclomethasone for prevention of asthma attacks: a single-blind clinical trial.

PubMed

Huerta, M; Urzúa, Z; Trujillo, X; González-Sánchez, R; Trujillo-Hernández, B

2010-01-01

This single-blind study compared the efficacy of oral forskolin versus inhaled beclomethasone for mild or moderately persistent adult asthma. Patients were randomly assigned to receive forskolin (one 10-mg capsule orally per day; n = 30) or beclomethasone (two 50 microg inhalations every 12 h; n = 30) for 2 months. No statistically significant improvement occurred in any lung function parameter in the forskolin-treated patients. Subjects in the beclomethasone-treated group presented a slight but statistically significant improvement in percentage forced expiratory volume in 1 s (FEV(1)), percentage forced expiratory flow in the middle (25 - 75%) expiratory phase (FEF(25 - 75%)) and percentage forced vital capacity (FVC) after 2 months of treatment, though the improvement in absolute values for FEV(1), FEF(25 - 75%), FVC and FEV(1):FVC did not reach statistical significance. There was no statistically significant difference between the forskolin and beclomethasone treatment groups for any lung function parameter at baseline or after treatment. None of the beclomethasone-treated patients had an asthma attack and one forskolin-treated patient had a mild asthma attack during the 2-month study period. More studies are needed in adult asthma patients to confirm whether forskolin may be a useful preventive treatment for mild or moderately persistent adult asthma.

The Short-Term Effect of Breathing Tasks Via an Incentive Spirometer on Lung Function Compared With Autogenic Drainage in Subjects With Cystic Fibrosis.

PubMed

Sokol, Gil; Vilozni, Daphna; Hakimi, Ran; Lavie, Moran; Sarouk, Ifat; Bat-El Bar; Dagan, Adi; Ofek, Miryam; Efrati, Ori

2015-12-01

Forced expiration may assist secretion movement by manipulating airway dynamics in patients with cystic fibrosis (CF). Expiratory resistive breathing via a handheld incentive spirometer has the potential to control the expiratory flow via chosen resistances (1-8 mm) and thereby mobilize secretions and improve lung function. Our objective was to explore the short-term effect of using a resistive-breathing incentive spirometer on lung function in subjects with CF compared with the autogenic drainage technique. This was a retrospective study. Subjects with CF performed 30-45 min of either the resistive-breathing incentive spirometer (n = 40) or autogenic drainage (n = 32) technique on separate days. The spirometer encourages the patient to exhale as long as possible while maintaining a low lung volume. The autogenic drainage technique includes repetitive inspiratory and expiratory maneuvers at various tidal breathing magnitudes while exhalation is performed in a sighing manner. Spirometry was performed before and 20-30 min after the therapy. Use of a resistive-breathing incentive spirometer improved FVC and FEV1 by 5-42% in 26 subjects. The forced expiratory flow during the middle half of the FVC maneuver (FEF25-75%) improved by >20% in 9 (22%) subjects. FVC improved the most in subjects with an FEV1 of 40-60% of predicted. Improvements negatively correlated with baseline percent-of-predicted FVC values provided improvements were above 10% (r(2) = 0.28). Values improved in a single subjects using the autogenic drainage technique. These 2 techniques may allow lower thoracic pressures and assist in the prevention of central airway collapse. The resistive-breathing incentive spirometer is a self-administered simple method that may aid airway clearance and has the potential to improve lung function as measured by FVC, FEV1, and FEF25-75% in patients with CF. Copyright © 2015 by Daedalus Enterprises.

Indoor environmental factors associated with pulmonary function among adults in an acid rain-plagued city in Southwest China.

PubMed

Yu, Jie; Zhang, Longju; Luo, Ya; Tang, Yin; Tuo, Fangxu; Yang, Jiaqi; Xu, Jie

2017-04-01

To assess the association of indoor environmental risk factors with respiratory function among adults in an acid rain-plagued city in China where coal use is frequent. The subjects were randomly selected in the winter season. Information on selected home environmental factors was collected through administered questionnaires. Additionally, pulmonary function tests, including Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 s (FEV 1 ), FEV 1 /FVC and Peak Expiratory Flow Rate (PEFR) were also performed in participants. This study showed that, among a variety of risk factors, coal fuel use, cooking oil fumes and active and passive smoking exposure together with asthma in childhood were important factors for deterioration of pulmonary function among adults in the winter season (p < 0.05). Additionally, subjects whose kitchen was located in the living room or bedroom, who opened their windows only occasionally or never, who noted the presence of cooking oil fumes and pests, whose bedroom was shared by 3 or more residents and who kept pets tended to exhibit lower values of FVC, FEV 1 and PEFR values compared with non-exposed counterparts (p < 0.05). This study demonstrated impaired pulmonary function among adults who were exposed to indoor risk factors, such as coal fires and cigarette smoking compared to non-users in the winter season and emphasizes the need for public health efforts to decrease exposure to indoor air pollution.

Pulmonary involvement in Fabry disease: effect of plasma globotriaosylsphingosine and time to initiation of enzyme replacement therapy.

PubMed

Franzen, Daniel; Haile, Sarah R; Kasper, David C; Mechtler, Thomas P; Flammer, Andreas J; Krayenbühl, Pierre A; Nowak, Albina

2018-01-01

Anderson-Fabry disease (AFD) is an X-linked lysosomal storage disorder caused by mutations of GLA gene leading to reduced α-galactosidase activity and resulting in a progressive accumulation of globotriaosylceramide (Gb3) and its deacylated derivative, globotriaosyl-sphingosine (Lyso-Gb3). Plasma Lyso-Gb3 levels serve as a disease severity and treatment monitoring marker during enzyme replacement therapy (ERT). Adult patients with AFD who had yearly pulmonary function tests between 1999 and 2015 were eligible for this observational study. Primary outcome measures were the change in z-score of forced expiratory volume in the first second (FEV 1 ) and FEV 1 /FVC over time. Plasma Lyso-Gb3 levels and the age of ERT initiation were investigated for their association with lung function decline. Fifty-three patients (42% male, median (range) age at diagnosis of AFD 34 (6-61) years in men, 34 (13-67) in women) were included. The greatest decrease of FEV 1 /FVC z-scores was observed in Classic men (-0.048 per year, 95% CI -0.081 to -0.014), compared with the Later-Onset men (+0.013,95% CI -0.055 to 0.082), Classic women (-0.008, 95% CI -0.035 to +0.020) and Later-Onset women (-0.013, 95% CI -0.084 to +0.058). Cigarette smoking (P=0.022) and late ERT initiation (P=0.041) were independently associated with faster FEV 1 decline. FEV 1 /FVC z-score decrease was significantly reduced after initiation of ERT initiation (-0.045 compared with -0.015, P=0.014). Furthermore, there was a trend towards a relevant influence of Lyso-Gb3 (P=0.098) on airflow limitation with age. Early ERT initiation seems to preserve pulmonary function. Plasma Lyso-Gb3 is maybe a useful predictor for airflow limitation. Classic men need a closer monitoring of the lung function.

Prognostic value of serum zinc levels in patients with acute HC/zinc chloride smoke inhalation

PubMed Central

Xie, Fei; Zhang, Xingang; Xie, Lixin

2017-01-01

Abstract Hexachloroethane (HC)/zinc chloride (ZnCl, smoke bomb) exposure in the military setting results in lung injury which is uncommon and has been rarely described in previous studies. The aim of this study is to investigate the correlation between the serum zinc in patients with HC/ZnCl smoke inhalation lung injury and disease severity. A total of 15 patients with HC/ZnCl-related conditions were recruited in this study. The serum zinc level and the pulmonary function tests and liver function tests including total lung capacity (TLC), forced vital capacity (FVC), forced expiratory pressure in 1 second (FEV1), alanine aminotransferase (ALT), and aspartate transaminase (AST) were analyzed. Eleven cases had mild clinical manifestations. Four cases rapidly developed features typical of severe adult respiratory distress syndrome. The level of serum zinc was increased, but FVC, FEV1, and TLC was decreased significantly in the moderate and severe cases. In addition, the serum zinc level correlated well with the TLC, FVC, and FEV1 (r = −0.587, −0.626, −0.617, respectively; P = .027, .017, .019, respectively). The 4 cases in moderate and severe group had delayed impairment of liver functions after the accident. This study suggested that the serum zinc level may be associated with the severity of lung and liver injuries after HC/ZnCl smoke inhalation. PMID:28953660

Ambient particulate matter and lung function growth in Chinese children.

PubMed

Roy, Ananya; Hu, Wei; Wei, Fusheng; Korn, Leo; Chapman, Robert S; Zhang, Junfeng Jim

2012-05-01

Exposure to particulate matter (PM) has been associated with deficits in lung function growth among children in Western countries. However, few studies have explored this association in developing countries, where PM levels are often substantially higher. Children (n = 3273) 6-12 years of age were recruited from 8 schools in 4 Chinese cities. The lung function parameters of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were measured using computerized spirometers twice a year for up to 3 years (1993-1996). Dichotomous samplers placed in each schoolyard were used to measure PM2.5 and PM10 (PM with diameter ≤ 2.5 μm and ≤ 10 μm, respectively). Multivariable generalized estimating equations were used to examine the association between the quarterly average PM levels and lung function growth during the period of follow-up. Annual average PM2.5 and PM10 levels in the 4 cities ranged from 57 to 158 μg/m and 95 to 268 μg/m, respectively. In multivariable models, an increase of 10 μg/m of PM2.5 was associated with decreases of 2.7 mL FEV1 (95% confidence interval = -3.5 to -2.0), 3.5 mL FVC (-4.3 to -2.7), 1.4 mL/year FEV1 growth (-1.8 to -0.9), and 1.5 mL/year FVC growth (-2.0 to -1.0). Similar results were seen with PM10 exposure. Exposure to ambient particulate matter was associated with decreased growth in lung function among Chinese children.

Indoor molds and lung function in healthy adults.

PubMed

Hernberg, Samu; Sripaiboonkij, Penpatra; Quansah, Reginald; Jaakkola, Jouni J K; Jaakkola, Maritta S

2014-05-01

Indoor mold exposure is common worldwide and constitutes an important health problem. There are very few studies assessing the relation between mold exposure and lung function levels among non-asthmatic adults. Our objective was to assess the relations between dampness and mold exposures at home and at work and lung function. In particular, we elaborated the importance of different exposure indicators. In a population-based study, 269 non-asthmatic adults from South Finland answered a questionnaire on indoor dampness and mold exposures at home or at work and other factors potentially influencing lung function, and performed spirometry. Multiple linear regression model was applied to study the relations between exposures and spirometric lung function levels. In linear regression adjusting for confounding, FEV1 level was reduced on average 200 ml related to mold odor at home (effect estimate -0.20, 95% CI -0.60 to 0.21) and FVC level was reduced on average 460 ml (-0.46, -0.95 to 0.03) respectively. Exposure to mold odor at home or at work or both was related to reduced FEV1 (-0.15, -0.42 to 0.12) and FVC (-0.22, -0.55 to 0.11) levels. Women had on average 510 ml reduced FEV1 levels (-0.51, -1.0 to 0.03) and 820 ml reduced FVC levels (-0.82, -1.4 to -0.20) related to mold odor exposure at home. Mold odor exposure was related to lower lung function levels among non-asthmatic adults, especially among women. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association between lung function in adults and plasma DDT and DDE levels: results from the Canadian Health Measures Survey.

PubMed

Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan

2015-05-01

Although DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane] has been banned in many countries since the 1970s, it may still pose a risk to human respiratory health. In agriculture, DDT exposures have been associated with asthma and chronic bronchitis. However, little is known about the effect of DDT on lung function. We used data on 1,696 participants 20-79 years of age from the Canadian Health Measures Survey (CHMS) and conducted multiple regression analysis to estimate associations between plasma p,p´-DDT/DDE and lung function. Almost all participants (> 99.0%) had detectable concentrations of plasma p,p´-DDE, but only 10.0% had detectable p,p´-DDT. Participants with detectable p,p´-DDT had significantly lower mean FVC (difference = 311 mL; 95% CI: -492, -130; p = 0.003) and FEV1 (difference = 232 mL; 95% CI: -408, -55; p = 0.015) than those without. A 100-ng/g lipid increase in plasma p,p´-DDE was associated with an 18.8-mL decrease in mean FVC (95% CI: -29, -9) and an 11.8-mL decrease in mean FEV1 (95% CI: -21, -3). Neither exposure was associated with FEV1/FVC ratio or FEF25%-75%. DDT exposures, which may have occurred decades ago, were still detectable among Canadians. Plasma DDT and DDE were negatively associated with lung function parameters. Additional research on the potential effects of DDT use on lung function is warranted.

Severity of Airflow Obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a New Classification.

PubMed

Coton, Sonia; Vollmer, William M; Bateman, Eric; Marks, Guy B; Tan, Wan; Mejza, Filip; Juvekar, Sanjay; Janson, Christer; Mortimer, Kevin; P A, Mahesh; Buist, A Sonia; Burney, Peter G J

2017-10-01

Current classifications of Chronic Obstructive Pulmonary Disease (COPD) severity are complex and do not grade levels of obstruction. Obstruction is a simpler construct and independent of ethnicity. We constructed an index of obstruction severity based on the FEV 1 /FVC ratio, with cut-points dividing the Burden of Obstructive Lung Disease (BOLD) study population into four similarly sized strata to those created by the GOLD criteria that uses FEV 1 . We measured the agreement between classifications and the validity of the FEV 1 -based classification in identifying the level of obstruction as defined by the new groupings. We compared the strengths of association of each classification with quality of life (QoL), MRC dyspnoea score and the self-reported exacerbation rate. Agreement between classifications was only fair. FEV 1 -based criteria for moderate COPD identified only 79% of those with moderate obstruction and misclassified half of the participants with mild obstruction as having more severe COPD. Both scales were equally strongly associated with QoL, exertional dyspnoea and respiratory exacerbations. Severity assessed using the FEV 1 /FVC ratio is only in moderate agreement with the severity assessed using FEV 1 but is equally strongly associated with other outcomes. Severity assessed using the FEV 1 /FVC ratio is likely to be independent of ethnicity.

Effect of gender specific anthropometric characteristics on lung function in young competitive triathletes from Malaysia.

PubMed

Johari, Hanapi M; Zainudin, Hakimi A; Knight, Victor F; Lumley, Steven A; Subramanium, Ananthan S; Caszo, Brinnell A; Gnanou, Justin V

2017-04-01

Anthropometric and lung function characteristics of triathletes are important for the implementation of individual specific training and recovery recommendations. However, limited data are available for these parameters in triathletes. Hence, the aim of this study was to characterize and examine the gender differences of lung function and anthropometry parameters in competitive triathletes from Malaysia. Body composition assessment and lung function tests were performed on sixteen competitive triathletes (nine male and seven female). The subject's body composition profile including muscle mass (kg), fat free mass (kg), and percent body fat was measured using a bio-impedance segmental body composition analyzer. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured by Quark PFT2 spirometer. The anthropometric measurements revealed that male triathletes were significantly taller than female triathletes and had significantly more protein and skeletal muscle mass. The female triathletes, however, had significantly higher percent body fat. Male triathletes had statistically significant higher FVC and FEV1 than female triathletes. Both the male and female triathletes showed a positive correlation between height, fat free mass and the lung function markers FVC and FEV1. This association was not seen with Body Mass Index (BMI) in female triathletes. The data from our study shows that anthropometric parameters are directly linked to lung function of a triathlete. We also found the relationship between BMI and lung function to be gender specific in triathletes and is dependent on the body protein and fat content. Hence, body composition characterization is essential and provides valuable information for developing individual specific training modules.

Pulmonary function abnormalities in never-smoking flight attendants exposed to secondhand tobacco smoke in the aircraft cabin.

PubMed

Arjomandi, Mehrdad; Haight, Thaddeus; Redberg, Rita; Gold, Warren M

2009-06-01

To determine whether the flight attendants who were exposed to secondhand tobacco smoke in the aircraft cabin have abnormal pulmonary function. We administered questionnaires and performed pulmonary function testing in 61 never-smoking female flight attendants who worked in active air crews before the smoking ban on commercial aircraft (preban). Although the preban flight attendants had normal FVC, FEV1, and FEV1/FVC ratio, they had significantly decreased flow at mid- and low-lung volumes, curvilinear flow-volume curves, and evidence of air trapping. Furthermore, the flight attendants had significantly decreased diffusing capacity (77.5% +/- 11.2% predicted normal) with 51% having a diffusing capacity below their 95% normal prediction limit. This cohort of healthy never-smoking flight attendants who were exposed to secondhand tobacco smoke in the aircraft cabin showed pulmonary function abnormalities suggestive of airway obstruction and impaired diffusion.

Obesity in children with poorly controlled asthma: Sex differences.

PubMed

Lang, Jason E; Holbrook, Janet T; Wise, Robert A; Dixon, Anne E; Teague, W Gerald; Wei, Christine Y; Irvin, Charles G; Shade, David; Lima, John J

2013-09-01

Obesity increases asthma risk, and may alter asthma severity. In adults, sex appears to modify the effect of obesity on asthma. Among children, the effect of sex on the relationship between obesity and asthma severity remains less clear, particularly when considering race. To determine how obesity affects disease characteristics in a diverse cohort of children with poorly controlled asthma, and if obesity effects are altered by sex. We analyzed 306 children between 6 and 17 years of age with poorly controlled asthma enrolled in a 6-month trial assessing lansoprazole for asthma control. In this secondary analysis, we determined associations between obesity and symptom severity, spirometry, exacerbation risk, airway biomarkers, bronchial reactivity, and airflow perception. We used both a multivariate linear regression and longitudinal mixed-effect model to determine if obesity interacted with sex to affect asthma severity. Regardless of sex, BMI >95th percentile did not affect asthma control, exacerbation risk or airway biomarkers. Sex changed the effect of obesity on lung function (sex × obesity FEV1%, interaction P-value < 0.01, sex × obesity FEV1/FVC, interaction P-value = 0.03). Obese males had significantly worse airflow obstruction compared to non-obese males, while in females there was no obesity effect on airflow obstruction. In females, obesity was associated with significantly greater FEV1 and FVC, and a trend toward reduced airway reactivity. Obesity did not affect asthma control, airway markers or disease stability; however obesity did affect lung function in a sex-dependent manner. In males, obesity associated with reduced FEV1/FVC, and in females, obesity associated with substantially improved lung function. Copyright © 2012 Wiley Periodicals, Inc.

[Pulmonary function in patients with infiltrative pulmonary tuberculosis].

PubMed

Nefedov, V B; Popova, L A; Shergina, E A

2007-01-01

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), R(aw), R(in),, R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 103 patients with infiltrative pulmonary tuberculosis. Pulmonary dysfunction was detected in 83.5% of the patients. Changes were found in lung volumes and capacities in 63.1%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 60.2 and 41.7%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC and FVC, and decreased and increased TGV and TLC; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, FEV1/VC% and increased R(aw) R(in), and R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, and PaO2 and decreased and increased PaCO2. The magnitude of the observed functional changes was generally slight. Significant disorders were observed rarely and very pronounced ones were exceptional.

[Pulmonary function in patients with disseminated pulmonary tuberculosis].

PubMed

Nefedov, V B; Shergina, E A; Popova, L A

2007-01-01

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25%, MEF50%, MEF75%, TLS, TGV, pulmonary residual volume (PRV), Raw, Rin, Rex, DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 29 patients with disseminated pulmonary tuberculosis. Pulmonary dysfunction was detected in 93.1% of the patients. Changes were found in lung volumes and capacities in 65.5%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 79.3 and 37.9%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC, FVC, and TLS, decreased and increased TGV; impaired bronchial patency presented as decreased PEF, MEF25%, MEF50%, MEF75%, and FEV1/VC% and increased Raw, Rin, and Rex; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SS and PaO2 and decreased and increased PaCO2. The observed functional changes varied from slight to significant and pronounced with a preponderance of small disorders, a lower detection rate of significant disorders, and rare detection of very pronounced ones.

Predicted equations for ventilatory function among Kuching (Sarawak, Malaysia) population.

PubMed

Djojodibroto, R D; Pratibha, G; Kamaluddin, B; Manjit, S S; Sumitabha, G; Kumar, A Deva; Hashami, B

2009-12-01

Spirometry data of 869 individuals (males and females) between the ages of 10 to 60 years were analyzed. The analysis yielded the following conclusions: 1. The pattern of Forced Vital Capacity (FVC) and Forced Expiratory Volume in One Second (FEV1) for the selected subgroups seems to be gender dependant: in males, the highest values were seen in the Chinese, followed by the Malay, and then the Dayak; in females, the highest values were seen in the Chinese, followed by the Dayak, and then the Malay. 2. Smoking that did not produce respiratory symptom was not associated with a decline in lung function, in fact we noted higher values in smokers as compared to nonsmokers. 3. Prediction formulae (54 in total) are worked out for FVC & FEV1 for the respective gender and each of the selected subgroups.

Sixteen new lung function signals identified through 1000 Genomes Project reference panel imputation

PubMed Central

Artigas, María Soler; Wain, Louise V.; Miller, Suzanne; Kheirallah, Abdul Kader; Huffman, Jennifer E.; Ntalla, Ioanna; Shrine, Nick; Obeidat, Ma'en; Trochet, Holly; McArdle, Wendy L.; Alves, Alexessander Couto; Hui, Jennie; Zhao, Jing Hua; Joshi, Peter K.; Teumer, Alexander; Albrecht, Eva; Imboden, Medea; Rawal, Rajesh; Lopez, Lorna M.; Marten, Jonathan; Enroth, Stefan; Surakka, Ida; Polasek, Ozren; Lyytikäinen, Leo-Pekka; Granell, Raquel; Hysi, Pirro G.; Flexeder, Claudia; Mahajan, Anubha; Beilby, John; Bossé, Yohan; Brandsma, Corry-Anke; Campbell, Harry; Gieger, Christian; Gläser, Sven; González, Juan R.; Grallert, Harald; Hammond, Chris J.; Harris, Sarah E.; Hartikainen, Anna-Liisa; Heliövaara, Markku; Henderson, John; Hocking, Lynne; Horikoshi, Momoko; Hutri-Kähönen, Nina; Ingelsson, Erik; Johansson, Åsa; Kemp, John P.; Kolcic, Ivana; Kumar, Ashish; Lind, Lars; Melén, Erik; Musk, Arthur W.; Navarro, Pau; Nickle, David C.; Padmanabhan, Sandosh; Raitakari, Olli T.; Ried, Janina S.; Ripatti, Samuli; Schulz, Holger; Scott, Robert A.; Sin, Don D.; Starr, John M.; Deloukas, Panos; Hansell, Anna L.; Hubbard, Richard; Jackson, Victoria E.; Marchini, Jonathan; Pavord, Ian; Thomson, Neil C.; Zeggini, Eleftheria; Viñuela, Ana; Völzke, Henry; Wild, Sarah H.; Wright, Alan F.; Zemunik, Tatijana; Jarvis, Deborah L.; Spector, Tim D.; Evans, David M.; Lehtimäki, Terho; Vitart, Veronique; Kähönen, Mika; Gyllensten, Ulf; Rudan, Igor; Deary, Ian J.; Karrasch, Stefan; Probst-Hensch, Nicole M.; Heinrich, Joachim; Stubbe, Beate; Wilson, James F.; Wareham, Nicholas J.; James, Alan L.; Morris, Andrew P.; Jarvelin, Marjo-Riitta; Hayward, Caroline; Sayers, Ian; Strachan, David P.; Hall, Ian P.; Tobin, Martin D.

2015-01-01

Lung function measures are used in the diagnosis of chronic obstructive pulmonary disease. In 38,199 European ancestry individuals, we studied genome-wide association of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC with 1000 Genomes Project (phase 1)-imputed genotypes and followed up top associations in 54,550 Europeans. We identify 14 novel loci (P<5 × 10−8) in or near ENSA, RNU5F-1, KCNS3, AK097794, ASTN2, LHX3, CCDC91, TBX3, TRIP11, RIN3, TEKT5, LTBP4, MN1 and AP1S2, and two novel signals at known loci NPNT and GPR126, providing a basis for new understanding of the genetic determinants of these traits and pulmonary diseases in which they are altered. PMID:26635082

[Study of the clinical phenotype of symptomatic chronic airways disease by hierarchical cluster analysis and two-step cluster analyses].

PubMed

Ning, P; Guo, Y F; Sun, T Y; Zhang, H S; Chai, D; Li, X M

2016-09-01

To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis. A population sample of adult patients in Donghuamen community, Dongcheng district and Qinghe community, Haidian district, Beijing from April 2012 to January 2015, who had wheeze within the last 12 months, underwent detailed investigation, including a clinical questionnaire, pulmonary function tests, total serum IgE levels, blood eosinophil level and a peak flow diary. Nine variables were chosen as evaluating parameters, including pre-salbutamol forced expired volume in one second(FEV1)/forced vital capacity(FVC) ratio, pre-salbutamol FEV1, percentage of post-salbutamol change in FEV1, residual capacity, diffusing capacity of the lung for carbon monoxide/alveolar volume adjusted for haemoglobin level, peak expiratory flow(PEF) variability, serum IgE level, cumulative tobacco cigarette consumption (pack-years) and respiratory symptoms (cough and expectoration). Subjects' different clinical phenotype by hierarchical cluster analysis and two-step cluster analysis was identified. (1) Four clusters were identified by hierarchical cluster analysis. Cluster 1 was chronic bronchitis in smokers with normal pulmonary function. Cluster 2 was chronic bronchitis or mild chronic obstructive pulmonary disease (COPD) patients with mild airflow limitation. Cluster 3 included COPD patients with heavy smoking, poor quality of life and severe airflow limitation. Cluster 4 recognized atopic patients with mild airflow limitation, elevated serum IgE and clinical features of asthma. Significant differences were revealed regarding pre-salbutamol FEV1/FVC%, pre-salbutamol FEV1% pred, post-salbutamol change in FEV1%, maximal mid-expiratory flow curve(MMEF)% pred, carbon monoxide diffusing capacity per liter of alveolar(DLCO)/(VA)% pred, residual volume(RV)% pred, total serum IgE level, smoking history (pack-years), St.George's respiratory questionnaire(SGRQ) score, acute exacerbation in the past one year, PEF variability and allergic dermatitis (P<0.05). (2) Four clusters were also identified by two-step cluster analysis as followings, cluster 1, COPD patients with moderate to severe airflow limitation; cluster 2, asthma and COPD patients with heavy smoking, airflow limitation and increased airways reversibility; cluster 3, patients having less smoking and normal pulmonary function with wheezing but no chronic cough; cluster 4, chronic bronchitis patients with normal pulmonary function and chronic cough. Significant differences were revealed regarding gender distribution, respiratory symptoms, pre-salbutamol FEV1/FVC%, pre-salbutamol FEV1% pred, post-salbutamol change in FEV1%, MMEF% pred, DLCO/VA% pred, RV% pred, PEF variability, total serum IgE level, cumulative tobacco cigarette consumption (pack-years), and SGRQ score (P<0.05). By different cluster analyses, distinct clinical phenotypes of chronic airway diseases are identified. Thus, individualized treatments may guide doctors to provide based on different phenotypes.

Modifications in forced vital capacity during adenosine monophosphate-induced bronchoconstriction in asthma: relationship with the response to methacholine and the effect of inhaled corticosteroids.

PubMed

Prieto, Luis; López, Victoria; Catalan, Pablo; Barato, Desiree; Marín, Julio

2009-05-01

The effect of adenosine monophosphate (AMP) on forced vital capacity (FVC) has never been systematically investigated. To compare methacholine- and AMP-induced changes in FVC, as a marker of air trapping, in asthmatic patients treated and not treated with inhaled corticosteroids (ICSs). Airway responsiveness to equipotent concentrations of AMP and methacholine was obtained in asthmatic patients treated (n = 32) and not treated (n = 18) with ICSs. The response was expressed by the provocation concentration of agonist that caused a decrease in forced expiratory volume in 1 second (FEV1) of 20% (PC20) and by the slope of the FVC values recorded at each step of the challenge against the corresponding FEV1 values (sFVC). Although methacholine and AMP PC20 values were similar in patients treated and not treated with ICSs, the mean (95% confidence interval) methacholine sFVC (but not AMP sFVC) was higher in those treated with ICSs (0.91; 0.77-1.06) than in those not taking ICSs (0.69; 0.57-0.81; P = .03). No significant correlation was found between sFVC and PC20 values obtained with either methacholine or AMP. Methacholine and AMP sFVC values were significantly related, but only in the group treated with ICSs (r = 0.60, P < .001). Although the AMP-induced decline in FVC in asthmatic patients is similar to that observed with equipotent concentrations of methacholine, the apparently different effect of ICSs on changes in FVC induced by each agonist suggests that the information provided by the 2 bronchoconstrictor agents is not interchangeable and that the information generated by the analysis of the effect of each agonist on FEV1 and FVC may be complementary.

Evaluation of the turbine pocket spirometer.

PubMed Central

Gunawardena, K A; Houston, K; Smith, A P

1987-01-01

A compact electronic spirometer, the turbine pocket spirometer, which measures the FEV1, forced vital capacity (FVC), and peak expiratory flow (PEF) in a single expiration, was compared with the Vitalograph and the Wright peak flow meter in 99 subjects (FEV1 range 0.40-5.50 litres; FVC 0.58-6.48 l; PEF 40-650 l min-1). The mean differences between the machines were small--0.05 l for FEV1, 0.05 l for FVC, and 11.6 l min-1 for PEF, with the limits of agreement at +/- 0.25 l, +/- 0.48 l, and +/- 52.2 l min-1 respectively. The wide limits of agreement for the PEF comparison were probably because of the difference in the technique of blowing: a fast, long blow was used for the pocket spirometer and a short, sharp one for the Wright peak flow meter. The FEV1 and FVC showed a proportional bias of around 4-5% in favour of the Vitalograph. The repeatability coefficient for the pocket spirometer FEV1 was 0.18 l, for FVC 0.22 l, and for PEF 31 l min-1. These compared well with the repeatability coefficients of the Vitalograph and the Wright peak flow meter, which gave values of 0.18 l, 0.28 l, and 27 l min-1 respectively. At flow rates of over 600 l min-1 the resistance of the pocket spirometer marginally exceeded the American Thoracic Society recommendations. The machine is easy to operate and portable, and less expensive than the Vitalograph and Wright peak flow meter combined. It can be recommended for general use. Images PMID:3686460

An epidemiological study of salt miners in diesel and nondiesel mines

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gamble, J.; Jones, W.; Hudak, J.

1983-01-01

A cross-sectional study of 5 NaCl mines and 259 miners addressed the following questions: 1) Is there an association of increased respiratory symptoms, radiographic findings, and reduced pulmonary function with exposure to nitrogen dioxide (NO2) and/or respirable particulate (RP) among these miners. 2) Is there increased morbidity of these miners compared to other working populations. Personal samples of NO2 and respirable particulate for jobs in each mine were used to estimate cumulative exposure. NO2 is used as a surrogate measure of diesel exposure. Cough was associated with age and smoking, dyspnea with age; neither symptom was associated with exposure (yearsmore » worked, estimated cumulative NO2 or RP exposure). Phlegm was associated with age, smoking, and exposure. Reduced pulmonary function (FVC, FEV1, peak, flow, FEF50, FEF75) showed no association with exposure. There was one case of small rounded and one case of small irregular opacities; pneumoconiosis was not analyzed further. Compared to underground coal miners, above ground coal miners, potash miners, and nonmining workers, the study population after adjustment for age and smoking generally showed no increased prevalence of cough, phlegm, dyspnea, or obstruction (FEV1/FVC less than 0.7). Obstruction in younger salt miners and phlegm in older salt miners was elevated compared to nonmining workers. Mean predicted pulmonary function was reduced 2-4% for FEV1 and FVC, 7-13% for FEF50, and 18-22% for FEF75 below all comparison populations.« less

Effects of side lying on lung function in older individuals.

PubMed

Manning, F; Dean, E; Ross, J; Abboud, R T

1999-05-01

Body positioning exerts a strong effect on pulmonary function, but its effect on other components of the oxygen transport pathway are less well understood, especially the effects of side-lying positions. This study investigated the interrelationships between side-lying positions and indexes of lung function such as spirometry, alveolar diffusing capacity, and inhomogeneity of ventilation in older individuals. Nineteen nonsmoking subjects (mean age=62.8 years, SD=6.8, range=50-74) with no history of cardiac or pulmonary disease were tested over 2 sessions. The test positions were sitting and left side lying in one session and sitting and right side lying in the other session. In each of the positions, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), single-breath pulmonary diffusing capacity (DLCO/VA), and the slope of phase III (DN2%/L) of the single-breath nitrogen washout test to determine inhomogeneity of ventilation were measured. Compared with measurements obtained in the sitting position, FVC and FEV1 were decreased equally in the side-lying positions, but no change was observed in DLCO/VA or DN2%/L. Side-lying positions resulted in decreases in FVC and FEV1, which is consistent with the well-documented effects of the supine position. These findings further support the need for prescriptive rather than routine body positioning of patients with risks of cardiopulmonary compromise and the need to use upright positions in which lung volumes and capacities are maximized.

Pulmonary function and symptoms in workers exposed to wood dust.

PubMed Central

Shamssain, M H

1992-01-01

BACKGROUND: Exposure to wood dust can cause a variety of lung problems, including chronic airflow obstruction. METHODS: Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory ratio (FEV1/FVC x 100), forced expiratory flow (FEF), forced mid expiratory flow (FMF), peak expiratory flow (PEF), and respiratory symptoms (cough, phlegm, breathlessness, wheezing, and nasal symptoms) were recorded in 145 non-smoking workers (77 male, 68 female) exposed to wood dust in a furniture factory in Umtata, Republic of Transkei, and 152 non-smoking control subjects (77 male, 75 female) from a bottling factory with a clean environment. RESULTS: After adjustment for age and standing height the forced expiratory indices were significantly lower in the exposed male workers than in the control subjects. FEF and PEF in the exposed men were 81.3% and 89.4% of predicted values and were lower than other indices. FVC in exposed men showed a significant inverse correlation with exposure (expressed in number of years of employment). The FVC was reduced by 26 ml per year of employment. The proportion of men with an FEV1/FVC below 70 was higher in exposed workers than in control subjects and higher in the exposed workers with more years of employment. The exposed workers had more respiratory symptoms than the control subjects, the prevalence, especially of cough and nasal symptoms, increasing with the increase in the number of years of employment. CONCLUSION: Workers exposed to pine and fibre dust have more respiratory symptoms and a greater risk of airflow obstruction. PMID:1549828

Association of generic health-related quality of life (EQ-5D dimensions) and inactivity with lung function in lung-healthy German adults: results from the KORA studies F4L and Age.

PubMed

Luzak, Agnes; Karrasch, Stefan; Wacker, Margarethe; Thorand, Barbara; Nowak, Dennis; Peters, Annette; Schulz, Holger

2018-03-01

Among patients with lung disease, decreased lung function is associated with lower health-related quality of life. However, whether this association is detectable within the physiological variability of respiratory function in lung-healthy populations is unknown. We analyzed the association of each EQ-5D-3L dimension (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and self-reported physical inactivity with spirometric indices in lung-healthy adults. Modulating effects between inactivity and EQ-5D dimensions were considered. 1132 non-smoking, apparently lung-healthy participants (48% male, aged 64 ± 12 years) from the population-based KORA F4L and Age surveys in Southern Germany were analyzed. Associations of each EQ-5D dimension and inactivity with spirometric indices serving as outcomes (forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), FEV 1 /FVC, and mid-expiratory flow) were examined by linear regression, considering possible confounders. Interactions between EQ-5D dimensions (no problems/any problems) and inactivity (four categories of time spent engaging in exercise: inactive to most active) were assessed. Among all participants 42% reported no problems in any EQ-5D dimension, 24% were inactive and 32% exercised > 2 h/week. After adjustment, FEV 1 was - 99 ml (95% CI - 166; - 32) and FVC was - 109 ml (95% CI - 195; - 24) lower among subjects with mobility problems. Comparable estimates were observed for usual activities. Inactivity was negatively associated with FVC (β-coefficient: - 83 ml, 95% CI - 166; 0), but showed no interactions with EQ-5D. Problems with mobility or usual activities, and inactivity were associated with slightly lower spirometric parameters in lung-healthy adults, suggesting a relationship between perceived physical functioning and volumetric lung function.

Spirometry results (FEV1 and FVC) in young Bantu men from Tanzania vs environmental and family characteristics.

PubMed

Rębacz-Maron, Ewa; Parafiniuk, Mirosław

2014-01-01

The aim of this paper was to examine the extent to which socioeconomic factors, anthropological data and somatic indices influenced the results of spirometric measurements (FEV1 and FVC) in Tanzanian youth. The population studied were young black Bantu men aged 12.8-24.0 years. Analysis was performed for the whole data set (n = 255), as well as separately for two age groups: under 17.5 years (n = 168) and 17.5 + (n = 87). A backward stepwise multiple regression analysis was performed for FEV1 and FVC as dependent variables on socioeconomic and anthropometric data. Multiple regression analysis for the whole group revealed that the socioeconomic and anthropometric data under analysis accounted for 38% of the variation in FEV1. In addition the analysis demonstrated that 34% of the variation in FVC could be accounted for by the variables used in the regression. A significant impact in explaining the variability of FVC was exhibited by the thorax mobility, financial situation of the participants and Pignet-Verwaecka Index. Analysis of the data indicates the significant role of selected socio-economic factors on the development of the biological specimens investigated. There were no perceptible pathologies, and the results can be treated as a credible interpretation of the influence exerted by the environment in which the teenagers under study grew up.

[Function in patients with chronic fibrocavernous tuberculosis].

PubMed

Nefedov, V B; Popova, L A; Shergina, E A

2008-01-01

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, residual volume (RV), R(aw), R(in), R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 62 patients with chronic fibrocavernous tuberculosis. Lung dysfunctions were detected in 96.8% of the patients. Changes in lung volumes and capacities were found in 90.3%, impaired bronchial patency was in 90.3%, and pulmonary gas exchange dysfunction was in 79.0%. The lung volume and capacity changes appeared as decreased VC and FVC, decreased and increased TLC, TGV, RV; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, and FEV1/VC%; and increased R(aw), R(in), R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, PaO2, and decreased and increased PaCO2. The magnitude of the observed functional changes ranges from slight to significant and drastic with a predominance of considerable and drastic changes in lung volumes and capacities and mild impairments of bronchial patency and pulmonary gas exchange function.

Adult lung function and long-term air pollution exposure. ESCAPE: a multicentre cohort study and meta-analysis

PubMed Central

Adam, Martin; Schikowski, Tamara; Carsin, Anne Elie; Cai, Yutong; Jacquemin, Benedicte; Sanchez, Margaux; Vierkötter, Andrea; Marcon, Alessandro; Keidel, Dirk; Sugiri, Dorothee; Al Kanani, Zaina; Nadif, Rachel; Siroux, Valérie; Hardy, Rebecca; Kuh, Diana; Rochat, Thierry; Bridevaux, Pierre-Olivier; Eeftens, Marloes; Tsai, Ming-Yi; Villani, Simona; Phuleria, Harish Chandra; Birk, Matthias; Cyrys, Josef; Cirach, Marta; de Nazelle, Audrey; Nieuwenhuijsen, Mark J.; Forsberg, Bertil; de Hoogh, Kees; Declerq, Christophe; Bono, Roberto; Piccioni, Pavilio; Quass, Ulrich; Heinrich, Joachim; Jarvis, Deborah; Pin, Isabelle; Beelen, Rob; Hoek, Gerard; Brunekreef, Bert; Schindler, Christian; Sunyer, Jordi; Krämer, Ursula; Kauffmann, Francine; Hansell, Anna L.; Künzli, Nino; Probst-Hensch, Nicole

2015-01-01

The chronic impact of ambient air pollutants on lung function in adults is not fully understood. The objective of this study was to investigate the association of long-term exposure to ambient air pollution with lung function in adult participants from five cohorts in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Residential exposure to nitrogen oxides (NO2, NOx) and particulate matter (PM) was modelled and traffic indicators were assessed in a standardised manner. The spirometric parameters forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from 7613 subjects were considered as outcomes. Cohort-specific results were combined using meta-analysis. We did not observe an association of air pollution with longitudinal change in lung function, but we observed that a 10 μg·m−3 increase in NO2 exposure was associated with lower levels of FEV1 (−14.0 mL, 95% CI −25.8 to −2.1) and FVC (−14.9 mL, 95% CI −28.7 to −1.1). An increase of 10 μg·m−3 in PM10, but not other PM metrics (PM2.5, coarse fraction of PM, PM absorbance), was associated with a lower level of FEV1 (−44.6 mL, 95% CI −85.4 to −3.8) and FVC (−59.0 mL, 95% CI −112.3 to −5.6). The associations were particularly strong in obese persons. This study adds to the evidence for an adverse association of ambient air pollution with lung function in adults at very low levels in Europe. PMID:25193994

Study of computerized spirometric parameters of traffic police personnel of Saurashtra region, Gujarat, India.

PubMed

Makwana, Amit H; Solanki, Jayesh D; Gokhale, Pradnya A; Mehta, Hemant B; Shah, Chinmay J; Gadhavi, Bhakti P

2015-01-01

Air pollution due to road traffic is a serious health hazard and air quality crisis in cities is mainly due to vehicular emission. Thus the persons who are continuously exposed are at an increased risk. The study was carried out to evaluate the extent of impairment in lung function in traffic police personnel compared to matched unexposed control group. A cross-sectional study was conducted to measure the spirometric parameters of 100 traffic police personnel, aged 20-55 years, working in Saurashtra region, as compared to matched control group, consisting of 100 unexposed males. Measurement of lung volumes and capacities was done with SPIROEXCEL. The statistical analysis was carried out with Graph pad instat 3. Traffic police personnel had significantly declined forced vital capacity (FVC), forced expiratory volume in one second (FEV 1), slow vital capacity (SVC) and maximum voluntary ventilation (MVV) when compared with predictive normal values, which is probably due to exposure to vehicular exhaust. Comparison of test values between groups showed significantly reduced FVC, MVV and increased FEV1/FVC ratio and insignificantly declined FEV1 and SVC in cases as compared to controls. Traffic personnel with longer duration of exposure showed significantly reduced lung functions than those with shorter duration. Smokers showed lower test values as compared to non-smokers with significance only in unexposed group. The effect of pollution by vehicular exhausts may be responsible for these pulmonary function impairments and traffic police personnel should be offered personal protective or preventive measures.

Respiratory symptoms and lung function in alumina refinery employees.

PubMed

Musk, A W; de Klerk, N H; Beach, J R; Fritschi, L; Sim, M R; Benke, G; Abramson, M; McNeil, J J

2000-04-01

Employees in alumina refineries are known to be exposed to a number of potential respiratory irritants, particularly caustic mist and bauxite and alumina dusts. To examine the prevalence of work related respiratory symptoms and lung function in alumina refinery employees and relate these to their jobs. 2964 current employees of three alumina refineries in Western Australia were invited to participate in a cross sectional study, and 89% responded. Subjects were given a questionnaire on respiratory symptoms, smoking, and occupations with additional questions on temporal relations between respiratory symptoms and work. Forced expiratory volume in 1 second (FEV(1)) and forced vital capacity (FVC) were measured with a rolling seal spirometer. Atopy was assessed with prick skin tests for common allergens. Associations between work and symptoms were assessed with Cox's regression to estimate prevalence ratios, and between work and lung function with linear regression. Work related wheeze, chest tightness, shortness of breath, and rhinitis were reported by 5.0%, 3.5%, 2.5%, and 9.5% of participants respectively. After adjustment for age, smoking, and atopy, most groups of production employees reported a greater prevalence of work related symptoms than did office employees. After adjustment for age, smoking, height, and atopy, subjects reporting work related wheeze, chest tightness, and shortness of breath had significantly lower mean levels of FEV(1) (186, 162, and 272 ml respectively) than subjects without these symptoms. Prevalence of most work related symptoms was higher at refinery 2 than at the other two refineries, but subjects at this refinery had an adjusted mean FEV(1) >60 ml higher than the others. Significant differences in FVC and FEV(1)/FVC ratio, but not FEV(1), were found between different process groups. There were significant differences in work related symptoms and lung function between process groups and refineries, but these were mostly not consistent. Undefined selection factors and underlying population differences may account for some of these findings but workplace exposures may also contribute. The differences identified between groups were unlikely to be clinically of note.

Respiratory symptoms and lung function in alumina refinery employees

PubMed Central

Musk, A; de Klerk, N. H; Beach, J.; Fritschi, L.; Sim, M.; Benke, G.; Abramson, M.; McNeil, J.

2000-01-01

OBJECTIVES—Employees in alumina refineries are known to be exposed to a number of potential respiratory irritants, particularly caustic mist and bauxite and alumina dusts. To examine the prevalence of work related respiratory symptoms and lung function in alumina refinery employees and relate these to their jobs.
METHODS—2964 current employees of three alumina refineries in Western Australia were invited to participate in a cross sectional study, and 89% responded. Subjects were given a questionnaire on respiratory symptoms, smoking, and occupations with additional questions on temporal relations between respiratory symptoms and work. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured with a rolling seal spirometer. Atopy was assessed with prick skin tests for common allergens. Associations between work and symptoms were assessed with Cox's regression to estimate prevalence ratios, and between work and lung function with linear regression.
RESULTS—Work related wheeze, chest tightness, shortness of breath, and rhinitis were reported by 5.0%, 3.5%, 2.5%, and 9.5% of participants respectively. After adjustment for age, smoking, and atopy, most groups of production employees reported a greater prevalence of work related symptoms than did office employees. After adjustment for age, smoking, height, and atopy, subjects reporting work related wheeze, chest tightness, and shortness of breath had significantly lower mean levels of FEV1 (186, 162, and 272 ml respectively) than subjects without these symptoms. Prevalence of most work related symptoms was higher at refinery 2 than at the other two refineries, but subjects at this refinery had an adjusted mean FEV1 >60 ml higher than the others. Significant differences in FVC and FEV1/FVC ratio, but not FEV1, were found between different process groups.
CONCLUSIONS—There were significant differences in work related symptoms and lung function between process groups and refineries, but these were mostly not consistent. Undefined selection factors and underlying population differences may account for some of these findings but workplace exposures may also contribute. The differences identified between groups were unlikely to be clinically of note.


Keywords: aluminium; alumina; bauxite; caustic mist; occupational epidemiology PMID:10810116

Occupation and three-year incidence of respiratory symptoms and lung function decline: the ARIC Study.

PubMed

Mirabelli, Maria C; London, Stephanie J; Charles, Luenda E; Pompeii, Lisa A; Wagenknecht, Lynne E

2012-03-20

Specific occupations are associated with adverse respiratory health. Inhalation exposures encountered in these jobs may place workers at risk of new-onset respiratory disease. We analyzed data from 8,967 participants from the Atherosclerosis Risk in Communities (ARIC) study, a longitudinal cohort study. Participants included in this analysis were free of chronic cough and phlegm, wheezing, asthma, chronic bronchitis, emphysema, and other chronic lung conditions at the baseline examination, when they were aged 45-64 years. Using data collected in the baseline and first follow-up examination, we evaluated associations between occupation and the three-year incidence of cough, phlegm, wheezing, and airway obstruction and changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) measured by spirometry. All associations were adjusted for age, cigarettes per day, race, smoking status, and study center. During the approximately three-year follow-up, the percentage of participants developing chronic cough was 3%; chronic phlegm, 3%; wheezing, 3%; and airway obstruction, defined as FEV1 < lower limit of normal (LLN) and FEV1/FVC < LLN, 2%. The average annual declines in FEV1 and FVC were 56 mL and 66 mL, respectively, among men and 40 mL and 52 mL, respectively, among women. Relative to a referent category of managerial and administrative support occupations, elevated risks of new-onset chronic cough and chronic phlegm were observed for mechanics and repairers (chronic cough: RR: 1.81, 95% CI: 1.02, 3.21; chronic phlegm: RR: 2.10, 95% CI: 1.23, 3.57) and cleaning and building service workers (chronic cough: RR: 1.85, 95% CI: 1.01, 3.37; chronic phlegm: RR: 2.28, 95% CI: 1.27, 4.08). Despite the elevated risk of new-onset symptoms, employment in cleaning and building services was associated with attenuated lung function decline, particularly among men, who averaged annual declines in FEV1 and FVC of 14 mL and 23 mL, respectively, less than the declines observed in the referent population. Employment in mechanic and repair jobs and cleaning and building service occupations are associated with increased incidence of respiratory symptoms. Specific occupations affect the respiratory health of adults without pre-existing respiratory health symptoms and conditions, though long-term health consequences of inhalation exposures in these jobs remain largely unexplored.

Occupation and three-year incidence of respiratory symptoms and lung function decline: the ARIC Study

PubMed Central

2012-01-01

Background Specific occupations are associated with adverse respiratory health. Inhalation exposures encountered in these jobs may place workers at risk of new-onset respiratory disease. Methods We analyzed data from 8,967 participants from the Atherosclerosis Risk in Communities (ARIC) study, a longitudinal cohort study. Participants included in this analysis were free of chronic cough and phlegm, wheezing, asthma, chronic bronchitis, emphysema, and other chronic lung conditions at the baseline examination, when they were aged 45-64 years. Using data collected in the baseline and first follow-up examination, we evaluated associations between occupation and the three-year incidence of cough, phlegm, wheezing, and airway obstruction and changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) measured by spirometry. All associations were adjusted for age, cigarettes per day, race, smoking status, and study center. Results During the approximately three-year follow-up, the percentage of participants developing chronic cough was 3%; chronic phlegm, 3%; wheezing, 3%; and airway obstruction, defined as FEV1 < lower limit of normal (LLN) and FEV1/FVC < LLN, 2%. The average annual declines in FEV1 and FVC were 56 mL and 66 mL, respectively, among men and 40 mL and 52 mL, respectively, among women. Relative to a referent category of managerial and administrative support occupations, elevated risks of new-onset chronic cough and chronic phlegm were observed for mechanics and repairers (chronic cough: RR: 1.81, 95% CI: 1.02, 3.21; chronic phlegm: RR: 2.10, 95% CI: 1.23, 3.57) and cleaning and building service workers (chronic cough: RR: 1.85, 95% CI: 1.01, 3.37; chronic phlegm: RR: 2.28, 95% CI: 1.27, 4.08). Despite the elevated risk of new-onset symptoms, employment in cleaning and building services was associated with attenuated lung function decline, particularly among men, who averaged annual declines in FEV1 and FVC of 14 mL and 23 mL, respectively, less than the declines observed in the referent population. Conclusions Employment in mechanic and repair jobs and cleaning and building service occupations are associated with increased incidence of respiratory symptoms. Specific occupations affect the respiratory health of adults without pre-existing respiratory health symptoms and conditions, though long-term health consequences of inhalation exposures in these jobs remain largely unexplored. PMID:22433119

Respiratory symptoms and pulmonary function impairment among detergent plant workers in Jos, Northern Nigeria.

PubMed

Babashani, M; Iliyasu, Z; Ukoli, C O

2008-01-01

The industrial process of detergent production could be deleterious to lung function. This study describes respiratory symptoms and ventilatory function impairment among detergent workers in Jos, Northern Nigeria. Two hundred detergent plant workers and controls were studied for the presence of respiratory symptoms and ventilatory function impairment using the MRC questionnaire and Spirometry. A significantly higher proportion of exposed detergent workers 178 (87.0%) reported respiratory symptoms compared to 52 (26.0%) controls [OR=23; 95% CI=12.9-41.3] (P<0.001). Commonest symptoms include rhinitis (57.5% versus 11.0%) and cough (48.5% versus 15%). Symptoms were most prevalent in the packaging section. FEV1, FVC and PEFR were significantly reduced among exposed detergent workers. Similarly, the predicted values of PEFR, FVC and FEV1, were significantly reduced among smokers (P<0. 001). Respiratory symptoms are highly prevalent among detergent workers. This was associated with impaired pulmonary function. Protective equipment and periodic lung function tests could reduce these effects.

Respiratory health effects of fifteen years of improved collective protection in a wheat-processing worker population.

PubMed

Dorribo, Victor; Wild, Pascal; Pralong, Jacques A; Danuser, Brigitta; Reboux, Gabriel; Krief, Peggy; Niculita-Hirzel, Hélène

2015-01-01

Occupational exposure to grain dust causes respiratory symptoms and pathologies. To decrease these effects, major changes have occurred in the grain processing industry in the last twenty years. However, there are no data on the effects of these changes on workers' respiratory health. The aim of this study was to evaluate the respiratory health of grain workers and farmers involved in different steps of the processing industry of wheat, the most frequently used cereal in Europe, fifteen years after major improvements in collective protective equipment due to mechanisation. Information on estimated personal exposure to wheat dust was collected from 87 workers exposed to wheat dust and from 62 controls. Lung function (FEV1, FVC, and PEF), exhaled nitrogen monoxide (FENO) and respiratory symptoms were assessed after the period of highest exposure to wheat during the year. Linear regression models were used to explore the associations between exposure indices and respiratory effects. Acute symptoms - cough, sneezing, runny nose, scratchy throat - were significantly more frequent in exposed workers than in controls. Increased mean exposure level, increased cumulative exposure and chronic exposure to more than 6 mg.m (-3) of inhaled wheat dust were significantly associated with decreased spirometric parameters, including FEV1 and PEF (40 ml and 123 ml.s (-1) ), FEV1 and FVC (0.4 ml and 0.5 ml per 100 h.mg.m (-3) ), FEV1 and FVC (20 ml and 20 ml per 100 h at >6 mg.m (-3) ). However, no increase in FENO was associated with increased exposure indices. The lung functions of wheat-related workers are still affected by their cumulative exposure to wheat dust, despite improvements in the use of collective protective equipment.

Nocturnal Oxygen Desaturation Index is Inversely Correlated with Airflow Limitation in Patients with Chronic Obstructive Pulmonary Disease.

PubMed

Tamai, Koji; Matsuoka, Hirofumi; Suzuki, Yujiro; Yoshimatsu, Harukazu; Masuya, Daiki; Nakashima, Nariyasu; Okada, Nobuhiko; Oda, Nao; Inoue, Sayaka; Koma, Yasuko; Otsuka, Akiko

2016-01-01

The concurrent diagnosis of chronic obstructive pulmonary disease (COPD) and sleep apnoea-hypopnoea syndrome (SAHS) (overlap syndrome), can contribute to worsening respiratory symptoms, but whether the severity of COPD is associated with co-morbid SAHS is unknown. We investigated whether the severity of COPD is associated with the complication of SAHS by examination of nocturnal oximetry as an alternative to polysomnography. Patients with COPD concurrently completed nocturnal oximetry, pulmonary function tests, a COPD assessment test, an Epworth sleepiness scale and a hospital anxiety and depression scale to evaluate the severity of COPD and possible concurrent presence of SAHS. We retrospectively analysed the data to assess correlation between the oxygen desaturation index (ODI) and each clinical variables and evaluated the predictors of ODI ≥ 15. This study included 103 patients (91 males, 88%) with a mean age of 72 ± 8 years and body mass index of 22 ± 3 kg/m(2). ODI was positively correlated with FEV1, FEV1/FVC and FEV1% predicted, which meant that ODI was inversely correlated with airflow limitation. Univariate logistic regression analysis revealed that FEV1% predicted and FEV1/FVC were predictors of ODI ≥ 15. ODI is inversely correlated with airflow limitation and milder COPD patients may have co-morbid SAHS.

Dust is in the air. Part II: Effects of occupational exposure to welding fumes on lung function in a 9-year study.

PubMed

Haluza, Daniela; Moshammer, Hanns; Hochgatterer, Karl

2014-02-01

Adverse health effects of work-related contact with respirable hazardous substances are of great public interest. Because related prospective and long-term follow-up studies are rare, the extent of acute and chronic pulmonary health risks of occupational exposure to welding fumes is discussed controversially in the scientific literature. The objective of the present longitudinal study during a 9-year period was to investigate the annual changes of lung function in welders. Anthropometric measures and smoking behaviour, and spirometric tests (FVC, FEV1, and MEF50) obtained during routine occupational health checkups of female and male workers (n = 1,982) in Austria during the years 2002-2010 were analyzed. The study participants displayed average lung function values lower than the age- and sex-specific norm. Decrease in respiratory capacity was dependent on smoking habits and duration of occupational exposure. Specifically for welders (n = 1,326), decrease of pulmonary function was significantly associated with heavy smoking (FVC -70.7 ml, p = 0.07; FEV1 -167.4 ml, p < 0.001; MEF50 -356.2 ml/s, p < 0.001), but not with moderate smoking habits, and also with duration of occupational exposure to welding fumes per year (FVC -0.89 ml, p = 0.36; FEV1 -2.91 ml, p < 0.001; MEF50 -4.7 ml/s, p = 0.047). Individual smoking habits as well as duration of occupational exposure to welding fumes showed a negative impact on lung function parameters. To reduce the risk of work-associated respiratory morbidity, smoking cessation is highly recommended to personnel engaged in welding fumes- and dust-exposed occupations.

Obesity disproportionately impacts lung volumes, airflow and exhaled nitric oxide in children.

PubMed

Yao, Tsung-Chieh; Tsai, Hui-Ju; Chang, Su-Wei; Chung, Ren-Hua; Hsu, Jing-Ya; Tsai, Ming-Han; Liao, Sui-Ling; Hua, Man-Chin; Lai, Shen-Hao; Chen, Li-Chen; Yeh, Kuo-Wei; Tseng, Yu-Lun; Lin, Wan-Chen; Chang, Su-Ching; Huang, Jing-Long

2017-01-01

The current literature focusing on the effect of obesity and overweight on lung function and fraction of exhaled nitric oxide (FeNO) in children, particularly among healthy children of non-European descent, remains controversial. Furthermore, whether the relationship of obesity and overweight with lung function and FeNO in children is modified by atopy is unclear. The objective of this study was to examine the effect of excess weight on lung function parameters and FeNO among Asian children, with a particular focus on exploring the potential effect modification by atopy. We investigated the effect of excess weight on lung function and FeNO in a population sample of 1,717 children aged 5 to 18 years and explored the potential modifying effect of atopy. There were positive associations of body mass index (BMI) z-score with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and forced expiratory flow at 25-75% (FEF25-75) (all P<0.001), after controlling for confounders. The beta coefficient for FEV1 (0.084) was smaller than that for FVC (0.111). In contrast, a negative association was found between BMI z-score and FEV1/FVC ratio (P<0.001) and FeNO (P = 0.03). A consistent pattern of association for lung function variables was observed when stratifying by atopy. There was a negative association of BMI z-score with FeNO in atopic subjects (P = 0.006), but not in non-atopic subjects (P = 0.46). Excess weight disproportionately impacts lung volumes and airflow in children from the general population, independent of atopic status. Excess weight inversely affects FeNO in atopic but not in non-atopic children.

[Clinical analysis of nasal resistance and pulmonary function testing in patients with chronic nasal-sinusitis and nasal polyps].

PubMed

Liao, Hua; Shen, Ying; Wang, Pengjun

2015-05-01

To study the pulmonary function and nasal resistance characteristics of patients with chronic nose-sinusitis and nasal polyps (CRSwNP), to explore the evaluation role of nasal resistance in nasal ventilation function and the effect of endoscopic sinus surgery on pulmonary function in patients with CRSwNP. Fifty CRSwNP patients that met the study criteria were selected . The patients were performed endoscopic surgeries according to Messerklinger surgical procedures under general anesthesia. Extent of surgery was based on preoperative CT showing the range of the lesion of disease and endoscopic findings. Perioperative treatments contained intranasal corticosteroids, cephalosporin or penicillin antibiotics, nasal irrigation and other treatments. Main outcome measures included visual analog scale (VAS), endoscopic Lind-Kennedy scores, nasal resistence, pulmonary function in patientsone week before and after surgery, three months and six months after surgery. Pulmonary function includes forced expiratory volume in one second (FEV1), forced vital capacity FEV1/FVC and peak expiratory flow (PEF). The study found that there were significantly positive correlations among VAS score, Lund-Kennedy score and nasal resistance (P < 0.05) in CRSwNP patients, but there is a significantly negative correlation between VAS score, Lund-Kennedy score, nasal resistance and pulmonary function indexes of FEV1, FVC and PEF (P < 0.05). The VAS score, Lund-Kennedy score and nasal resistance values of CRSwNP patients were decreased significantly after comprehensive treatments with nasal endoscopic operation as the major one, the difference was statistically different (P < 0.05). And the pulmonary function indexs (FEV1, FVC, PEF) were significantly increased after surgery in CRSwNP patients. The nasal resistance can objectively and reliably reflect the degree of nasal congestion and the recovery of nasal function in CRSwNP patients after endoscopic sinus surgery. The detection method of nasal resistance is simple. Functional endoscopic sinus surgery can effectively improve the pulmonary ventilation function in CRSwNP patients, providing some clinical references about the prevention and treatment of CRS related lower respiratory disease.

Risk Evaluation of Construction Workers' Exposure to Silica Dust and the Possible Lung Function Impairments.

PubMed

Tavakol, Elahe; Azari, Mansour; Zendehdel, Rezvan; Salehpour, Sousan; Khodakrim, Soheila; Nikoo, Saeed; Saranjam, Behzad

2017-06-01

Aerosols generated during construction activities are an integral part of building operations. Considering the nature of materials used in construction activities, respirable dust contains crystalline silica and particulates not otherwise specified (PNOS). Due to lack of data regarding the occupational health status of Iranian construction workers, the objective of this study was to evaluate occupational exposure to silica and to examine their respiratory health status. In this cross sectional study, 85 construction workers and 40 controls (without active exposure to construction dust) were studied. The workers' exposure to PNOS and silica aerosols was monitored by the NIOSH method No.0600 and a new Fourier transform infrared spectroscopy (FTIR)-based method, respectively. All subjects were also monitored for lung function parameters, such as forced expiratory volume/forced vital capacity (FEV 1 /FVC), peak expiratory flow rate (PEFR), forced expiratory flow (FEF 25-75 ), FVC, and FEV 1 . The mean exposure of workers to respirable PNOS and silica was 9.8 (0.35) and 0.13 (0.019) mg/m 3 , respectively. The groups of construction workers showed significant differences in exposure to PNOS ( P < 0.001) and silica ( P = 0.007). The mean pulmonary function parameters, including FEV 1 % and FVC%, were significantly lower among construction workers, compared to the control group ( P < 0.001 and P = 0.009, respectively). The pulmonary status of 51.8% of construction workers showed moderate restriction, while 4.70% exhibited obstruction. Considering the construction workers' excessive exposure to PNOS and silica, besides depressed lung function parameters, they can be classified as a high-risk group for respiratory diseases.

Pulmonary function and respiratory symptoms of school children exposed to ambient air pollution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Yoon Shin; Ko, Ung Ring

1996-12-31

This study was undertaken to evaluate the health effect of air pollution on pulmonary function and respiratory symptoms of Korean school children between 7 and 10 years of age during November 1995-January 1996. A standard respiratory symptom questionnaire was administered and spirometry was performed to examine pulmonary function of 121 children in an urban polluted area, Seoul, and of 119 children in non-polluted area, Sokcho, respectively. There was significant difference in the level of pulmonary function [forced expiratory volume in second (FEV{sub 1.0}) and forced vital capacity (FVC)] between exposed groups to polluted area and non-polluted area. Parental smoking wasmore » significantly related to respiratory symptoms of cough, phlegm, and the level of pulmonary function. The observed changes in FEV{sub 1.0} and FVC seemed to relate to home cooking fuel, not to respiratory symptoms. The additional longitudinal work that carefully monitors ambient and indoor air pollution and health effects data should be conducted to confirm these results.« less

Diagnostic accuracy of FEV1/forced vital capacity ratio z scores in asthmatic patients.

PubMed

Lambert, Allison; Drummond, M Bradley; Wei, Christine; Irvin, Charles; Kaminsky, David; McCormack, Meredith; Wise, Robert

2015-09-01

The FEV1/forced vital capacity (FVC) ratio is used as a criterion for airflow obstruction; however, the test characteristics of spirometry in the diagnosis of asthma are not well established. The accuracy of a test depends on the pretest probability of disease. We wanted to estimate the FEV1/FVC ratio z score threshold with optimal accuracy for the diagnosis of asthma for different pretest probabilities. Asthmatic patients enrolled in 4 trials from the Asthma Clinical Research Centers were included in this analysis. Measured and predicted FEV1/FVC ratios were obtained, with calculation of z scores for each participant. Across a range of asthma prevalences and z score thresholds, the overall diagnostic accuracy was calculated. One thousand six hundred eight participants were included (mean age, 39 years; 71% female; 61% white). The mean FEV1 percent predicted value was 83% (SD, 15%). In a symptomatic population with 50% pretest probability of asthma, optimal accuracy (68%) is achieved with a z score threshold of -1.0 (16th percentile), corresponding to a 6 percentage point reduction from the predicted ratio. However, in a screening population with a 5% pretest probability of asthma, the optimum z score is -2.0 (second percentile), corresponding to a 12 percentage point reduction from the predicted ratio. These findings were not altered by markers of disease control. Reduction of the FEV1/FVC ratio can support the diagnosis of asthma; however, the ratio is neither sensitive nor specific enough for diagnostic accuracy. When interpreting spirometric results, consideration of the pretest probability is an important consideration in the diagnosis of asthma based on airflow limitation. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Investigation of Acute Pulmonary Deficits Associated with Biomass Fuel Cookstove Emissions in Rural Bangladesh

PubMed Central

Medgyesi, Danielle N.; Holmes, Heather A.; Angermann, Jeff E.

2017-01-01

The use of solid biomass fuels in cookstoves has been associated with chronic health impacts that disproportionately affect women worldwide. Solid fuel stoves that use wood, plant matter, and cow dung are commonly used for household cooking in rural Bangladesh. This study investigates the immediate effects of acute elevated cookstove emission exposures on pulmonary function. Pulmonary function was measured with spirometry before and during cooking to assess changes in respiratory function during exposure to cookstove emissions for 15 females ages 18–65. Cookstove emissions were characterized using continuous measurements of particulate matter (PM2.5—aerodynamic diameter <2.5 μm) concentrations at a 1 s time resolution for each household. Several case studies were observed where women ≥40 years who had been cooking for ≥25 years suffered from severe pulmonary impairment. Forced expiratory volume in one second over forced vital capacity (FEV1/FVC) was found to moderately decline (p = 0.06) during cooking versus non-cooking in the study cohort. The study found a significant (α < 0.05) negative association between 3- and 10-min maximum PM2.5 emissions during cooking and lung function measurements of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC obtained during cooking intervals. This study found that exposure to biomass burning emissions from solid fuel stoves- associated with acute elevated PM2.5 concentrations- leads to a decrease in pulmonary function, although further research is needed to ascertain the prolonged (e.g., daily, for multiple years) impacts of acute PM2.5 exposure on immediate and sustained respiratory impairment. PMID:28617349

Challenges in Collating Spirometry Reference Data for South-Asian Children: An Observational Study.

PubMed

Lum, Sooky; Bountziouka, Vassiliki; Quanjer, Philip; Sonnappa, Samatha; Wade, Angela; Beardsmore, Caroline; Chhabra, Sunil K; Chudasama, Rajesh K; Cook, Derek G; Harding, Seeromanie; Kuehni, Claudia E; Prasad, K V V; Whincup, Peter H; Lee, Simon; Stocks, Janet

2016-01-01

Spirometry datasets from South-Asian children were collated from four centres in India and five within the UK. Records with transcription errors, missing values for height or spirometry, and implausible values were excluded(n = 110). Following exclusions, cross-sectional data were available from 8,124 children (56.3% male; 5-17 years). When compared with GLI-predicted values from White Europeans, forced expired volume in 1s (FEV1) and forced vital capacity (FVC) in South-Asian children were on average 15% lower, ranging from 4-19% between centres. By contrast, proportional reductions in FEV1 and FVC within all but two datasets meant that the FEV1/FVC ratio remained independent of ethnicity. The 'GLI-Other' equation fitted data from North India reasonably well while 'GLI-Black' equations provided a better approximation for South-Asian data than the 'GLI-White' equation. However, marked discrepancies in the mean lung function z-scores between centres especially when examined according to socio-economic conditions precluded derivation of a single South-Asian GLI-adjustment. Until improved and more robust prediction equations can be derived, we recommend the use of 'GLI-Black' equations for interpreting most South-Asian data, although 'GLI-Other' may be more appropriate for North Indian data. Prospective data collection using standardised protocols to explore potential sources of variation due to socio-economic circumstances, secular changes in growth/predictors of lung function and ethnicities within the South-Asian classification are urgently required.

Feasibility of spirometry in preschool children.

PubMed

Veras, Tiago Neves; Pinto, Leonardo Araujo

2011-01-01

To determine the rate at which satisfactory spirometry results are obtained (spirometry success rate) in preschool children. We analyzed the spirometry results of children ≤ 6 years of age. All tests were conducted between June of 2009 and February of 2010 in the Pulmonary Function Laboratory of the Hospital Infantil Jeser Amarante Faria, located in the city of Joinville, Brazil. The spirometry program employed features an animated incentive (soap bubbles). The procedures were performed by a pediatric pulmonologist, in accordance with the reproducibility and acceptability criteria recommended by the American Thoracic Society. We attempted to achieve an expiratory time of at least 1 s. The following parameters were measured: FVC, FEV0.5, FEV1, and the FEV1/FVC ratio. Our sample comprised 74 children. The spirometry success rate was 82%. Although the performance improved with age, the difference between younger and older children was not significant (p > 0.05). An average of 6.6 attempts/test were needed in order to achieve acceptable, reproducible curves. All 61 successful tests produced satisfactory FEV0.5 and FEV1 values. By calculating Z scores, we found that 21.6% of the children presented with an obstructive pattern. In our sample, the spirometry success rate was high, showing that spirometry is a valid method for assessing pulmonary function in preschool children. The high success rate in our sample might be attributable to the use of an incentive and to the fact that the tests were performed by professionals specializing in pediatrics.

20 CFR 718.103 - Pulmonary function tests.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report..., noncomplying tests may form the basis for a finding if, in the opinion of the adjudication officer, the tests...

20 CFR 718.103 - Pulmonary function tests.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report..., noncomplying tests may form the basis for a finding if, in the opinion of the adjudication officer, the tests...

20 CFR 718.103 - Pulmonary function tests.

Code of Federal Regulations, 2013 CFR

2013-04-01

... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report..., noncomplying tests may form the basis for a finding if, in the opinion of the adjudication officer, the tests...

20 CFR 718.103 - Pulmonary function tests.

Code of Federal Regulations, 2012 CFR

2012-04-01

... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report..., noncomplying tests may form the basis for a finding if, in the opinion of the adjudication officer, the tests...

20 CFR 718.103 - Pulmonary function tests.

Code of Federal Regulations, 2014 CFR

2014-04-01

... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report..., noncomplying tests may form the basis for a finding if, in the opinion of the adjudication officer, the tests...

[Quantitative analysis of emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT scan in smokers: correlation with pulmonary function test].

PubMed

Zhang, D; Guan, Y; Fan, L; Xia, Y; Liu, S Y

2018-05-22

Objective: To quantify emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT(MSCT) scanning in smokers without respiratory symptoms, and analyze the correlation between the CT quantifiable parameters and lung function parameters. Methods: A total of 72 smokers, who underwent medical examinations from September 2013 to September 2016 in Changzheng Hospital were enrolled in this research and were divided into two groups: 24 smokers with COPD and 48 smokers without COPD.Besides, thirty-nine non-smokers with normal pulmonary function were enrolled as the controls.All subjects underwent double phase MSCT scanning and pulmonary function tests.CT quantifiable parameters of emphysema included the low attenuation area below a threshold of -950 Hounsfield Units (HU)(LAA%(-950)), the lowest 15th percentile of the histogram of end-inspiratory attenuation values (P(15-IN)), the lowest 15th percentile of the histogram of end-expiratory attenuation values (P(15-EX)), relative volume change(RVC) and the expiratory to inspiratory ratio of mean lung density (E/I(MLD)). Pulmonary function parameters included forced expiratory volume in 1 second expressed as percent predicted (FEV(1)%), forced expiratory volume in one second to forced vital capacity ratio (FEV(1)/FVC), residual volume to total lung capacity ratio (RV/TLC) and carbon monoxide diffusion capacity corrected for alveolar volume (DLCO/VA). The differences of CT quantifiable parameters and pulmonary function parameters among the three groups were analyzed by using one-way analysis of variance or Kruskal - Wallis H test.The correlation between CT quantifiable parameters and pulmonary function parameters was analyzed by using Spearman ' s correlation analysis. Results: The differences of LAA%(-950)(the values for the controls, the group of smokers with out COPD and the group of smokers with COPD were 0.5%±0.7%, 0.7%±1.2% and 2.0%±2.4% respectively), P(15-IN)(the values of the three groups were (-892±33), (-905±15) and (-907±22) HU respectively), FEV(1)%(the values of the three groups were 88.4%±8.8%, 84.2%±7.5% and 82.1%±8.0% respectively), FEV(1)/FVC(the values of the three groups were 78.0%±3.8%, 76.6%±4.3% and 67.3%±5.5% respectively), DLCO/VA (the values of the three groups were (1.36±0.25), (1.30±0.22) and (1.21±0.22) mmol·min(-1)·kPa(-1)·L(-1) respectively) and RV/TLC (the values of the three groups were 49.5%±6.6%, 45.9%±6.0% and 53.0%±6.4% respectively) among the three groups were statistically significant (all P <0.05). In the control group, LAA%(-950) negatively correlated with FEV(1)/FVC and DLCO/VA( r =-0.32, P =0.04; r =-0.69, P =0.00) and neither did P(15-IN) with FEV(1)%( r =-0.14, P =0.02). Inversely, P(15-IN) positively correlated with DLCO/VA ( r =0.55, P =0.00). In the group of smokers without COPD, LAA%(-950) negatively correlated with FEV(1)/FVC and DLCO/VA( r =-0.31, P =0.04; r =-0.42, P =0.00), and P(15-IN) positively correlated with FEV(1)/FVC and DLCO/VA ( r =0.33, P =0.02; r =0.30, P =0.04). In the group of smokers with COPD, LAA%(-950) negatively correlated with DLCO/VA ( r =-0.62, P =0.00), but positively correlated with RV/TLC ( r =0.59, P =0.00). And P(15-IN) positively correlated with DLCO/VA( r =0.53, P =0.01). Conclusions: Smokers emphysema and air trapping can be effectively evaluated by double phase MSCT. Moreover, two of the CT quantifiable parameters, LAA%(-950) and P(15-IN), are highly sensitive to changes in pulmonary function.

Exposure to ammonia and acute respiratory effects in a urea fertilizer factory.

PubMed

Rahman, Md Hamidur; Bråtveit, Magne; Moen, Bente E

2007-01-01

Personal exposures to ammonia and acute respiratory effects were determined in workers at a urea fertilizer factory in Bangladesh. Full-shift personal exposure to ammonia was measured using a PAC III direct reading instrument and Drager diffusion tubes. Respiratory symptoms were elicited by a questionnaire study (n = 113), and preshift and postshift lung function (FVC, FEV1, and PEFR) were tested using spirometry (n = 88). Urea plant workers had higher mean exposure to ammonia and prevalence of acute respiratory symptoms than did workers in the ammonia plant. The symptoms with highest prevalence in the urea plant were chest tightness (33%) and cough (28%). FVC and FEV1 decreased significantly across the work shift among urea plant workers. The higher level of exposure to ammonia in the urea plant was associated with an increased prevalence of respiratory symptoms and an acute decline in lung function.

Evaluation of respiratory variables in smelter and control workers before and during a shutdown period

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holness, D.L.; Batten, B.; Broder, I.

1985-05-01

Thirty-six smelter workers examined in this pilot study were found to have a higher prevalence of cough and dyspnea and lower baseline lung function than did 31 controls. They also experienced decreases in forced vital capacity (FVC) and forced expiratory volume in 1s (FEV1) over the workweek while the controls did not. Baseline airflow rates and change in FVC and FEV1 over the workweek varied with levels of sulfur dioxide and particulates. Twenty-three smelter workers and 21 controls were seen on a second occasion, six months into an extended shutdown. The smelter workers continued to have a higher prevalence ofmore » cough and dyspnea and lower baseline lung function than the controls. There was, however, a slight increase in lung function in both the exposed workers and the controls during the shutdown. The results suggest that smelter workers may develop both acute and chronic work-related pulmonary effects and that the chronic effects may be nonreversible.« less

LONG TERM EFFECTS OF PRENATAL AND POSTNATAL AIRBORNE PAH EXPOSURE ON VENTILATORY LUNG FUNCTION OF NON-ASTHMATIC PREADOLESCENT CHILDREN. PROSPECTIVE BIRTH COHORT STUDY IN KRAKOW

PubMed Central

Jedrychowski, Wieslaw A.; Perera, Frederica P.; Maugeri, Umberto; Majewska, Renata; Mroz, Elzbieta; Flak, Elzbieta; Camman, David; Sowa, Agata; Jacek, Ryszard

2014-01-01

The main goal of the study was to test the hypothesis that prenatal and postnatal exposure to polycyclic aromatic hydrocarbons (PAH) is associated with depressed lung function in non-asthmatic children. The study sample comprises 195 non-asthmatic children of non-smoking mothers, among whom the prenatal PAH exposure was assessed by personal air monitoring in pregnancy. At the age of 3, residential air monitoring was carried out to evaluate the residential PAH exposure indoors and outdoors. At the age of 5 to 8, children were given allergic skin tests for indoor allergens; and between 5–9 years lung function testing (FVC, FEV05, FEV1 and FEF25–75) was performed. The effects of prenatal PAH exposure on lung function tests repeated over the follow-up were adjusted in the General Estimated Equation (GEE) model for the relevant covariates. No association between FVC with prenatal PAH exposure was found; however for the FEV1 deficit associated with higher prenatal PAH exposure (above 37ng/m3) amounted to 53 mL (p = 0.050) and the deficit of FEF25–75 reached 164 mL (p=0.013). The corresponding deficits related to postnatal residential indoor PAH level (above 42 ng/m3) were 59 mL of FEV1 (p=0.028) and 140 mL of FEF25–75 (p=0.031). At the higher residential outdoor PAH level (above 90 ng/m3) slightly greater deficit of FEV1 (71mL, p = 0.009) was observed. The results of the study suggest that transplacental exposure to PAH compromises the normal developmental process of respiratory airways and that this effect is compounded by postnatal PAH exposure. PMID:25300014

Chronic obstructive pulmonary disease in Welsh slate miners.

PubMed

Reynolds, C J; MacNeill, S J; Williams, J; Hodges, N G; Campbell, M J; Newman Taylor, A J; Cullinan, P

2017-01-01

Exposure to respirable crystalline silica (RCS) causes emphysema, airflow limitation and chronic obstructive pulmonary disease (COPD). Slate miners are exposed to slate dust containing RCS but their COPD risk has not previously been studied. To study the cumulative effect of mining on lung function and risk of COPD in a cohort of Welsh slate miners and whether these were independent of smoking and pneumoconiosis. The study was based on a secondary analysis of Medical Research Council (MRC) survey data. COPD was defined as forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC) ratio <0.7. We created multivariable models to assess the association between mining and lung function after adjusting for age and smoking status. We used linear regression models for FEV 1 and FVC and logistic regression for COPD. In the original MRC study, 1255 men participated (726 slate miners, 529 unexposed non-miners). COPD was significantly more common in miners (n = 213, 33%) than non-miners (n = 120, 26%), P < 0.05. There was no statistically significant difference in risk of COPD between miners and non-miners when analysis was limited to non-smokers or those without radiographic evidence of pneumoconiosis. After adjustment for smoking, slate mining was associated with a reduction in %predicted FEV 1 [β coefficient = -3.97, 95% confidence interval (CI) -6.65, -1.29] and FVC (β coefficient = -2.32, 95% CI -4.31, -0.33) and increased risk of COPD (odds ratio: 1.38, 95% CI 1.06, 1.81). Slate mining may reduce lung function and increase the incidence of COPD independently of smoking and pneumoconiosis. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Evaluation of chronic bronchitis, chronic obstructive pulmonary disease, and ventilatory function among workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin

DOE Office of Scientific and Technical Information (OSTI.GOV)

Calvert, G.M.; Sweeney, M.H.; Morris, J.A.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is produced as an undesirable contaminant in the manufacture of 2,4,5-trichlorophenol (TCP) and its derivatives. There is considerable concern about the health effects that may be associated with exposure to TCDD-contaminated substances. A cross-sectional medical study that included a comprehensive medical history, medical examination, and measurement of pulmonary function was conducted on workers employed more than 15 yr earlier in the manufacture of NaTCP and its derivatives at two chemical plants. The workers had substantial exposure to substances contaminated with TCDD, as evidenced by a mean serum TCDD level, lipid adjusted, of 200 ppt compared with a meanmore » of 7 ppt in the unexposed reference group. The comparison group consisted of individuals with no occupational exposure to phenoxy herbicides who lived in the same communities as the workers. A total of 281 workers and 260 unexposed referents participated in the medical examination. Logistic and linear regression analyses, which contained categorical and continuous measures of TCDD exposure, were performed to control for important confounders, including cigarette and alcohol consumption. No difference was found between workers and referents in the risk for chronic bronchitis or COPD. Analysis of the ventilatory function data revealed no association between history of exposure to substances contaminated with TCDD and the forced expiratory volume at one second (FEV1), forced vital capacity (FVC), or the ratio of FEV1 to FVC (FEV1/FVC%).« less

CFTR-dependent chloride efflux in cystic fibrosis mononuclear cells is increased by ivacaftor therapy.

PubMed

Guerra, Lorenzo; D'Oria, Susanna; Favia, Maria; Castellani, Stefano; Santostasi, Teresa; Polizzi, Angela M; Mariggiò, Maria A; Gallo, Crescenzio; Casavola, Valeria; Montemurro, Pasqualina; Leonetti, Giuseppina; Manca, Antonio; Conese, Massimo

2017-07-01

The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) potentiator ivacaftor (Kalydeco®) improves clinical outcome in G551D cystic fibrosis (CF) patients. Here, we have investigated whether ivacaftor has a clinical impact on non-G551D gating mutations and function of circulating leukocytes as well. Seven patients were treated with ivacaftor and evaluated at baseline, and at 1-3 and 6 months. Besides clinical and systemic inflammatory parameters, circulating mononuclear cells (MNC) were evaluated for CFTR-dependent chloride efflux by spectrofluorimetry, neutrophils for oxidative burst by cytofluorimetry and HVCN1 mRNA expression by real time PCR. Ivacaftor determined a significant decrease in sweat chloride concentrations at all time points during treatment. Body mass index (BMI), FEV 1 , and FVC showed an increasing trend. While C-reactive protein decreased significantly at 2 months, the opposite behavior was noticed for circulating monocytes. CFTR activity in MNC was found to increase significantly at 3 and 6 months. Neutrophil oxidative burst peaked at 2 months and then decreased to baseline. HVCN1 mRNA expression was significantly higher than baseline at 1-3 months and decreased after 6 months of treatment. The chloride efflux in MNC correlated positively with both FEV 1 and FVC. On the other hand, sweat chloride correlated positively with CRP and WBC, and negatively with both respiratory function tests. A cluster analysis confirmed that sweat chloride, FEV 1 , FVC, BMI, and MNC chloride efflux behaved as a single entity over time. In patients with non-G551D mutations, ivacaftor improved both chloride transport in sweat ducts and chloride efflux in MNC, that is, functions directly imputed to CFTR. © 2017 Wiley Periodicals, Inc.

Respiratory Symptoms and Lung Function among Greek Cotton Industry Workers: A Cross-Sectional Study.

PubMed

Anyfantis, Ioannis D; Rachiotis, Georgios; Hadjichristodoulou, Cristos; Gourgoulianis, Konstantinos I

2017-01-01

Workers in cotton industry are occupationally exposed to various dust-related hazards. The nature of these agents and the respective exposure levels depend on the cotton industry specific sector. These exposures could be associated with respiratory symptoms and changes in lung function parameters. To evaluate associations between occupational exposure and respiratory function as well as reported symptoms in several groups of workers at different stages of the cotton industry in a vertical approach that covers all the major sectors-from cotton ginning to weaving and fabric production. A questionnaire on respiratory symptoms and individual as well as workplace characteristics was completed by 256 workers at the cotton industry and 148 office workers (control group). Both groups underwent spirometry. Workers in cotton industry reported a higher prevalence of severe dyspnea (p=0.002) and wheezing (p=0.004) compared to the control group. Also they were found to have a lower predicted FEV 1 % (p<0.029) and lower FEV 1 /FVC (p<0.001) values. In addition, a higher prevalence of FEV 1 % <80% (p<0.001) and FEV 1 /FVC <70% (p=0.041) were found among textile workers. Similar results were found for non-smoker textile workers compared to non-smoker control group workers. Those working in cotton ginning mills recorded the highest decrease of spirometric values. Duration of employment in cotton industry and smoking use were found to be predictors of lung function decline for cotton industry workers. Occupational exposure to cotton dust was associated with increased prevalence of respiratory symptoms and obstructive pattern in pulmonary function test.

Efficacy of concomitant administration of clarithromycin and acetylcysteine in bronchiolitis obliterans in seventeen sulfur mustard—exposed patients: An open-label study

PubMed Central

Ghanei, Mostafa; Abolmaali, Kamran; Aslani, Jafar

2004-01-01

Background: Victims of sulfur mustard (SM) gas exposure experience different types of chronic pulmonary disease, manifested as cough, sputum production, and dyspnea. Conventional therapies (eg, immunosuppressive drugs, corticosteroids) have not been effective in these patients. Objective: This study was carried out to determine the efficacy of concomitant administration of the macrolide clarithromycin and the mucolytic agent acetylcysteine in the treatment of bronchiolitis obliterans in SM-exposed patients. Methods: This open-label clinical study was conducted at the Research Center of Chemical Injuries, Baqiyatallah Medical Sciences University, Tehran, Iran. Clarithromycin and acetylcysteine were administered concomitantly for 6 months to male SM-exposed patients with chronic bronchitis and bronchiolitis obliterans who were nonresponsive to conventional treatments. Efficacy analysis included symptom assessment and pulmonary function tests (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], and FEV1/FVC ratio) using spirometry, performed at baseline and after 2 and 6 months of treatment. Results: Seventeen male patients (mean [SD] age, 38.3 [5.3] years [range, 31–50 years]; mean [SD] body weight, 77.9 [15.7] kg) were included in the study. Cough and sputum production were each found in 10 of 17 patients (58.8%) at baseline and were improved in all 10 patients after the administration of clarithromycin and acetylcysteine. FEV1 and FVC also were improved, by mean (SD) 10.6% (9.7%) (P < 0.001 vs baseline) and 12.9% (13.6%) (P = 0.001 vs baseline). No significant change in FEV1/FVC ratio was found. Conclusions: In this study of concomitant administration of clarithromycin and acetylcysteine for the treatment of bronchiolitis obliterans in SM-exposed patients, symptoms and pulmonary function were improved. These results may have been related to the therapeutic effects of a macrolide antibiotic on chronic bronchitis and bronchiolitis obliterans in these patients. Based on the results of this study, we recommend this treatment for chemical warfare victims with recurrent exacerbation of bronchitis who do not respond to conventional treatment. PMID:24672101

Chronic bronchitis, work related respiratory symptoms, and pulmonary function in welders in New Zealand.

PubMed

Bradshaw, L M; Fishwick, D; Slater, T; Pearce, N

1998-03-01

A cross sectional study of respiratory symptoms and lung function in welders was performed at eight New Zealand welding sites: 62 current welders and 75 non-welders participated. A questionnaire was administered to record demographic data, smoking habit, and current respiratory symptoms. Current and previous welding exposures were recorded to calculate a total lifetime welding fume exposure index. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were measured before the start of the shift. There were no significant differences in ethnicity, smoking habits, or years of work experience between welders and non-welders. Symptoms of chronic bronchitis were more common in current welders (11.3%) than in non-welders (5.0%). Of those workers with a cumulative exposure index to welding fume > or = 10 years, 16.7% reported symptoms of chronic bronchitis compared with 4.7% of those with a cumulative exposure index < 4 years (odds ratio (OR) 4.1, 95% confidence interval (95% CI) 0.90 to 17.6). Workers with chronic bronchitis had significantly lower measures of baseline PEF (p = 0.008) and FEV/FVC ratio (p = 0.001) than workers without chronic bronchitis. Multivariate analysis showed that current smoking (OR 9.3, 1.0 to 86.9) and total exposure index to welding fumes > 10 years (OR 9.5, 1.3 to 71.9) were independent risk factors for chronic bronchitis. The report of any work related respiratory symptom was more prevalent in welders (30.7%) than non-welders (15.0%) and workers with these symptoms had significantly lower FEV, (p = 0.004) and FVC (p = 0.04) values. Multivariate analysis identified a high proportion of time spent welding in confined spaces as the main risk factor for reporting these symptoms (OR 2.8, 1.0 to 8.3). This study has documented a high prevalence of symptoms of chronic bronchitis and other work related respiratory symptoms in current welders. Also, workers with chronic bronchitis had reduced PEF and FEV/FVC compared with those without chronic bronchitis. These symptoms related both to cigarette smoking and a measure of lifetime exposure to welding fume.

Applicability of the Old European Respiratory Society/European Community for Steel and Coal reference equations for spirometry interpretation in Tunisian adult population.

PubMed

El Attar, Mohamed Nour; Hadj Mabrouk, Khaoula; Ben Abdelaziz, Ahmed; Abdelghani, Ahmed; Bousarssar, Mohamed; Limam, Khélifa; Maatoug, Chiraz; Bouslah, Hmida; Charrada, Ameur; Rouatbi, Sonia; Ben Saad, Helmi

2014-01-01

Tunisian pulmonary functional laboratories accept the default settings for reference equations (European Respiratory Society/European Community for Steel and Coal (ERS/ECSC1983) offered by the manufacturer even though adult Tunisian reference equations (Tunisian1995) are available. To compare the spirometric profile of Tunisian subjects, according to the two reference equations. Spirometric data were recorded from 1192 consecutive spirometry procedures in adults aged 18-60 years. Reference values and lower limits of normality (LLN) were calculated using the two reference equations. Applied definitions: large airway obstructive ventilatory defect (LAOVD): ratio between the 1st second expiratory volume and forced vital capacity (FEV1/FVC) < LLN. Small AOVD (SAOVD): FEV1/FVC > LLN and FVC > LLN and maximal midexpiratory flow < LLN. Tendency through a restrictive ventilatory defect (TRVD): FEV1 and FVC < LLN. The spirometric profile, according the two reference equations, was determined. Using Tunisian1995 reference equations, 34%, 7%, 37% and 19% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using ERS/ECSC1983 reference equations, 85%, 3%, 9% and 2% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using the ERS/ECSC1983 reference equations, misclassification was worse for LAOVD, for SAOVD and for TRVD, respectively, 68%, 94% and 89%. Our results showed that the use of the old Caucasian reference equations resulted in misinterpretation of spirometry data in a significant proportion of subjects. This could result in inappropriate diagnosis and/or management.

Use of the forced-oscillation technique to estimate spirometry values.

PubMed

Yamamoto, Shoichiro; Miyoshi, Seigo; Katayama, Hitoshi; Okazaki, Mikio; Shigematsu, Hisayuki; Sano, Yoshifumi; Matsubara, Minoru; Hamaguchi, Naohiko; Okura, Takafumi; Higaki, Jitsuo

2017-01-01

Spirometry is sometimes difficult to perform in elderly patients and in those with severe respiratory distress. The forced-oscillation technique (FOT) is a simple and noninvasive method of measuring respiratory impedance. The aim of this study was to determine if FOT data reflect spirometric indices. Patients underwent both FOT and spirometry procedures prior to inclusion in development (n=1,089) and validation (n=552) studies. Multivariate linear regression analysis was performed to identify FOT parameters predictive of vital capacity (VC), forced VC (FVC), and forced expiratory volume in 1 second (FEV 1 ). A regression equation was used to calculate estimated VC, FVC, and FEV 1 . We then determined whether the estimated data reflected spirometric indices. Agreement between actual and estimated spirometry data was assessed by Bland-Altman analysis. Significant correlations were observed between actual and estimated VC, FVC, and FEV 1 values (all r >0.8 and P <0.001). These results were deemed robust by a separate validation study (all r >0.8 and P <0.001). Bias between the actual data and estimated data for VC, FVC, and FEV 1 in the development study was 0.007 L (95% limits of agreement [LOA] 0.907 and -0.893 L), -0.064 L (95% LOA 0.843 and -0.971 L), and -0.039 L (95% LOA 0.735 and -0.814 L), respectively. On the other hand, bias between the actual data and estimated data for VC, FVC, and FEV 1 in the validation study was -0.201 L (95% LOA 0.62 and -1.022 L), -0.262 L (95% LOA 0.582 and -1.106 L), and -0.174 L (95% LOA 0.576 and -0.923 L), respectively, suggesting that the estimated data in the validation study did not have high accuracy. Further studies are needed to generate more accurate regression equations for spirometric indices based on FOT measurements.

Short-Term Exposure to Air Pollution and Lung Function in the Framingham Heart Study

PubMed Central

Ljungman, Petter L.; Wilker, Elissa H.; Gold, Diane R.; Schwartz, Joel D.; Koutrakis, Petros; Washko, George R.; O’Connor, George T.; Mittleman, Murray A.

2013-01-01

Rationale: Short-term exposure to ambient air pollution has been associated with lower lung function. Few studies have examined whether these associations are detectable at relatively low levels of pollution within current U.S. Environmental Protection Agency (EPA) standards. Objectives: To examine exposure to ambient air pollutants within EPA standards and lung function in a large cohort study. Methods: We included 3,262 participants of the Framingham Offspring and Third Generation cohorts living within 40 km of the Harvard Supersite monitor in Boston, Massachusetts (5,358 examinations, 1995–2011) who were not current smokers, with previous-day pollutant levels in compliance with EPA standards. We compared lung function (FEV1 and FVC) after previous-day exposure to particulate matter less than 2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) in the “moderate” range of the EPA Air Quality Index to exposure in the “good” range. We also examined linear relationships between moving averages of pollutant concentrations 1, 2, 3, 5, and 7 days before spirometry and lung function. Measurements and Main Results: Exposure to pollutant concentrations in the “moderate” range of the EPA Air Quality Index was associated with a 20.1-ml lower FEV1 for PM2.5 (95% confidence interval [CI], −33.4, −6.9), a 30.6-ml lower FEV1 for NO2 (95% CI, −60.9, −0.2), and a 55.7-ml lower FEV1 for O3 (95% CI, −100.7, −10.8) compared with the “good” range. The 1- and 2-day moving averages of PM2.5, NO2, and O3 before testing were negatively associated with FEV1 and FVC. Conclusions: Short-term exposure to PM2.5, NO2, and O3 within current EPA standards was associated with lower lung function in this cohort of adults. PMID:24200465

A prospective study of the impact of diabetes mellitus on restrictive and obstructive lung function impairment: The Saku study.

PubMed

Sonoda, Nao; Morimoto, Akiko; Tatsumi, Yukako; Asayama, Kei; Ohkubo, Takayoshi; Izawa, Satoshi; Ohno, Yuko

2018-05-01

To assess the impact of diabetes on restrictive and obstructive lung function impairment. This 5-year prospective study included 7524 participants aged 40-69years without lung function impairment at baseline who underwent a comprehensive medical check-up between April 2008 and March 2009 at Saku Central Hospital. Diabetes was defined by fasting plasma glucose ≥7.0mmol/l (126mg/dl), HbA1c≥6.5% (48mmol/mol), or a history of diabetes, as determined by interviews conducted by the physicians. Restrictive and obstructive lung function impairment were defined as forced vital capacity (FVC) <80% predicted and forced expiratory volume in 1s (FEV 1 ) to FVC ratio (FEV 1 /FVC) <0.70, respectively. Participants were screened until they developed restrictive or obstructive lung function impairment or until March 2014. During the follow-up period, 171 and 639 individuals developed restrictive and obstructive lung function impairment, respectively. Individuals with diabetes had a 1.6-fold higher risk of restrictive lung function impairment than those without diabetes after adjusting for sex, age, height, abdominal obesity, smoking status, exercise habits, systolic blood pressure, HDL-cholesterol, log-transformed high-sensitivity C-reactive protein, and baseline lung function [multivariable-adjusted HR and 95% CI; 1.57 (1.04-2.36)]. In contrast, individuals with diabetes did not have a significantly higher risk of obstructive lung function impairment [multivariable-adjusted HR and 95% CI; 0.93 (0.72-1.21)]. Diabetes was associated with restrictive lung function impairment but not obstructive lung function impairment. Copyright © 2017. Published by Elsevier Inc.

Respiratory effects of work in retail food stores. III. Pulmonary function findings.

PubMed

Wegman, D H; Eisen, E A; Smith, T J; Greaves, I A; Fine, L J

1987-06-01

Findings are reported from a prospective morbidity study which examined the effects on pulmonary function associated with the particulate and gaseous air contaminants to which retail food store workers are exposed. A total of 685 supermarket employees (including meat wrappers, meat cutters and store clerks) performed standard ventilatory function tests [forced expiratory volume in 1 s (FEV1.0) and forced vital capacity (FVC)] during a base-line survey. Those available four years later (305) were resurveyed in a similar manner. A suggestive chronic effect on pulmonary function was shown in those with high cumulative exposures and allergic history. Among those workers who had continuous exposure to air contaminants in settings with "hot-wire" plastic wrap film cutters the annual rates of change in FEV1.0 and FVC were twice as great as the changes found among comparable workers who were not exposed to fumes from wrapping film. Those who switched from the "hot-wire" to the "cool-rod" cutters during the course of the follow-up had intermediate rates of change in lung function.

Associations of children's lung function with ambient air pollution: joint effects of regional and near-roadway pollutants.

PubMed

Urman, Robert; McConnell, Rob; Islam, Talat; Avol, Edward L; Lurmann, Frederick W; Vora, Hita; Linn, William S; Rappaport, Edward B; Gilliland, Frank D; Gauderman, W James

2014-06-01

Previous studies have reported adverse effects of either regional or near-roadway air pollution (NRAP) on lung function. However, there has been little study of the joint effects of these exposures. To assess the joint effects of NRAP and regional pollutants on childhood lung function in the Children's Health Study. Lung function was measured on 1811 children from eight Southern Californian communities. NRAP exposure was assessed based on (1) residential distance to the nearest freeway or major road and (2) estimated near-roadway contributions to residential nitrogen dioxide (NO2), nitric oxide (NO) and total nitrogen oxides (NOx). Exposure to regional ozone (O3), NO2, particulate matter with aerodynamic diameter <10 µm (PM10) and 2.5 µm (PM2.5) was measured continuously at community monitors. An increase in near-roadway NOx of 17.9 ppb (2 SD) was associated with deficits of 1.6% in forced vital capacity (FVC) (p=0.005) and 1.1% in forced expiratory volume in 1 s (FEV1) (p=0.048). Effects were observed in all communities and were similar for NO2 and NO. Residential proximity to a freeway was associated with a reduction in FVC. Lung function deficits of 2-3% were associated with regional PM10 and PM2.5 (FVC and FEV1) and with O3 (FEV1), but not NO2 across the range of exposure between communities. Associations with regional pollution and NRAP were independent in models adjusted for each. The effects of NRAP were not modified by regional pollutant concentrations. The results indicate that NRAP and regional air pollution have independent adverse effects on childhood lung function. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Lung function growth in children with long-term exposure to air pollutants in Mexico City.

PubMed

Rojas-Martinez, Rosalba; Perez-Padilla, Rogelio; Olaiz-Fernandez, Gustavo; Mendoza-Alvarado, Laura; Moreno-Macias, Hortensia; Fortoul, Teresa; McDonnell, William; Loomis, Dana; Romieu, Isabelle

2007-08-15

Although short-term exposure to air pollution has been associated with acute, reversible lung function decrements, the impact of long-term exposure has not been well established. To evaluate the association between long-term exposure to ozone (O(3)), particulate matter less than 10 mum in diameter (PM(10)), and nitrogen dioxide (NO(2)) and lung function growth in Mexico City schoolchildren. A dynamic cohort of 3,170 children aged 8 years at baseline was followed from April 23, 1996, through May 19, 1999. The children attended 39 randomly selected elementary schools located near 10 air quality monitoring stations and were visited every 6 months. Statistical analyses were performed using general linear mixed models. After adjusting for acute exposure and other potential confounding factors, deficits in FVC and FEV(1) growth over the 3-year follow-up period were significantly associated with exposure to O(3), PM(10), and NO(2). In multipollutant models, an interquartile range (IQR) increase in mean O(3) concentration (IQR, 11.3 ppb) was associated with an annual deficit in FEV(1) of 12 ml in girls and 4 ml in boys, an IQR range (IQR, 36.4 microg/m(3)) increase in PM(10) with an annual deficit in FEV(1) of 11 ml in girls and 15 ml in boys, and an IQR range (IQR, 12.0 ppb) increase in NO(2) with an annual deficit in FEV(1) of 30 ml in girls and 25 ml in boys. We conclude that long-term exposure to O(3), PM(10), and NO(2) is associated with a deficit in FVC and FEV(1) growth among schoolchildren living in Mexico City.

Association between Lung Function in Adults and Plasma DDT and DDE Levels: Results from the Canadian Health Measures Survey

PubMed Central

Ye, Ming; Beach, Jeremy; Martin, Jonathan W.

2014-01-01

Background Although DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane] has been banned in many countries since the 1970s, it may still pose a risk to human respiratory health. In agriculture, DDT exposures have been associated with asthma and chronic bronchitis. However, little is known about the effect of DDT on lung function. Methods We used data on 1,696 participants 20–79 years of age from the Canadian Health Measures Survey (CHMS) and conducted multiple regression analysis to estimate associations between plasma p,p´-DDT/DDE and lung function. Results Almost all participants (> 99.0%) had detectable concentrations of plasma p,p´-DDE, but only 10.0% had detectable p,p´-DDT. Participants with detectable p,p´-DDT had significantly lower mean FVC (difference = 311 mL; 95% CI: –492, –130; p = 0.003) and FEV1 (difference = 232 mL; 95% CI: –408, –55; p = 0.015) than those without. A 100-ng/g lipid increase in plasma p,p´-DDE was associated with an 18.8-mL decrease in mean FVC (95% CI: –29, –9) and an 11.8-mL decrease in mean FEV1 (95% CI: –21, –3). Neither exposure was associated with FEV1/FVC ratio or FEF25%–75%. Conclusions DDT exposures, which may have occurred decades ago, were still detectable among Canadians. Plasma DDT and DDE were negatively associated with lung function parameters. Additional research on the potential effects of DDT use on lung function is warranted. Citation Ye M, Beach J, Martin JW, Senthilselvan A. 2015. Association between lung function in adults and plasma DDT and DDE levels: results from the Canadian Health Measures Survey. Environ Health Perspect 123:422–427; http://dx.doi.org/10.1289/ehp.1408217 PMID:25536373

Pulmonary function in children with development coordination disorder.

PubMed

Wu, Sheng K; Cairney, John; Lin, Hsiao-Hui; Li, Yao-Chuen; Song, Tai-Fen

2011-01-01

The purpose of this study was to compare pulmonary function in children with developmental coordination disorder (DCD) with children who are typically developing (TD), and also analyze possible gender differences in pulmonary function between these groups. The Movement ABC test was used to identify the movement coordination ability of children. Two hundred and fifty participants (90 children with DCD and 160 TD children) aged 9-10 years old completed this study. Using the KoKo spirometry, forced vital capacity (FVC) and forced expiratory volume in 1s (FEV(1.0)) were used to measure pulmonary function. The 800-m run was also conducted to assess cardiopulmonary fitness of children in the field. There was a significant difference in pulmonary function between TD children and those with DCD. The values of FVC and FEV(1.0) in TD children were significantly higher than in children with DCD. A significant, but low correlation (r = -0.220, p < .001) was found between total score on the MABC and FVC; similarly, a positive but low correlation (r = 0.252, p < .001) was found between total score on the MABC and the completion time of 800-m run. However, no significant correlation between FVC and the time of 800-m run was found (p > .05). Significant correlations between total score on the MABC and the completion time of the 800-m run (r = 0.352, p < .05) and between FVC and the time of 800-m run (r = -0.285, p < .05) were observed in girls with DCD but not boys with this condition. Based on the results of this study, pulmonary function in children with DCD was significantly lower than that of TD children. The field test, 800-m run, may not be a good indicator to distinguish aerobic ability between children with DCD and those who are TD. It is possible that poor pulmonary function in children with DCD is due to reduced physical activity in this population. Copyright © 2010 Elsevier Ltd. All rights reserved.

The effect of dietary antioxidant on the COPD risk: the community-based KoGES (Ansan–Anseong) cohort

PubMed Central

Joshi, Pankaj; Kim, Woo Jin; Lee, Sang-Ah

2015-01-01

Background Dietary antioxidants have been suggested to have protective role against chronic obstructive pulmonary disease (COPD), but few prospective studies examined this relationship. The prospective study was conducted to evaluate the effect of dietary antioxidants on COPD risk and lung function in the Korean population. Methods The data were collected from the community-based Korean Genome Epidemiology Study (KoGES) cohort. To diagnose COPD, forced expiratory volume (FEV1) and forced vital capacity (FVC) were measured by spirometry. The dietary intake of antioxidant vitamins was estimated from validated Food-Frequency Questionnaire. For the analysis, 325 COPD patients and 6,781 at risk subjects were selected from the cohort of 10,038 subjects. Multiple logistic regression models were used to examine the odds ratio (OR) after adjusting for age, sex, marital status, income, history of asthma, history of tuberculosis, and smoking. Results The risk of COPD was positively associated with aging, low education, low household income, lower body mass index, and cigarette smoking. The risk of COPD decreased with increase in the dietary vitamin C (ORQ1 vs Q5=0.66, Ptrend=0.03) and vitamin E (ORQ1 vs Q5=0.56, Ptrend=0.05) intake, predominantly, in men (Ptrend=0.01 and 0.05 for vitamins C and E, respectively). In addition, the lung function was significantly improved with increase in vitamins C (FEV1, P=0.04; FVC, P=0.03) and E (FEV1, P=0.03; FVC, P=0.04) intake. No statistically significant interactions were observed between smoking and vitamin C or E intake in relation to COPD risk among men. Conclusion Our results suggest the independent beneficial effect of antioxidants, particularly vitamins C and E, on COPD risk and lung function in men. PMID:26504380

Lung function reductions associated with motor vehicle density in chronic obstructive pulmonary disease: a cross-sectional study.

PubMed

Nitschke, Monika; Appleton, Sarah L; Li, Qiaoyu; Tucker, Graeme R; Shah, Pushan; Bi, Peng; Pisaniello, Dino L; Adams, Robert J

2016-10-24

Motor vehicle-related air pollution can potentially impair lung function. The effect of pollution in people with compromised pulmonary function such as in COPD has not been previously investigated. To examine the association of lung function with motor vehicle density in people with spirometrically determined COPD in a cross-sectional study. In 2004-06, The North West Adelaide Health Study (NWAHS), a biomedical cohort of adults assessed pre and post-bronchodilator spirometry (n = 3,103). Traffic density, obtained from the motor vehicle inventory maintained by the South Australian Environment Protection Authority, was expressed as the daily numbers of vehicles travelling within a 200 m diameter zone around participants' geocoded residences. In subjects with COPD (FEV 1 /FVC <0.7, n = 221, 7.1 %), increasing daily vehicle density was associated with statistically significant decreases in lung function parameters after adjustment for smoking and socio-economic variables. Mean (95 % CI) post-bronchodilator % predicted FEV 1 was 81 % (76-87) in the low (≤7179/day) compared with 71 % (67-75) in the high (≥15,270/day) vehicle exposure group (p < 0.05). Linear regression analysis in all subjects with COPD showed significant decrements in post-bronchodilator FEV 1 /FVC ratio and % predicted FEV 1 of 0.03 and 0.05 % respectively per daily increase in 1000 vehicles. In men with COPD (n = 150), the corresponding reductions were 0.03 and 0.06 %. Smaller, non-significant decrements were seen in females. No difference was seen in those without COPD. Vehicle traffic density was associated with significant reductions in lung function in people with COPD. Urban planning should consider the health impacts for those with pre-existing respiratory conditions.

Automated Quantitative Computed Tomography Versus Visual Computed Tomography Scoring in Idiopathic Pulmonary Fibrosis: Validation Against Pulmonary Function.

PubMed

Jacob, Joseph; Bartholmai, Brian J; Rajagopalan, Srinivasan; Kokosi, Maria; Nair, Arjun; Karwoski, Ronald; Raghunath, Sushravya M; Walsh, Simon L F; Wells, Athol U; Hansell, David M

2016-09-01

The aim of the study was to determine whether a novel computed tomography (CT) postprocessing software technique (CALIPER) is superior to visual CT scoring as judged by functional correlations in idiopathic pulmonary fibrosis (IPF). A total of 283 consecutive patients with IPF had CT parenchymal patterns evaluated quantitatively with CALIPER and by visual scoring. These 2 techniques were evaluated against: forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLco), carbon monoxide transfer coefficient (Kco), and a composite physiological index (CPI), with regard to extent of interstitial lung disease (ILD), extent of emphysema, and pulmonary vascular abnormalities. CALIPER-derived estimates of ILD extent demonstrated stronger univariate correlations than visual scores for most pulmonary function tests (PFTs): (FEV1: CALIPER R=0.29, visual R=0.18; FVC: CALIPER R=0.41, visual R=0.27; DLco: CALIPER R=0.31, visual R=0.35; CPI: CALIPER R=0.48, visual R=0.44). Correlations between CT measures of emphysema extent and PFTs were weak and did not differ significantly between CALIPER and visual scoring. Intriguingly, the pulmonary vessel volume provided similar correlations to total ILD extent scored by CALIPER for FVC, DLco, and CPI (FVC: R=0.45; DLco: R=0.34; CPI: R=0.53). CALIPER was superior to visual scoring as validated by functional correlations with PFTs. The pulmonary vessel volume, a novel CALIPER CT parameter with no visual scoring equivalent, has the potential to be a CT feature in the assessment of patients with IPF and requires further exploration.

Plasma Inflammatory Cytokine IL-4, IL-8, IL-10, and TNF-α Levels Correlate with Pulmonary Function in Patients with Asthma-Chronic Obstructive Pulmonary Disease (COPD) Overlap Syndrome.

PubMed

Huang, Ai-Xia; Lu, Li-Wen; Liu, Wen-Juan; Huang, Mao

2016-08-09

BACKGROUND The aim of this study was to investigate the plasma inflammatory cytokine levels and their correlations with pulmonary function in patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). MATERIAL AND METHODS Between January 2013 and December 2014, a total of 96 patients with asthma, acute exacerbation of chronic obstructive pulmonary disease (AECOPD), or ACOS were enrolled, and 35 healthy people were included as a control group. Fasting plasma interleukin (IL)-4, IL-8, IL-10, and tumor necrosis factor alpha (TNF-α) levels were detected using enzyme-linked immunosorbent assay (ELISA). Correlations between the plasma inflammatory cytokine levels and forced expiratory volume in 1 second (FEV1), FEV1/predicted value ratio (FEV1%pred), and FEV1/forced vital capacity (FVC) were analyzed. RESULTS IL-4 and IL-8 levels showed statistically significant differences among the 3 groups of patients (both P<0.001); IL-4 level was significantly lower, while IL-8 level was significantly higher in the AECOPD group and ACOS group than those in the asthma group (all P<0.05). IL-10 level and TNF-α level were significantly different among the 3 patient groups (both P<0.001). IL-10 level was significantly different between each of the 2 groups (all P<0.001). TNF-α level in the asthma group was higher than in the AECOPD group and ACOS group (both P<0.001). IL-4 and IL-10 were positively and IL-8 and TNF-α were negatively related with FEV1, FEV1%pred, and FEV1/FVC. CONCLUSIONS Plasma levels of inflammatory cytokines IL-4, IL-8, IL-10, and TNF-α are related with severity of airway diseases and could be potential markers for the evaluation of asthma, COPD, and ACOS.

Lung function parameters of healthy Sri Lankan Tamil young adults.

PubMed

Balasubramaniam, M; Sivapalan, K; Thuvarathipan, R

2014-06-01

To establish reference norms of lung function parameters for healthy Sri Lankan Tamil young adults. Cross sectional study of Tamil students at the Faculty of Medicine, Jaffna. Healthy non smoking students of Sri Lankan Tamil ethnic group were enrolled. Age, height, weight, BMI and spirometric measurements (Micro Quark) were recorded in 267 participants (137 females and 130 males). Height was significantly correlated with (p<0.05) all the lung function parameters except FEV1%, PEFR and MEF75 in males. Prediction equations were derived by regression analysis based on the height as an independent variable. Predicted lung function values for a particular age and height were lower than values predicted for Pakistanis, Kelatanese Malaysians and eastern Indians. The values were comparable to south Indians in Madras. Our FVC values of males and VC of females were closer to Sri Lankan Sinhalese. FEV1 and FEF25-75 in males were slightly higher and FVC, FEV1 and FEF25-75 in females were slightly lower in Tamils. When mean values were compared, these parameters were significantly higher in Tamil males (p<0.001) and significantly lower in Tamil females (p<0.001). These values will be useful in interpreting lung function parameters of the particular age group as there are no published norms for Sri Lankan Tamils. However, our study sample was confined to medical students of 20-28 years which may explain the differences with Sinhalese.

Pulmonary function in perlite workers.

PubMed

Cooper, W C

1976-11-01

Pulmonary function was studied in 117 men employed in three plants engaged in the mining and processing of perlite. Of these, 38 had been employed for ten years or more; 18 for 15 years or more and four men for 20 years or more. Review of chest films confirmed previous studies which showed no changes indicative of pneumoconiosis. Measurement of forced vital capacity (FVC) by Jones Pulmonor and by Collins 9-liter spirometer did not show reductions correlated with length of exposure, after effects of cigarette smoking had been taken into account. There was instead a slight increase in FVC associated with years in the perlite industry. The distribution of individuals with FVC below 80% of predicted also showed no association with duration of perlite exposure. Although there were slight reductions in forced expiratory volume in one second (FEV1) and in FEV1/FVC% which were associated with years in the perlite industry and which could not be explained by cigarette smoking, these reductions were not statistically significant. In summary, the population of men available for study in the major perlite-producing area of the United States, who have worked for periods up to 23 years, showed no evidence of pneumoconiosis by chest radiography or by measurement of forced vital capacity. Nevertheless, continued control of dust to ensure exposures below nuisance dust levels is essential. Medical surveillance should also continue with records being retained for periodic reevaluation.

Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction.

PubMed

Svanes, Øistein; Bertelsen, Randi J; Lygre, Stein H L; Carsin, Anne E; Antó, Josep M; Forsberg, Bertil; García-García, José M; Gullón, José A; Heinrich, Joachim; Holm, Mathias; Kogevinas, Manolis; Urrutia, Isabel; Leynaert, Bénédicte; Moratalla, Jesús M; Le Moual, Nicole; Lytras, Theodore; Norbäck, Dan; Nowak, Dennis; Olivieri, Mario; Pin, Isabelle; Probst-Hensch, Nicole; Schlünssen, Vivi; Sigsgaard, Torben; Skorge, Trude D; Villani, Simona; Jarvis, Debbie; Zock, Jan P; Svanes, Cecilie

2018-05-01

Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. Long-term consequences of cleaning agents on respiratory health are, however, not well described. This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction. The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders. As compared with women not engaged in cleaning (ΔFEV 1  = -18.5 ml/yr), FEV 1 declined more rapidly in women responsible for cleaning at home (-22.1; P = 0.01) and occupational cleaners (-22.4; P = 0.03). The same was found for decline in FVC (ΔFVC = -8.8 ml/yr; -13.1, P = 0.02; and -15.9, P = 0.002; respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV 1 decline (-22.0, P = 0.04; and -22.9, P = 0.004; respectively). Cleaning was not significantly associated with lung function decline in men or with FEV 1 /FVC decline or airway obstruction. Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.

Variable versus conventional lung protective mechanical ventilation during open abdominal surgery (PROVAR): a randomised controlled trial.

PubMed

Spieth, P M; Güldner, A; Uhlig, C; Bluth, T; Kiss, T; Conrad, C; Bischlager, K; Braune, A; Huhle, R; Insorsi, A; Tarantino, F; Ball, L; Schultz, M J; Abolmaali, N; Koch, T; Pelosi, P; Gama de Abreu, M

2018-03-01

Experimental studies showed that controlled variable ventilation (CVV) yielded better pulmonary function compared to non-variable ventilation (CNV) in injured lungs. We hypothesized that CVV improves intraoperative and postoperative respiratory function in patients undergoing open abdominal surgery. Fifty patients planned for open abdominal surgery lasting >3 h were randomly assigned to receive either CVV or CNV. Mean tidal volumes and PEEP were set at 8 ml kg -1 (predicted body weight) and 5 cm H 2 O, respectively. In CVV, tidal volumes varied randomly, following a normal distribution, on a breath-by-breath basis. The primary endpoint was the forced vital capacity (FVC) on postoperative Day 1. Secondary endpoints were oxygenation, non-aerated lung volume, distribution of ventilation, and pulmonary and extrapulmonary complications until postoperative Day 5. FVC did not differ significantly between CVV and CNV on postoperative Day 1, 61.5 (standard deviation 22.1) % vs 61.9 (23.6) %, respectively; mean [95% confidence interval (CI)] difference, -0.4 (-13.2-14.0), P=0.95. Intraoperatively, CVV did not result in improved respiratory function, haemodynamics, or redistribution of ventilation compared to CNV. Postoperatively, FVC, forced expiratory volume at the first second (FEV 1 ), and FEV 1 /FVC deteriorated, while atelectasis volume and plasma levels of interleukin-6 and interleukin-8 increased, but values did not differ between groups. The incidence of postoperative pulmonary and extrapulmonary complications was comparable in CVV and CNV. In patients undergoing open abdominal surgery, CVV did not improve intraoperative and postoperative respiratory function compared with CNV. NCT 01683578. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

[The dose response decrease of lung function associated with the urinary polycyclic aromatic hydrocarbons metabolites in coke oven workers].

PubMed

Hu, Die; Deng, Qi-fei; Huang, Su-li; He, Yun-feng; Guo, Huan; Wu, Tang-chun

2012-12-01

To analyze the relationship between metabolites of polycyclic aromatic hydrocarbons (PAHs) and lung function in coke oven workers, and to provide scientific basis for further exploring the potential mechanism and developing the preventing strategies of the workers' early lung damage. We measured carbon monoxide, sulfur dioxide, benzene soluble matter, particulate matters, and PAHs at different workplaces of a coke oven plant. Detailed information on demography and occupational health condition of 912 workers were collected. We divided these workers into control group and coke oven group according to their workplaces and the different concentrations of COEs in the environment. We detected 10 urinary PAH metabolites and lung function using gas chromatography-mass spectrometry and spirometric tests, respectively. FEV(1.0) (91.12 ± 13.31) and FEV(1.0)/FVC (108.61 ± 20.37) of the coke oven group is significantly lower than the control group (94.16 ± 15.57, 113.45 ± 19.70). In the coke oven group, the hydroxyphenanthrene and 1-hydroxypyrene are negatively correlated with FEV(1.0)/FVC (β = -0.136, β = -0.100), Ptrend < 0.05 for all. The dose response decrease of lung function is associated with the urinary PAH metabolites in coke oven workers. Indicated that the long exposure to PAHs may cause the early lung damage in coke oven workers, phenanthrene and pyrene may be the main factors.

Joint Effects of Smoking and Sedentary Lifestyle on Lung Function in African Americans: The Jackson Heart Study Cohort

PubMed Central

Campbell Jenkins, Brenda W.; Sarpong, Daniel F.; Addison, Clifton; White, Monique S.; Hickson, DeMarc A.; White, Wendy; Burchfiel, Cecil

2014-01-01

This study examined: (a) differences in lung function between current and non current smokers who had sedentary lifestyles and non sedentary lifestyles and (b) the mediating effect of sedentary lifestyle on the association between smoking and lung function in African Americans. Sedentary lifestyle was defined as the lowest quartile of the total physical activity score. The results of linear and logistic regression analyses revealed that non smokers with non sedentary lifestyles had the highest level of lung function, and smokers with sedentary lifestyles had the lowest level. The female non-smokers with sedentary lifestyles had a significantly higher FEV1% predicted and FVC% predicted than smokers with non sedentary lifestyles (93.3% vs. 88.6%; p = 0.0102 and 92.1% vs. 86.9%; p = 0.0055 respectively). FEV1/FVC ratio for men was higher in non smokers with sedentary lifestyles than in smokers with non sedentary lifestyles (80.9 vs. 78.1; p = 0.0048). Though smoking is inversely associated with lung function, it seems to have a more deleterious effect than sedentary lifestyle on lung function. Physically active smokers had higher lung function than their non physically active counterparts. PMID:24477212

Joint effects of smoking and sedentary lifestyle on lung function in African Americans: the Jackson Heart Study cohort.

PubMed

Campbell Jenkins, Brenda W; Sarpong, Daniel F; Addison, Clifton; White, Monique S; Hickson, Demarc A; White, Wendy; Burchfiel, Cecil

2014-01-28

This study examined: (a) differences in lung function between current and non current smokers who had sedentary lifestyles and non sedentary lifestyles and (b) the mediating effect of sedentary lifestyle on the association between smoking and lung function in African Americans. Sedentary lifestyle was defined as the lowest quartile of the total physical activity score. The results of linear and logistic regression analyses revealed that non smokers with non sedentary lifestyles had the highest level of lung function, and smokers with sedentary lifestyles had the lowest level. The female non-smokers with sedentary lifestyles had a significantly higher FEV1% predicted and FVC% predicted than smokers with non sedentary lifestyles (93.3% vs. 88.6%; p = 0.0102 and 92.1% vs. 86.9%; p = 0.0055 respectively). FEV1/FVC ratio for men was higher in non smokers with sedentary lifestyles than in smokers with non sedentary lifestyles (80.9 vs. 78.1; p = 0.0048). Though smoking is inversely associated with lung function, it seems to have a more deleterious effect than sedentary lifestyle on lung function. Physically active smokers had higher lung function than their non physically active counterparts.

[The specificity between "fei and dachang" in the lung injury of rats with ulcerative colitis].

PubMed

Zhu, Li; Wang, Xin-yue; Yang, Xue; Jing, Shan; Zhou, Bo; Huang, Xiu-xia; Jia, Xu

2013-03-01

To observe the features of bronchopulmonary lesions in ulcerative colitis (UC) rats and the specificity with Fei and Dachang, thus providing reliance for the theory of "intestinal diseases involved Fei". The UC rat model was duplicated by using rabbit intestine mucosa tissue allergenic model and TNBS-ethanol model. A normal rat group was set up as the control. The pulmonary functions [including inspiratory resistance (Ri), expiratory resistance (Re), forced vital capacity (FVC); FEV. 2/FVC, maximal voluntary ventilation (MVV), forced expiratory flow rate (FEF25% - 75%)], and indicators of liver and kidney functions [serum alanine aminotransferase (ALT), aspartate amino transferase (AST), blood urea nitrogen (BUN), and creatinine (Cr)] were detected in the two groups. The pathological changes of colon, lung, liver, and kidney were observed in the two groups. Rats in the model group in both acute and chronic stages had weight loss, mucus and loose stool. Partial rats had such symptoms as dyspnea, shortness of breath, and wheezing. Compared with the normal group, the MW, FVC, FEV0.2 and FEF25% -75% in the acute stage; Ri, Re, MVV, FVC, and FEF25% - 75% in the chronic stage all significantly decreased (P <0.05, P <0.01), and FEV0.2/FVC significantly increased in the model group (P <0.05). The pathological results showed interstitial pneumonia and pulmonary interstitial fibrosis in the model group. But the indicators of liver and kidney functions were all in the normal range. No obvious pathological change was seen in the renal and liver tissues in the two groups. UC could specifically induce bronchopulmonary lesions. Lung injury was one of UC's intestinal manifestations. The theory of "Fei and Dachang being interior-exteriorly correlated" was demonstrated from the theory of "intestinal diseases involved Fei".

Arsenic Exposure and Impaired Lung Function. Findings from a Large Population-based Prospective Cohort Study

PubMed Central

Parvez, Faruque; Chen, Yu; Yunus, Mahbub; Olopade, Christopher; Segers, Stephanie; Slavkovich, Vesna; Argos, Maria; Hasan, Rabiul; Ahmed, Alauddin; Islam, Tariqul; Akter, Mahmud M.; Graziano, Joseph H.

2013-01-01

Rationale: Exposure to arsenic through drinking water has been linked to respiratory symptoms, obstructive lung diseases, and mortality from respiratory diseases. Limited evidence for the deleterious effects on lung function exists among individuals exposed to a high dose of arsenic. Objectives: To determine the deleterious effects on lung function that exist among individuals exposed to a high dose of arsenic. Methods: In 950 individuals who presented with any respiratory symptom among a population-based cohort of 20,033 adults, we evaluated the association between arsenic exposure, measured by well water and urinary arsenic concentrations measured at baseline, and post-bronchodilator–administered pulmonary function assessed during follow-up. Measurements and Main Results: For every one SD increase in baseline water arsenic exposure, we observed a lower level of FEV1 (−46.5 ml; P < 0.0005) and FVC (−53.1 ml; P < 0.01) in regression models adjusted for age, sex, body mass index, smoking, socioeconomic status, betel nut use, and arsenical skin lesions status. Similar inverse relationships were observed between baseline urinary arsenic and FEV1 (−48.3 ml; P < 0.005) and FVC (−55.2 ml; P < 0.01) in adjusted models. Our analyses also demonstrated a dose-related decrease in lung function with increasing levels of baseline water and urinary arsenic. This association remained significant in never-smokers and individuals without skin lesions, and was stronger in male smokers. Among male smokers and individuals with skin lesions, every one SD increase in water arsenic was related to a significant reduction of FEV1 (−74.4 ml, P < 0.01; and −116.1 ml, P < 0.05) and FVC (−72.8 ml, P = 0.02; and −146.9 ml, P = 0.004), respectively. Conclusions: This large population-based study confirms that arsenic exposure is associated with impaired lung function and the deleterious effect is evident at low- to moderate-dose range. PMID:23848239

Rolling Tobacco in Banana Leaves, Newspaper, or Copybook Paper Associated With Significant Reduction in Lung Function in Vanuatu.

PubMed

Weitz, Charles A; Olszowy, Kathryn M; Dancause, Kelsey N; Sun, Cheng; Pomer, Alysa; Silverman, Howard; Lee, G; Tarivonda, Len; Chan, Chim W; Kaneko, Akira; Lum, J K; Garruto, Ralph M

2017-04-01

In addition to the widespread availability of packaged cigarettes, the inhabitants of island nations of the Southwest Pacific frequently smoke commercially available loose tobacco using manufactured rolling papers, as well as locally grown tobacco rolled in manufactured rolling paper or wrapped in leaves, copybook paper, and newspaper. In this study, Vanuatu men who smoked local tobacco rolled in leaves, copybook paper, or newspaper showed significantly lower forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), and FEV 1 /FVC ratios than men who smoked packaged cigarettes, store-bought tobacco rolled in manufactured rolling paper, or who smoked locally grown tobacco rolled in manufactured rolling papers. The addition of toxins from these unusual tobacco-wrapping media produces lung function deficits similar to the pattern noted among tobacco smokers who also inhale smoke from burning biomass. Thus, public health initiatives should consider including strategies addressing the use of wrapping media among smokers in South Pacific island societies.

Commuting mode and pulmonary function in Shanghai, China

PubMed Central

Gaffney, Adam W.; Hang, Jing-qing; Lee, Mi-Sun; Su, Li; Zhang, Fengying; Christiani, David C.

2016-01-01

Introduction Exposure to air pollution can be particularly high during commuting, and may depend on the mode of transportation. We investigated the impact of commuting mode on pulmonary function in Shanghai, China. Material and methods The Shanghai Putuo Study is a cross-sectional population-based study. Our primary outcomes were FEV1 and FVC percent predicted, and the secondary outcome was spirometric airflow obstruction. We tested the association between mode of transportation and these outcomes after adjusting for confounders. Results The study population consisted of 20,102 subjects. After adjusting for confounders, the FEV1 percent predicted was 2.15 lower (95% CI −2.88, −1.42) among walkers, 1.32 lower (95% CI −2.05, −0.59) among those taking buses without air-conditioning, 1.33 lower (95% CI −2.05, −0.61) among those taking buses with air-conditioning, and 2.83 lower (95% CI −5.56, −0.10) among subway-riders, as compared to cyclists (the reference group). The effects of mode on FVC percent predicted were in the same direction. Private car use had a significant protective effect on FVC percent predicted and the risk of airflow obstruction (defined by GOLD but not by LLN criteria). Conclusions Mode of transportation is associated with differences in lung function, which may reflect pollution levels in different transportation microenvironments. PMID:26541519

The Influence of Short-Term Scoliosis-Specific Exercise Rehabilitation on Pulmonary Function in Patients with AIS.

PubMed

Moramarco, Marc; Fadzan, Maja; Moramarco, Kathryn; Heller, Amy; Righter, Sonia

2016-01-01

To investigate the short-term outcomes of treatment utilizing an outpatient scoliosis- specific back school program in thirty-six patients with adolescent idiopathic scoliosis (AIS). Improved signs and symptoms of AIS have been reported in response to curve-patternspecific exercise therapy programs. Additional outcome studies are needed. Thirty-six patients with adolescent idiopathic scoliosis (AIS), 33 females and 3 males, completed a twenty-hour multimodal exercise program (Schroth Best Practice® - SBP) for five to seven days at Scoliosis 3DC(SM). Average age was 13.89 years and average Cobb angles were 36.92° thoracic and 33.92° lumbar. The sample was comprised of patients under treatment from August 2011 to February 2015 who never had scoliosis-related surgery and who were not undergoing brace treatment. SBP program components included physio-logic® exercises, mobilizations, activities of daily living (ADLs), 3-D Made Easy®, and Schroth exercises. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), chest expansion (CE), and angle of trunk rotation (ATR) were clinical parameters used to evaluate results of this outpatient scoliosis-specific exercise program. Highly significant improvements were noted in FVC, FEV1, CE and Scoliometer(TM) readings. A short-term outpatient SBP program was found to have a positive influence on FVC, FEV1, ATR, and CE. We will present long-term results in a subsequent study.

[Design of Portable Spirometer Based on Internet of Things of Medicine].

PubMed

He, Yichen; Yang, Bo; Xiong, Shiqi; Li, Qing

2018-02-08

A kind of portable device for detecting common lung function parameters is mentioned in this paper. Using the singlechip microcomputer as the master control block to collect and process the data from high-accuracy gas pressure sensor, through the way of parametric calibration and linear interpolation to test and calculate the Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF), Forced Expiratory Volume in one second (FEV1), and FEV1/FVC. Meanwhile, the detected parameters can be uploaded to the intelligent mobile terminal through the wireless transmission module. The device is able to show expiratory volume-time curve and the final parameters clearly, the error of measurement is less than 5%. In addition, that device is small and convenient, not only is good for clinical application, but also can be used for family in a house.

Maximal Oxygen Consumption, Respiratory Volume and Some Related Factors in Fire-fighting Personnel.

PubMed

Khazraee, Touraj; Fararouei, Mohammad; Daneshmandi, Hadi; Mobasheri, Farzane; Zamanian, Zahra

2017-01-01

Firefighters for difficult activities and rescue of damaged people must be in appropriate physical ability. Maximal oxygen capacity is an indicator for diagnosis of physical ability of workers. This study aimed to assess the cardiorespiratory system and its related factors in firefighters. This study was conducted on 110 firefighters from various stations. An self-administered questionnaire (respiratory disorders questionnaire, Tuxworth-Shahnavaz step test, and pulmonary function test) was used to collection of required data. Average of humidity and temperature was 52% and 17°C, respectively. Background average noise levels were between 55 and 65 dB. Data were analyzed using SPSS software (version 19). The mean age of the study participants was 32 ± 6.2 years. The means of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC were 92% ±9.4%, 87% ±9.2%, and 80% ±6.1%, respectively. The participants' mean VO 2 -max was 2.79 ± 0.29 L/min or 37.34 ± 4.27 ml/kg body weight per minute. The results revealed that weight has a direct association with vital capacity (VC), FVC, and peak expiratory flow. In addition, height was directly associated with VC, FVC, and VO 2 -max ( P < 0.05). However, there was an inverse and significant association between height and FEV1/FVC ( r = -0.23, P < 0.05). Height, weight, body mass index, and waist circumference were directly associated with VO 2 -max. The findings of this study showed that the amount of maximum oxygen consumption is close with the proposed range of this parameter among firefighters in other studies. Furthermore, the results of the study revealed that individuals had normal amounts of lung volume index. This issue can be attributed to the appropriate usage of respiratory masks.

Physical activity is not associated with spirometric indices in lung-healthy German youth.

PubMed

Smith, Maia P; von Berg, Andrea; Berdel, Dietrich; Bauer, Carl-Peter; Hoffmann, Barbara; Koletzko, Sibylle; Nowak, Dennis; Heinrich, Joachim; Schulz, Holger

2016-08-01

In lung disease, physical activity improves lung function and reduces morbidity. However, healthy populations are not well studied. We estimate the relationship between spirometric indices and accelerometric physical activity in lung-healthy adolescents.895 nonsmoking German adolescents without chronic lung disease (45% male, mean±sd age 15.2±0.26 years) from the GINIplus and LISAplus cohorts completed questionnaires, spirometry, 7-day accelerometry and an activity diary. Physical activity was measured as minutes, quintiles and regularity of daily moderate, vigorous and moderate-to-vigorous physical activity (MVPA), participation in sport and active commuting to school. Primary outcomes were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC and forced expiratory flow at 25-75% of FVC; they were separately correlated with physical activity and adjusted for confounders of respiratory function, including early-life exposures.Adolescents averaged 40 min MVPA per day, typical for European youth. 79% participated in sports and 51% commuted actively. An association was suggested between 3% higher FVC (∼100 mL) and either extreme MVPA quintile or percentage of days with >30 min MVPA (p<0.05). However, after Bonferroni correction all associations between spirometry, active lifestyle and physical activity were nonsignificant.Spirometric indices were not significantly associated with active lifestyle or measures of activity in lung-healthy adolescents after adjustment for confounding and multiple-comparison artefacts. Copyright ©ERS 2016.

Effects of combinations of diesel exhaust and ozone exposure on lung function in human volunteers.

EPA Science Inventory

Ozone (03) exposure induces changes in human lung function, typically seen as a decrease in forced expiratory volume in one sec (FEV1) and forced vital capacity (FVC). Because people are usually exposed to other ambient air pollutants simultaneously with 03, there may be interact...

The effect of respiratory exercise on trunk control, pulmonary function, and trunk muscle activity in chronic stroke patients.

PubMed

Lee, Dong-Kyu; Kim, Se-Hun

2018-05-01

[Purpose] This study aims to identify the effect of respiratory exercise on trunk control, pulmonary function, and trunk muscle activity in chronic stroke patients. [Subjects and Methods] The study included 24 chronic stroke patients who were randomly assigned, 12 each, to the experimental and control groups, and received neurodevelopmental treatment. Moreover, the experimental group underwent respiratory exercise. In each patient, the trunk control was measured using the Trunk Impairment Scale (TIS); muscle activity of the trunk, through the surface electromyogram; and pulmonary function, using the pneumatometer. [Results] The intragroup comparison showed significant differences in TIS, Forced vital capacity (FVC), Forced expiratory volume at one second (FEV1), Rectus Abdominis (RA), Internal Oblique (IO) and External Oblique (EO) in the experimental group. The intergroup comparison showed that the differences in TIS, FVC, FEV1, RA, IO and EO within the experimental group appeared significant relative to the control group. [Conclusion] Based on these results, this study proved that respiratory exercise was effective in improving trunk control, pulmonary function, and trunk muscle activity in patients with chronic stroke.

Maximal degree of airway narrowing induced by methacholine and adenosine monophosphate: relationship with the decrease in forced vital capacity.

PubMed

Prieto, Luis; Lopez, Victoria; Perez-Frances, Carmen; Marin, Julio

2010-12-01

Changes in forced vital capacity (FVC) may represent an indirect method for the detection of plateau in response to inhaled bronchoconstrictor agents. To determine the relationship between the level of plateau obtained with either methacholine or adenosine monophosphate (AMP) and the decrease in FVC induced by each bronchoconstrictor agent. Airway responsiveness to high concentrations of methacholine and AMP was determined in patients with intermittent asthma (n = 41) or allergic rhinitis (n = 26). Furthermore, allergen-induced changes in the response to each bronchoconstrictor agent were investigated in 18 pollen-sensitive patients. Concentration-response curves were characterized by the slope of the FVC values recorded at each step of the challenge against the corresponding forced expiratory volume in 1 second (FEV1) values and, if possible, by the level of plateau. The slope FVC vs FEV1 was similar in patients with plateau and in those without plateau. In patients with pollen allergy, the mean (95% confidence interval) for the level of plateau detected with methacholine increased from 16.8% (11.8%-22.0%) before the pollen season to 21.7% (14.8%-28.6%, P = .008) during the pollen season, whereas pollen-induced changes in the slope FVC vs FEV1 were not significant. Similar results were obtained with AMP. In patients with allergic rhinitis or intermittent asthma, methacholine or AMP-induced changes in FVC are not significantly related to the presence or level of plateau. Furthermore, these 2 constituents of the concentration-response curve can be modified independently by a proinflammatory stimulus. These results suggest that the bronchoconstrictor-induced change in FVC cannot be used as a surrogate estimation of the level of plateau. Copyright © 2010 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Relationship between the baseline alveolar volume-to-total lung capacity ratio and airway responsiveness.

PubMed

Kaminsky, David A; Daud, Anees; Chapman, David G

2014-10-01

Ventilation heterogeneity (VH) has been linked to airway responsiveness (AR) based on various measures of VH involving inert gas washout, forced oscillation and lung imaging. We explore whether VH at baseline, as measured by the simple ratio of single breath alveolar volume to plethysmographically determined total lung capacity (VA/TLC), would correlate with AR as measured by methacholine challenge testing. We analysed data from spirometry, lung volumes, diffusing capacity and methacholine challenge to derive the VA/TLC and the dose-response slope (DRS) of forced expiratory volume in 1 s (DRS-FEV1) during methacholine challenge from 136 patients. We separated out airway closure versus narrowing by examining the DRS for forced vital capacity (DRS-FVC) and the DRS for FEV1/FVC (DRS-FEV1/FVC), respectively. Similarly, we calculated the DRS for sGaw (DRS-sGaw) as another measure of airway narrowing. We performed statistical analysis using Spearman rank correlation and multifactor linear regression using a backward stepwise modelling procedure. We found that the DRS-FEV1 correlated with baseline VA/TLC (rho = -0.26, P < 0.01), and VA/TLC and FEV1 were independently associated with DRS-FEV1 (R(2)  = 0.14, P = 0.01). In addition, VA/TLC was associated with both airway narrowing and closure in response to methacholine. These results confirm that baseline VA/TLC is associated with AR, and reflects both airway closure and airway narrowing following methacholine challenge. © 2014 Asian Pacific Society of Respirology.

Impact of direct substitution of arm span length for current standing height in elderly COPD.

PubMed

Pothirat, Chaicharn; Chaiwong, Warawut; Phetsuk, Nittaya

2015-01-01

Arm span length is related to standing height and has been studied as a substitute for current standing height for predicting lung function parameters. However, it has never been studied in elderly COPD patients. To evaluate the accuracy of substituting arm span length for current standing height in the evaluation of pulmonary function parameters and severity classification in elderly Thai COPD patients. Current standing height and arm span length were measured in COPD patients aged >60 years. Postbronchodilator spirometric parameters, forced vital capacity (FVC), forced expiratory volume in first second (FEV1), and ratio of FEV1/FVC (FEV1%), were used to classify disease severity according to global initiative for chronic obstructive lung disease criteria. Predicted values for each parameter were also calculated separately utilizing current standing height or arm span length measurements. Student's t-tests and chi-squared tests were used to compare differences between the groups. Statistical significance was set at P<0.05. A total of 106 COPD patients with a mean age of 72.1±7.8 years, mean body mass index of 20.6±3.8 kg/m(2), and mean standing height of 156.4±8.3 cm were enrolled. The mean arm span length exceeded mean standing height by 7.7±4.6 cm (164.0±9.0 vs 156.4±8.3 cm, P<0.001), at a ratio of 1.05±0.03. Percentages of both predicted FVC and FEV1 values based on arm span length were significantly lower than those using current standing height (76.6±25.4 vs 61.6±16.8, P<0.001 and 50.8±25.4 vs 41.1±15.3, P<0.001). Disease severity increased in 39.6% (42/106) of subjects using arm span length over current standing height for predicted lung function. Direct substitution of arm span length for current standing height in elderly Thai COPD patients should not be recommended in cases where arm span length exceeds standing height by more than 4 cm.

Adiposity, fractional exhaled nitric oxide, and asthma in U.S. children.

PubMed

Han, Yueh-Ying; Forno, Erick; Celedón, Juan C

2014-07-01

Whether allergic airway inflammation mediates the association between overweight or obesity and childhood asthma is unknown. To examine adiposity, asthma, and fractional exhaled nitric oxide (FeNO) in U.S. children. Cross-sectional study of indicators of adiposity or obesity, FeNO (a biomarker of eosinophilic airway inflammation), and asthma in 2,681 children aged 6-17 years in the 2007-2010 National Health and Nutrition Examination Survey. Adiposity measures included body mass index (BMI), percent body fat (PBF), and waist circumference (WC). BMI, PBF, and WC were associated with asthma among children with low FeNO (odds ratio, 1.54-1.68; P < 0.01), but not among children with increased FeNO. Among children without asthma, BMI, PBF, and WC were associated with higher FEV1 and FVC, and lower FEV1/FVC. Among children with asthma and a high FeNO, all adiposity indicators were associated with decreased FEV1/FVC (β = -1.5% to -1.7% per z score) but not with FEV1 or FVC. Higher BMI or PBF was associated with worse asthma severity or control in children with asthma and increased FeNO, but not in children with asthma and low FeNO. Similar results were obtained in a secondary multivariate analysis of overweight or obesity (defined as BMI ≥85th percentile) and asthma or indicators of asthma severity or control, stratified by FeNO level. Adiposity indicators are associated with asthma in children with low FeNO. Among children with asthma, adiposity indicators are associated with worse asthma severity or control in those with high FeNO.

Menopause Is Associated with Accelerated Lung Function Decline.

PubMed

Triebner, Kai; Matulonga, Bobette; Johannessen, Ane; Suske, Sandra; Benediktsdóttir, Bryndís; Demoly, Pascal; Dharmage, Shyamali C; Franklin, Karl A; Garcia-Aymerich, Judith; Gullón Blanco, José Antonio; Heinrich, Joachim; Holm, Mathias; Jarvis, Debbie; Jõgi, Rain; Lindberg, Eva; Moratalla Rovira, Jesús Martínez; Muniozguren Agirre, Nerea; Pin, Isabelle; Probst-Hensch, Nicole; Puggini, Luca; Raherison, Chantal; Sánchez-Ramos, José Luis; Schlünssen, Vivi; Sunyer, Jordi; Svanes, Cecilie; Hustad, Steinar; Leynaert, Bénédicte; Gómez Real, Francisco

2017-04-15

Menopause is associated with changes in sex hormones, which affect immunity, inflammation, and osteoporosis and may impair lung function. Lung function decline has not previously been investigated in relation to menopause. To study whether lung function decline, assessed by FVC and FEV 1 , is accelerated in women who undergo menopause. The population-based longitudinal European Community Respiratory Health Survey provided serum samples, spirometry, and questionnaire data about respiratory and reproductive health from three study waves (n = 1,438). We measured follicle-stimulating hormone and luteinizing hormone and added information on menstrual patterns to determine menopausal status using latent class analysis. Associations with lung function decline were investigated using linear mixed effects models, adjusting for age, height, weight, pack-years, current smoking, age at completed full-time education, spirometer, and including study center as random effect. Menopausal status was associated with accelerated lung function decline. The adjusted mean FVC decline was increased by -10.2 ml/yr (95% confidence interval [CI], -13.1 to -7.2) in transitional women and -12.5 ml/yr (95% CI, -16.2 to -8.9) in post-menopausal women, compared with women menstruating regularly. The adjusted mean FEV 1 decline increased by -3.8 ml/yr (95% CI, -6.3 to -2.9) in transitional women and -5.2 ml/yr (95% CI, -8.3 to -2.0) in post-menopausal women. Lung function declined more rapidly among transitional and post-menopausal women, in particular for FVC, beyond the expected age change. Clinicians should be aware that respiratory health often deteriorates during reproductive aging.

Acute effects of air pollution changes in schoolchildren: the Gardanne coal basin study

NASA Astrophysics Data System (ADS)

Charpin, D.; Kleisbauer, J. P.; Fondarai, A.; Francheterre, A.; Fondarai, J.; Graland, B.; Viala, A.

1988-12-01

In the literature, studies devoted to shortterm effects of air pollution episodes in children have provided controversial results. To evaluate if acute air pollution changes in the Gardanne coal basin (France) could have deleterious effects on children's pulmonary function, we studied 160 children on two different days. Each in-school examination consisted of a short questionnaire and a spirometric assessment. The area included districts of high and low pollution levels. In the former, the two examinations took place at different air pollution levels whereas, in the latter, the air pollution levels were comparable. We obtained higher spirometric values during the second examination, regardless of air pollution changes and suggesting a learning effect, which vanished when we used FEV1/FVC ratio. The difference in FEV1/FVC between days of low and high pollution was significant but merely equal to 2%. There was no change of clinical symptom score.

Respiratory muscle adaptations: a comparison between bodybuilders and endurance athletes.

PubMed

Hackett, D A; Johnson, N; Chow, C

2013-04-01

The purpose of this study was to compare the respiratory muscle and lung function measures of bodybuilders (BB) and endurance athletes (EA). Forty-two male subjects (22 BB and 20 EA) aged 20-35 years underwent respiratory muscle strength measurements (MIP and MEP), lung function testing (FEV1, FVC, FEV1/FVC%, IC, ERV, FRC, RV, and TLC), hydrostatic weighing and VO2max testing. One-repetition maximum (1RM) for bench press, squat and deadlift was performed by BB. BB had significantly greater MIP and MEP compared to EA by 43% and 53% respectively (P<0.01). Moderate correlation was found for MEP and 1RM bench press (P<0.01), and weak correlations found for the squat and deadlift (P<0.01). Fat-free mass was significantly greater for BB compared with EA (P<0.01), while VO2max was significantly greater for EA compared with BB (P<0.01). No differences in lung function indices were observed between groups. When compared to EA, BB exhibited significantly greater respiratory muscle strength. The maximal load lifted for bench press predicted expiratory muscle strength gain. Lung function measures did not differ between the groups.

The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study.

PubMed

Townend, John; Minelli, Cosetta; Mortimer, Kevin; Obaseki, Daniel O; Al Ghobain, Mohammed; Cherkaski, Hamid; Denguezli, Myriam; Gunesekera, Kirthi; Hafizi, Hasan; Koul, Parvaiz A; Loh, Li C; Nejjari, Chakib; Patel, Jaymini; Sooronbayev, Talant; Buist, Sonia A; Burney, Peter G J

2017-06-01

Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0-10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV 1 /FVC

Annual decline in forced expiratory volume is steeper in aluminum potroom workers than in workers without exposure to potroom fumes

PubMed Central

Henneberger, Paul K.; Einvik, Gunnar; Virji, Mohammed Abbas; Bakke, Berit; Kongerud, Johny

2016-01-01

Background Aluminum potroom exposure is associated with increased mortality of COPD but the association between potroom exposure and annual decline in lung function is unknown. We have measured lung volumes annually using spirometry from 1986 to 1996. The objective was to compare annual decline in forced expiratory volume in 1 s (dFEV1) and forced vital capacity (dFVC). Methods The number of aluminum potroom workers was 4,546 (81% males) and the number of workers in the reference group was 651 (76% males). The number of spirometries in the index group and the references were 24,060 and 2,243, respectively. Results After adjustment for confounders, the difference in dFEV1 and dFVC between the index and reference groups were 13.5 (P < 0.001) and −8.0 (P = 0.060) ml/year. Conclusion Aluminum potroom operators have increased annual decline in FEV1 relative to a comparable group with non‐exposure to potroom fumes and gases. Am. J. Ind. Med. 59:322–329, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26853811

Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function.

PubMed

Woodruff, Prescott G; Barr, R Graham; Bleecker, Eugene; Christenson, Stephanie A; Couper, David; Curtis, Jeffrey L; Gouskova, Natalia A; Hansel, Nadia N; Hoffman, Eric A; Kanner, Richard E; Kleerup, Eric; Lazarus, Stephen C; Martinez, Fernando J; Paine, Robert; Rennard, Stephen; Tashkin, Donald P; Han, MeiLan K

2016-05-12

Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) requires a ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) of less than 0.70 as assessed by spirometry after bronchodilator use. However, many smokers who do not meet this definition have respiratory symptoms. We conducted an observational study involving 2736 current or former smokers and controls who had never smoked and measured their respiratory symptoms using the COPD Assessment Test (CAT; scores range from 0 to 40, with higher scores indicating greater severity of symptoms). We examined whether current or former smokers who had preserved pulmonary function as assessed by spirometry (FEV1:FVC ≥0.70 and an FVC above the lower limit of the normal range after bronchodilator use) and had symptoms (CAT score, ≥10) had a higher risk of respiratory exacerbations than current or former smokers with preserved pulmonary function who were asymptomatic (CAT score, <10) and whether those with symptoms had different findings from the asymptomatic group with respect to the 6-minute walk distance, lung function, or high-resolution computed tomographic (HRCT) scan of the chest. Respiratory symptoms were present in 50% of current or former smokers with preserved pulmonary function. The mean (±SD) rate of respiratory exacerbations among symptomatic current or former smokers was significantly higher than the rates among asymptomatic current or former smokers and among controls who never smoked (0.27±0.67 vs. 0.08±0.31 and 0.03±0.21 events, respectively, per year; P<0.001 for both comparisons). Symptomatic current or former smokers, regardless of history of asthma, also had greater limitation of activity, slightly lower FEV1, FVC, and inspiratory capacity, and greater airway-wall thickening without emphysema according to HRCT than did asymptomatic current or former smokers. Among symptomatic current or former smokers, 42% used bronchodilators and 23% used inhaled glucocorticoids. Although they do not meet the current criteria for COPD, symptomatic current or former smokers with preserved pulmonary function have exacerbations, activity limitation, and evidence of airway disease. They currently use a range of respiratory medications without any evidence base. (Funded by the National Heart, Lung, and Blood Institute and the Foundation for the National Institutes of Health; SPIROMICS ClinicalTrials.gov number, NCT01969344.).

Subclinical respiratory dysfunction in chronic cervical cord compression: a pulmonary function test correlation.

PubMed

Bhagavatula, Indira Devi; Bhat, Dhananjaya I; Sasidharan, Gopalakrishnan M; Mishra, Rakesh Kumar; Maste, Praful Suresh; Vilanilam, George C; Sathyaprabha, Talakkad N

2016-06-01

OBJECTIVE Respiratory abnormalities are well documented in acute spinal cord injury; however, the literature available for respiratory dysfunction in chronic compressive myelopathy (CCM) is limited. Respiratory dysfunction in CCM is often subtle and subclinical. The authors studied the pattern of respiratory dysfunction in patients with chronic cord compression by using spirometry, and the clinical and surgical implications of this dysfunction. In this study they also attempted to address the postoperative respiratory function in these patients. METHODS A prospective study was done in 30 patients in whom cervical CCM due to either cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL) was diagnosed. Thirty age-matched healthy volunteers were recruited as controls. None of the patients included in the study had any symptoms or signs of respiratory dysfunction. After clinical and radiological diagnosis, all patients underwent pulmonary function tests (PFTs) performed using a standardized Spirometry Kit Micro before and after surgery. The data were analyzed using Statistical Software SPSS version 13.0. Comparison between the 2 groups was done using the Student t-test. The Pearson correlation coefficient was used for PFT results and Nurick classification scores. A p value < 0.05 was considered significant. RESULTS Cervical spondylotic myelopathy (prolapsed intervertebral disc) was the predominant cause of compression (n = 21, 70%) followed by OPLL (n = 9, 30%). The average patient age was 45.06 years. Degenerative cervical spine disease has a relatively younger onset in the Indian population. The majority of the patients (n = 28, 93.3%) had compression at or above the C-5 level. Ten patients (33.3%) underwent an anterior approach and discectomy, 11 patients (36.7%) underwent decompressive laminectomy, and the remaining 9 underwent either corpectomy with fusion or laminoplasty. The mean preoperative forced vital capacity (FVC) (65%) of the patients was significantly lower than that of the controls (88%) (p < 0.001). The mean postoperative FVC (73.7%) in the patients showed significant improvement compared with the preoperative values (p = 0.003). The mean postoperative FVC was still significantly lower than the control value (p = 0.002). The mean preoperative forced expiratory volume in 1 second (FEV1) (72%) of the patients was significantly lower than that of the controls (96%) (p < 0.001). The mean postoperative FEV1 (75.3%) in the cases showed no significant improvement compared with the preoperative values (p = 0.212). The mean postoperative FEV1 was still significantly lower than the control value (p < 0.001). The mean postoperative FEV1/FVC was not significantly different from the control value (p = 0.204). The mean postoperative peak expiratory flow rate was significantly lower than the control value (p = 0.01). The mean postoperative maximal voluntary ventilation was still significantly lower than the control value (p < 0.001). On correlating the FVC and Nurick scores using the Pearson correlation coefficient, a negative correlation was found. CONCLUSIONS There is subclinical respiratory dysfunction and significant impairment of various lung capacities in patients with CCM. The FVC showed significant improvement postoperatively. Respiratory function needs to be evaluated and monitored to avoid potential respiratory complications.

Long term effects of prenatal and postnatal airborne PAH exposures on ventilatory lung function of non-asthmatic preadolescent children. Prospective birth cohort study in Krakow.

PubMed

Jedrychowski, Wieslaw A; Perera, Frederica P; Maugeri, Umberto; Majewska, Renata; Mroz, Elzbieta; Flak, Elzbieta; Camann, David; Sowa, Agata; Jacek, Ryszard

2015-01-01

The main goal of the study was to test the hypothesis that prenatal and postnatal exposures to polycyclic aromatic hydrocarbons (PAH) are associated with depressed lung function in non-asthmatic children. The study sample comprises 195 non-asthmatic children of non-smoking mothers, among whom the prenatal PAH exposure was assessed by personal air monitoring in pregnancy. At the age of 3, residential air monitoring was carried out to evaluate the residential PAH exposure indoors and outdoors. At the age of 5 to 8, children were given allergic skin tests for indoor allergens; and between 5 and 9 years lung function testing (FVC, FEV05, FEV1 and FEF25-75) was performed. The effects of prenatal PAH exposure on lung function tests repeated over the follow-up were adjusted in the General Estimated Equation (GEE) model for the relevant covariates. No association between FVC with prenatal PAH exposure was found; however for the FEV1 deficit associated with higher prenatal PAH exposure (above 37 ng/m(3)) amounted to 53 mL (p=0.050) and the deficit of FEF25-75 reached 164 mL (p=0.013). The corresponding deficits related to postnatal residential indoor PAH level (above 42 ng/m(3)) were 59 mL of FEV1 (p=0.028) and 140 mL of FEF25-75 (p=0.031). At the higher residential outdoor PAH level (above 90 ng/m(3)) slightly greater deficit of FEV1 (71 mL, p=0.009) was observed. The results of the study suggest that transplacental exposure to PAH compromises the normal developmental process of respiratory airways and that this effect is compounded by postnatal PAH exposure. Copyright © 2014 Elsevier B.V. All rights reserved.

Respiratory-function changes in textile workers exposed to synthetic fibers.

PubMed

Valic, F; Zuskin, E

1977-01-01

The prevalence of respiratory symptoms and acute and chronic changes in ventilatory function were studied in three groups of textile workers: 68 workers with exposure to synthetic fibers only, 30 with previous exposure to cotton, and 77 with previous exposure to hemp. The prevalence of dyspnea, grade 3 to 4, was significantly lower (P less than .01) in workers with a history of exposure to synthetic fibers only than in those previously exposed to hemp or cotton. No case of byssinosis was found in any of the workers studied. Values in ventilatory-function tests (FEV 1.0, FVC and MEF 50%) were significantly reduced during the work shift on Monday and Thursday. The Monday MEF 50% preshift values were significantly lower than expected in all three groups of workers. A comparison of the 1963-1973 data on the 77 workers previously exposed to hemp showed a lower prevalence of most chronic respiratory symptoms and smaller acute FEV1.0 and FVC reductions when they worked with synthetic fibers (1973) than when they were exposed to hemp (1963).

Respiratory morbidity of pattern and model makers exposed to wood, plastic, and metal products

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robins, T.G.; Haboubi, G.; Demers, R.Y.

Pattern and model makers are skilled tradespersons who may be exposed to hardwoods, softwoods, phenol-formaldehyde resin-impregnated woods, epoxy and polyester/styrene resin systems, and welding and metal-casting fumes. The relationship of respiratory symptoms (wheezing, chronic bronchitis, dyspnea) and pulmonary function (FVC% predicted, FEV1% predicted, FEV1/FVC% predicted) with interview-derived cumulative exposure estimates to specific workplace agents and to all work with wood, plastic, or metal products was investigated in 751 pattern and model makers in southeast Michigan. In stratified analyses and age- and smoking-adjusted linear and logistic regression models, measures of cumulative wood exposures were associated with decrements in pulmonary function andmore » dyspnea, but not with other symptoms. In similar analyses, measures of cumulative plastic exposures were associated with wheezing, chronic bronchitis, and dyspnea, but not with decrements in pulmonary function. Prior studies of exposure levels among pattern and model makers and of respiratory health effects of specific agents among other occupational groups support the plausibility of wood-related effects more strongly than that of plastic-related effects.« less

Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction.

PubMed

Bao, Hongda; Yan, Peng; Bao, Mike; Qiu, Yong; Zhu, Zezhang; Liu, Zhen; Cheng, Jack C Y; Ng, Bobby K W; Zhu, Feng

2016-08-01

To investigate the change of pulmonary function in adult scoliosis patients with respiratory dysfunction undergoing HGT combined with assisted ventilation. 21 adult patients were retrospectively reviewed with a mean age of 26.2 years. Inclusion criteria were as follows: age over 18 years old; coronal Cobb angle greater than 100°; with respiratory failure; and duration of HGT more than 1 month. All patients underwent respiratory training. The Cobb angle averaged 131.21° and was reduced to 107.68° after HGT. Significantly increased mean forced vital capacity (FVC) was found after HGT (P = 0.003) with significantly improved percent-predicted values for FVC (P < 0.001). Meanwhile, significantly increased forced expiratory volume in 1 s (FEV1) was also observed (P < 0.001) with significantly improved percent-predicted values for FEV1 (P = 0.003) after HGT. The results of our study revealed that combined HGT and assisted ventilation would be beneficial to pulmonary function improvement in severe adult scoliosis cases, most of which were young adults.

Lung function in type 2 diabetes: the Normative Aging Study.

PubMed

Litonjua, Augusto A; Lazarus, Ross; Sparrow, David; Demolles, Debbie; Weiss, Scott T

2005-12-01

Cross-sectional studies have noted that subjects with diabetes have lower lung function than non-diabetic subjects. We conducted this analysis to determine whether diabetic subjects have different rates of lung function change compared with non-diabetic subjects. We conducted a nested case-control analysis in 352 men who developed diabetes and 352 non-diabetic subjects in a longitudinal observational study of aging in men. We assessed lung function among cases and controls at three time points: Time0, prior to meeting the definition of diabetes; Time1, the point when the definition of diabetes was met; and Time2, the most recent follow-up exam. Cases had lower forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) at all time points, even with adjustment for age, height, weight, and smoking. In multiple linear regression models adjusting for relevant covariates, there were no differences in rates of FEV1 or FVC change over time between cases and controls. Men who are predisposed to develop diabetes have decreased lung function many years prior to the diagnosis, compared with men who do not develop diabetes. This decrement in lung function remains after the development of diabetes. We postulate that mechanisms involved in the insulin resistant state contribute to the diminished lung function observed in our subjects.

The effect of duration of exposure on sulfuric acid-induced pulmonary function changes in asthmatic adolescent subjects: A dose-response study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koenig, J.Q.; Covert, D.S.; Larson, T.V.

To evaluate the pulmonary effects of varying doses of sulfuric acid, adolescent subjects with asthma were exposed to 35 or 70 micrograms/m3 sulfuric acid for 45 or 90 min. Exposure was carried out during intermittent moderate exercise. The pulmonary functions measured before and after exposure were FEV1, FVC, and total respiratory resistance. The 45 min exposures were associated with larger decreases in FEV1 (-6% or -3%) than the 90 min exposures (-1% or +2%). Analysis of variance of the change in FEV1 among the exposures revealed that the 45 min exposure to 35 micrograms/m3 was significant (p = 0.03). Themore » p value for 45 min exposure to 70 micrograms/m3 was not significant (p = 0.08). Using analysis of variance, neither of the 90 min exposures was associated with a significant decrease in FEV1 compared to air exposure. Also, none of the changes in FVC or RT was significant. When baseline to post-exposure changes were compared for each of the five test atmospheres using paired t tests, both of the 45 min exposures were associated with statistical significance (p < 0.001 for 35 micrograms/m3 and p < 0.005 for 70 micrograms/m3). This baseline to post exposure change was not statistically significant for the 90 min exposures. The reason for the lesser effect on pulmonary function at increased exposure duration is not known; it may be due to changes in either varying deposition patterns or changes in buffering capacity of the cells lining the airways. With respect to individual sensitivities to H2SO4, the data showed a significant consistency across test atmospheres.« less

Longitudinal lung function decline and wood dust exposure in the furniture industry.

PubMed

Jacobsen, G; Schlünssen, V; Schaumburg, I; Taudorf, E; Sigsgaard, T

2008-02-01

The aim of the present study was to investigate the relationship between change in lung function and cumulative exposure to wood dust. In total, 1,112 woodworkers (927 males, 185 females) and 235 reference workers (104 males, 185 females) participated in a 6-yr longitudinal study. Forced expiratory volume in one second (FEV(1)), forced vital capacity (FVC), height and weight were measured, and questionnaire data on respiratory symptoms, wood dust exposure and smoking habits were collected. Cumulative inhalable wood dust exposure was assessed using a study-specific job exposure matrix and exposure time. The median (range) for cumulative wood dust exposure was 3.75 (0-7.55) mg x year x m(-3). A dose-response relationship between cumulative wood dust exposure and percent annual decrease in FEV(1) was suggested for female workers. This was confirmed in a linear regression model adjusted for confounders, including smoking, height and age. An additional difference of -14.50 mL x yr(-1) and -27.97 mL x yr(-1) was revealed for females exposed to 3.75-4.71 mg x yr x m(-3) or to >4.71 mg x yr x m(-3), respectively, compared with non-/low-exposed females. For females, a positive trend between wood dust exposure and the cumulative incidence proportion of FEV(1)/FVC <70% was suggested. In conclusion, in the present low-exposed cohort, female woodworkers had an accelerated decline in lung function, which may be clinically relevant.

Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial.

PubMed

Kumar, Amaravadi Sampath; Alaparthi, Gopala Krishna; Augustine, Alfred Joseph; Pazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan

2016-01-01

Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni's 't'-test. Exercise tolerance was analysed by Paired 'T'-test. Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1(st), 2(nd) and 3(rd) postoperative day when compared with preoperative day. On 4(th) and 5(th) postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group. Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance.

Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial

PubMed Central

Kumar, Amaravadi Sampath; Augustine, Alfred Joseph; Pazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan

2016-01-01

Introduction Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group. Conclusion Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance. PMID:26894090

Urban city transportation mode and respiratory health effect of air pollution: a cross-sectional study among transit and non-transit workers in Nigeria.

PubMed

Ekpenyong, Chris E; Ettebong, E O; Akpan, E E; Samson, T K; Daniel, Nyebuk E

2012-01-01

To assess the respiratory health effect of city ambient air pollutants on transit and non-transit workers and compare such effects by transportation mode, occupational exposure and sociodemographic characteristics of participants. Cross-sectional, randomised survey. A two primary healthcare centre survey in 2009/2010 in Uyo metropolis, South-South Nigeria. Of the 245 male participants recruited, 168 (50 taxi drivers, 60 motorcyclists and 58 civil servants) met the inclusion criteria. These include age 18-35 years, a male transit worker or civil servant who had worked within Uyo metropolis for at least a year prior to the study, and had no history of respiratory disorders/impairment or any other debilitating illness. The adjusted ORs for respiratory function impairment (force vital capacity (FVC) and/or FEV(1)<80% predicted or FEV(1)/FVC<70% predicted) using Global Initiative for Chronic Obstructive Lung Diseases (GOLD) and National Institute for Health and Clinical Excellence (NICE) criteria were calculated. In order to investigate specific occupation-dependent respiratory function impairment, a comparison was made between the ORs for respiratory impairment in the three occupations. Adjustments were made for some demographic variables such as age, BMI, area of residence, etc. Exposure to ambient air pollution by occupation and transportation mode was independently associated with respiratory functions impairment and incident respiratory symptoms among participants. Motorcyclists had the highest effect, with adjusted OR 3.10, 95% CI 0.402 to 16.207 for FVC<80% predicted and OR 1.71, 95% CI 0.61 to 4.76 for FEV(1)/FVC<70% predicted using GOLD and NICE criteria. In addition, uneducated, currently smoking transit workers who had worked for more than 1 year, with three trips per day and more than 1 h transit time per trip were significantly associated with higher odds for respiratory function impairment at p<0.001, respectively. Findings of this study lend weights to the existing literature on the adverse respiratory health effect of ambient air pollution on city transit workers globally. The role of other confounders acting synergistically to cause a more deleterious effect is obvious. In all, the effect depends on the mode and duration of exposure.

Adiposity, Fractional Exhaled Nitric Oxide, and Asthma in U.S. Children

PubMed Central

Han, Yueh-Ying; Forno, Erick

2014-01-01

Rationale: Whether allergic airway inflammation mediates the association between overweight or obesity and childhood asthma is unknown. Objectives: To examine adiposity, asthma, and fractional exhaled nitric oxide (FeNO) in U.S. children. Methods: Cross-sectional study of indicators of adiposity or obesity, FeNO (a biomarker of eosinophilic airway inflammation), and asthma in 2,681 children aged 6–17 years in the 2007–2010 National Health and Nutrition Examination Survey. Adiposity measures included body mass index (BMI), percent body fat (PBF), and waist circumference (WC). Measurements and Main Results: BMI, PBF, and WC were associated with asthma among children with low FeNO (odds ratio, 1.54–1.68; P < 0.01), but not among children with increased FeNO. Among children without asthma, BMI, PBF, and WC were associated with higher FEV1 and FVC, and lower FEV1/FVC. Among children with asthma and a high FeNO, all adiposity indicators were associated with decreased FEV1/FVC (β = −1.5% to −1.7% per z score) but not with FEV1 or FVC. Higher BMI or PBF was associated with worse asthma severity or control in children with asthma and increased FeNO, but not in children with asthma and low FeNO. Similar results were obtained in a secondary multivariate analysis of overweight or obesity (defined as BMI ≥85th percentile) and asthma or indicators of asthma severity or control, stratified by FeNO level. Conclusions: Adiposity indicators are associated with asthma in children with low FeNO. Among children with asthma, adiposity indicators are associated with worse asthma severity or control in those with high FeNO. PMID:24922361

Differences in spirometry interpretation algorithms: influence on decision making among primary-care physicians.

PubMed

He, Xiao-Ou; D'Urzo, Anthony; Jugovic, Pieter; Jhirad, Reuven; Sehgal, Prateek; Lilly, Evan

2015-03-12

Spirometry is recommended for the diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in international guidelines and may be useful for distinguishing asthma from COPD. Numerous spirometry interpretation algorithms (SIAs) are described in the literature, but no studies highlight how different SIAs may influence the interpretation of the same spirometric data. We examined how two different SIAs may influence decision making among primary-care physicians. Data for this initiative were gathered from 113 primary-care physicians attending accredited workshops in Canada between 2011 and 2013. Physicians were asked to interpret nine spirograms presented twice in random sequence using two different SIAs and touch pad technology for anonymous data recording. We observed differences in the interpretation of spirograms using two different SIAs. When the pre-bronchodilator FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio was >0.70, algorithm 1 led to a 'normal' interpretation (78% of physicians), whereas algorithm 2 prompted a bronchodilator challenge revealing changes in FEV1 that were consistent with asthma, an interpretation selected by 94% of physicians. When the FEV1/FVC ratio was <0.70 after bronchodilator challenge but FEV1 increased >12% and 200 ml, 76% suspected asthma and 10% suspected COPD using algorithm 1, whereas 74% suspected asthma versus COPD using algorithm 2 across five separate cases. The absence of a post-bronchodilator FEV1/FVC decision node in algorithm 1 did not permit consideration of possible COPD. This study suggests that differences in SIAs may influence decision making and lead clinicians to interpret the same spirometry data differently.

Pulmonary function studies in young healthy Malaysians of Kelantan, Malaysia.

PubMed

Bandyopadhyay, Amit

2011-11-01

Pulmonary function tests have been evolved as clinical tools in diagnosis, management and follow up of respiratory diseases as it provides objective information about the status of an individual's respiratory system. The present study was aimed to evaluate pulmonary function among the male and female young Kelantanese Malaysians of Kota Bharu, Malaysia, and to compare the data with other populations. A total of 128 (64 males, 64 females) non-smoking healthy young subjects were randomly sampled for the study from the Kelantanese students' population of the University Sains Malaysia, Kota Bharu Campus, Kelantan, Malaysia. The study population (20-25 yr age group) had similar socio-economic background. Each subject filled up the ATS (1978) questionnaire to record their personal demographic data, health status and consent to participate in the study. Subjects with any history of pulmonary diseases were excluded from the study. The pulmonary function measurements exhibited significantly higher values among males than the females. FEV 1% did not show any significant inter-group variation probably because the parameter expresses FEV 1 as a percentage of FVC. FVC and FEV 1 exhibited significant correlations with body height and body mass among males whereas in the females exhibited significant correlation with body mass, body weight and also with age. FEV 1% exhibited significant correlation with body height and body mass among males and with body height in females. FEF 25-75% did not show any significant correlation except with body height among females. However, PEFR exhibited significant positive correlation with all the physical parameters except with age among the females. On the basis of the existence of significant correlation between different physical parameters and pulmonary function variables, simple and multiple regression norms have been computed. From the present investigation it can be concluded that Kelantanese Malaysian youths have normal range of pulmonary function in both the sexes and the computed regression norms may be used to predict the pulmonary function values in the studied population.

Pulmonary function studies in young healthy Malaysians of Kelantan, Malaysia

PubMed Central

Bandyopadhyay, Amit

2011-01-01

Background & objectives: Pulmonary function tests have been evolved as clinical tools in diagnosis, management and follow up of respiratory diseases as it provides objective information about the status of an individual's respiratory system. The present study was aimed to evaluate pulmonary function among the male and female young Kelantanese Malaysians of Kota Bharu, Malaysia, and to compare the data with other populations. Methods: A total of 128 (64 males, 64 females) non-smoking healthy young subjects were randomly sampled for the study from the Kelantanese students’ population of the University Sains Malaysia, Kota Bharu Campus, Kelantan, Malaysia. The study population (20-25 yr age group) had similar socio-economic background. Each subject filled up the ATS (1978) questionnaire to record their personal demographic data, health status and consent to participate in the study. Subjects with any history of pulmonary diseases were excluded from the study. Results: The pulmonary function measurements exhibited significantly higher values among males than the females. FEV1% did not show any significant inter-group variation probably because the parameter expresses FEV1 as a percentage of FVC. FVC and FEV1 exhibited significant correlations with body height and body mass among males whereas in the females exhibited significant correlation with body mass, body weight and also with age. FEV1% exhibited significant correlation with body height and body mass among males and with body height in females. FEF25-75% did not show any significant correlation except with body height among females. However, PEFR exhibited significant positive correlation with all the physical parameters except with age among the females. On the basis of the existence of significant correlation between different physical parameters and pulmonary function variables, simple and multiple regression norms have been computed. Interpretation & conclusions: From the present investigation it can be concluded that Kelantanese Malaysian youths have normal range of pulmonary function in both the sexes and the computed regression norms may be used to predict the pulmonary function values in the studied population. PMID:22199104

Pulmonary functions of narghile smokers compared to cigarette smokers: a case-control study.

PubMed

Ben Saad, Helmi; Khemiss, Mehdi; Nhari, Saida; Ben Essghaier, Mejda; Rouatbi, Sonia

2013-01-01

Studies of the lung function profiles of exclusive narghile smokers (ENS) are few, have some methodological limits, and present contradictory conclusions. The present study aimed to compare the plethysmographic profiles of ENS with age- and height-matched exclusive cigarette smokers (ECS). Males aged 35-60 living in Sousse, Tunisia, who have been smoking narghile exclusively for more than 10 narghile-years (n = 36) or cigarettes exclusively for more than 10 pack-years (n = 106) were recruited to participate in this case-control study. The anthropometric and plethysmographic data were measured according to international recommendations using a body plethysmograph (ZAN 500 Body II, Meβgreräte GmbH, Germany). Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as: first second forced expiratory volume/forced vital capacity (FEV1/FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total lung capacity < LLN. Lung hyperinflation was defined as residual volume > upper-limit-of-normal. Student t-test and χ(2) test were used to compare plethysmographic data and profiles of the two groups. The subjects in the ENS and ECS groups are well matched in age (45±7 vs. 47±5 years) and height (1.73±0.06 vs. 1.72±0.06 m) and used similar quantities of tobacco (36±22 narghile-years vs. 35±19 pack-years). Compared to the ENS group, the ECS group had significantly lower FEV1 (84±12 vs. 60±21%), FVC (90±12 vs. 76±18%), and FEV1/FVC (99±7 vs. 83±17%). The two groups had similar percentages of RVD (31 vs. 36%), while the ECS group had a significantly higher percentage of LAOVD (8 vs. 58%) and lung hyperinflation (36 vs.57%). Chronic exclusive narghile smoking has less adverse effects on pulmonary function tests than chronic exclusive cigarette smoking.

Pulmonary functions of narghile smokers compared to cigarette smokers: a case-control study.

PubMed

Saad, Helmi Ben; Khemiss, Mehdi; Nhari, Saida; Essghaier, Mejda Ben; Rouatbi, Sonia

2013-01-01

Background Studies of the lung function profiles of exclusive narghile smokers (ENS) are few, have some methodological limits, and present contradictory conclusions. The present study aimed to compare the plethysmographic profiles of ENS with age- and height-matched exclusive cigarette smokers (ECS). Methods Males aged 35-60 living in Sousse, Tunisia, who have been smoking narghile exclusively for more than 10 narghile-years (n = 36) or cigarettes exclusively for more than 10 pack-years (n = 106) were recruited to participate in this case-control study. The anthropometric and plethysmographic data were measured according to international recommendations using a body plethysmograph (ZAN 500 Body II, Meβgreräte GmbH, Germany). Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as: first second forced expiratory volume/forced vital capacity (FEV 1 /FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total lung capacity < LLN. Lung hyperinflation was defined as residual volume > upper-limit-of-normal. Student t-test and χ 2 test were used to compare plethysmographic data and profiles of the two groups. Results The subjects in the ENS and ECS groups are well matched in age (45±7 vs. 47±5 years) and height (1.73±0.06 vs. 1.72±0.06 m) and used similar quantities of tobacco (36±22 narghile-years vs. 35±19 pack-years). Compared to the ENS group, the ECS group had significantly lower FEV 1 (84±12 vs. 60±21%), FVC (90±12 vs. 76±18%), and FEV 1 /FVC (99±7 vs. 83±17%). The two groups had similar percentages of RVD (31 vs. 36%), while the ECS group had a significantly higher percentage of LAOVD (8 vs. 58%) and lung hyperinflation (36 vs.57%). Conclusion Chronic exclusive narghile smoking has less adverse effects on pulmonary function tests than chronic exclusive cigarette smoking.

Pulmonary Impairment in Tuberculosis Survivors: The Korean National Health and Nutrition Examination Survey 2008-2012.

PubMed

Jung, Jae-Woo; Choi, Jae-Chol; Shin, Jong-Wook; Kim, Jae-Yeol; Choi, Byoung-Whui; Park, In-Won

2015-01-01

Pulmonary tuberculosis (TB) can affect lung function, but studies regarding long-term follow-up in patients with no sequelae on chest X-ray (CXR) have not been performed. We evaluated lung functional impairment and persistent respiratory symptoms in those with prior pulmonary TB and those with prior pulmonary TB with no residual sequelae on CXR, and determined risk factors for airflow obstruction. We used data from adults aged ≥ 40 years from the annual Korean National Health and Nutrition Examination Surveys conducted between 2008 and 2012. P values for comparisons were adjusted for age, sex, and smoking status. In total of 14,967 adults, 822 subjects (5.5%) had diagnosed and treated pulmonary TB (mean 29.0 years ago). The FVC% (84.9 vs. 92.6), FEV1% (83.4 vs. 92.4), and FEV1/FVC% (73.4 vs. 77.9) were significantly decreased in subjects with prior pulmonary TB compared to those without (p < 0.001, each). In 12,885 subjects with no sequalae on CXR, those with prior pulmonary TB (296, 2.3%) had significantly lower FEV1% (90.9 vs. 93.4, p = 0.001) and FEV1/FVC% (76.6 vs. 78.4, p < 0.001) than those without. Subjects with prior pulmonary TB as well as subjects with no sequalae on CXR were more likely to experience cough and physical activity limitations due to pulmonary symptoms than those without prior pulmonary TB (p < 0.001, each). In total subjects, prior pulmonary TB (OR, 2.314; 95% CI, 1.922-2.785), along with age, male, asthma, and smoking mount was risk factor for airflow obstruction. In subjects with prior pulmonary tuberculosis, inactive TB lesion on chest x-ray (OR, 2.300; 95% CI, 1.606-3.294) were risk factors of airflow obstruction. In addition to subjects with inactive TB lesion on CXR, subjects with no sequelae on CXR can show impaired pulmonary function and respiratory symptoms. Prior TB is a risk factor for airflow obstruction and that the risk is more important when they have inactive lesions on chest X-ray. Hence, the patients with treated TB should need to have regular follow-up of lung function and stop smoking for early detection and prevention of the chronic airway disease.

Pulmonary dysfunctions, oxidative stress and DNA damage in brick kiln workers.

PubMed

Kaushik, R; Khaliq, F; Subramaneyaan, M; Ahmed, R S

2012-11-01

Brick kilns in the suburban areas in developing countries pose a big threat to the environment and hence the health of their workers and people residing around them. The present study was planned to assess the lung functions, oxidative stress parameters and DNA damage in brick kiln workers. A total of 31 male subjects working in brick kiln, and 32 age, sex and socioeconomic status matched controls were included in the study. The lung volumes, capacities and flow rates, namely, forced expiratory volume in first second (FEV(1)), forced vital capacity (FVC), FEV(1)/FVC, expiratory reserve volume, inspiratory capacity (IC), maximal expiratory flow when 50% of FVC is remaining to be expired, maximum voluntary ventilation, peak expiratory flow rate and vital capacity were significantly decreased in the brick kiln workers. Increased oxidative stress as evidenced by increased malonedialdehyde levels and reduced glutathione content, glutathione S-transferase activity and ferric reducing ability of plasma were observed in the study group when compared with controls. Our results indicate a significant correlation between oxidative stress parameters and pulmonary dysfunction, which may be due to silica-induced oxidative stress and resulting lung damage.

[Lung dysfunction in patients with mild chronic obstructive bronchitis].

PubMed

Nefedov, V B; Popova, L A; Shergina, E A

2004-01-01

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, TCL, TGV, RV, Ravt, Riin, Rex, DLCO-SS, PaO2, and PaO2 were determined in 33 patients with mild chronic obstructive lung disease (FEV1 > 70% of the normal value). All the patients were found to have impaired bronchial patency; most (63.6%) patients had lung volume and capacity changes, almost half (45.5%) the patients had pulmonary gas exchange dysfunction. Impaired bronchial patency mainly appeared as decreased MEF50, MEF15, and FEV1/VC%; altered lung volumes and capacities manifested chiefly by increased RV and decreased VC; pulmonary gas exchange dysfunction showed up primarily as lowered PaO2. The magnitude of the observed functional changes was generally slight. MEF50, MEF75, FEV1/VC%, and VC dropped to 59-20 and 79-70% of the normal value, respectively. RV increased up to 142-196% of the normal value; PaO2 reduced up to 79-60% mm Hg.

Reduced Lung Function and Cerebral Small Vessel Disease in Japanese Men: the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA).

PubMed

Seto-Yukimura, Ruriko; Ogawa, Emiko; Hisamatsu, Takashi; Torii, Sayuki; Shiino, Akihiko; Nozaki, Kazuhiko; Fujiyoshi, Akira; Miura, Katsuyuki; Nakano, Yasutaka; Ueshima, Hirotsugu

2018-02-16

We aimed to investigate the association between reduced lung function and cerebral small vessel diseases via cranial magnetic resonance imaging (MRI) in the cross-sectional study of the general Japanese population. We recruited participants aged ≥40 years from the general population of a single city in Japan. We clarified the comorbidities and treatments, smoking habits, second-hand smoke exposure, current alcohol consumption, education level, exercise habits, and occupation. The pulmonary function test was performed to assess the forced expiratory volume in 1 second (FEV 1 ) % predicted and forced vital capacity (FVC) % predicted values. Cranial MRI was performed to evaluate the white matter lesions (WMLs) and lacunar infarcts. We examined the association of the WMLs and lacunar infarcts with a 1-standard deviation (SD) lower in the FEV 1 % predicted and FVC % predicted, on the basis of the smoking status. A total of 473 men were examined. The association of WMLs and lacunar infarcts with the spirometry-based indices were significant only in never smokers. The association between lung function impairment and cerebral small vessel disease did not change after further adjusting for second-hand smoke exposure. In a community-based sample of Japanese men, we found an association between reduced lung function and WMLs and lacunar infarcts in never smokers.

Pulmonary function, bronchial reactivity, and epithelial permeability are response phenotypes to ozone and develop differentially in healthy humans

PubMed Central

Que, Loretta G.; Stiles, Jane V.; Sundy, John S.

2011-01-01

Effect of laboratory exposure to O3 (220 ppb) and filtered air (FA) on respiratory physiology were evaluated at two time points (acute and 1 day postexposure) in healthy cohort (n = 138, 18–35 yr, 40% women) comprised mainly of Caucasian (60%) and African American (33.3%) subjects. Randomized exposures had a crossover design and durations of 2.25 h that included rest and treadmill walking. Airway responsiveness (AHR) to methacholine (Mch) and permeability of respiratory epithelium (EI) to hydrophilic radiomarker (99mTc-DTPA, MW = 492), were measured at 1-day postexposure. O3 significantly affected FEV1 and FVC indices acutely with mean decrements from pre-exposure values on the order of 7.7 to 8.8% and 1.8 to 2.3% at 1-day post. Acute FEV1 and FVC decreases were most robust in African American male subjects. At 1-day post, O3 induced significant changes in AHR (slope of Mch dose response curve) and EI (Tc99m-DTPA clearance half-time). Based on conventional thresholds of response and dichotomous classification of subjects as responders and nonresponders, sensitivity to O3 was shown to be nonuniform. Acute decrements ≥15% in FEV1, a doubling of Mch slope, or ≥15% increase in EI developed in 20.3%, 23.1%, and 25.9%, respectively, of subjects evaluated. Results demonstrate a diffuse sensitivity to O3 and physiological responses, either acutely (decreases in FEV1) or 1 day post (development of AHR or change in EI) occur differentially in healthy young adults. Random overlap among subjects classified as responsive for respective FEV1, AHR, and EI endpoints suggests these are separate and independent phenotypes of O3 exposure. PMID:21700892

IL6R Variation Asp358Ala Is a Potential Modifier of Lung Function in Asthma

PubMed Central

Hawkins, Gregory A; Robinson, Mac B; Hastie, Annette T; Li, Xingnan; Li, Huashi; Moore, Wendy C; Howard, Timothy D; Busse, William W.; Erzurum, Serpil C.; Wenzel, Sally E.; Peters, Stephen P; Meyers, Deborah A; Bleecker, Eugene R

2012-01-01

Background The IL6R SNP rs4129267 has recently been identified as an asthma susceptibility locus in subjects of European ancestry but has not been characterized with respect to asthma severity. The SNP rs4129267 is in linkage disequilibrium (r2=1) with the IL6R coding SNP rs2228145 (Asp358Ala). This IL6R coding change increases IL6 receptor shedding and promotes IL6 transsignaling. Objectives To evaluate the IL6R SNP rs2228145 with respect to asthma severity phenotypes. Methods The IL6R SNP rs2228145 was evaluated in subjects of European ancestry with asthma from the Severe Asthma Research Program (SARP). Lung function associations were replicated in the Collaborative Study on the Genetics of Asthma (CSGA) cohort. Serum soluble IL6 receptor (sIL6R) levels were measured in subjects from SARP. Immunohistochemistry was used to qualitatively evaluate IL6R protein expression in BAL cells and endobronchial biopsies. Results The minor C allele of IL6R SNP rs2228145 was associated with lower ppFEV1 in the SARP cohort (p=0.005), the CSGA cohort (0.008), and in combined cohort analysis (p=0.003). Additional associations with ppFVC, FEV1/FVC, and PC20 were observed. The rs2228145 C allele (Ala358) was more frequent in severe asthma phenotypic clusters. Elevated serum sIL6R was associated with lower ppFEV1 (p=0.02) and lower ppFVC (p=0.008) (N=146). IL6R protein expression was observed in BAL macrophages, airway epithelium, vascular endothelium, and airway smooth muscle. Conclusions The IL6R coding SNP rs2228145 (Asp358Ala) is a potential modifier of lung function in asthma and may identify subjects at risk for more severe asthma. IL6 transsignaling may have a pathogenic role in the lung. PMID:22554704

Pulmonary function adaptation to ozone in subjects with chronic bronchitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kulle, T.J.; Milman, J.H.; Sauder, L.R.

Twenty smokers with chronic bronchitis were exposed to 0.41 ppm ozone for 3 hr-day for 5 consecutive days and reexposed 4 days later to determine (1) if they are sensitive to ozone, (2) if they adapt, and (3) if the adaptation lasts longer than 4 days. There were significant decrements in forced vital capacity (FVC) and forced expiratory volume in 3 sec (FEV/sub 3/) on the first day of the 5-day repeated exposures and also on reexposure 4 days following cessation of the sequential exposures. Symptoms experienced were mild and did not predominate on any exposure days. These results suggestmore » that individuals with chronic bronchitis adapt rapidly to ozone and lose this adaptive phenomenon within 4 days. The small decreases seen in FVC and FEV/sub 3/ ( less than or equal to 3%) appear to impose no more than minimal limitations on their daily activities.« less

Pulmonary function adaptation to ozone in subjects with chronic bronchitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kulle, T.J.; Milman, J.H.; Sauder, L.R.

Twenty smokers with chronic bronchitis were exposed to 0.41 ppm ozone for 3 hr-day for 5 consecutive days and reexposed 4 days later to determine (1) if they are sensitive to ozone, (2) if they adapt, and (3) if the adaptation lasts longer than 4 days. There were significant decrements in forced vital capacity (FVC) and forced expiratory volume in 3 sec (FEV3) on the first day of the 5-day repeated exposures and also on reexposure 4 days following cessation of the sequential exposures. Symptoms experienced were mild and did not predominate on any exposure days. These results suggest thatmore » individuals with chronic bronchitis adapt rapidly to ozone and lose the adaptive phenomenon within 4 days. The small decreases seen in FVC and FEV3 appear to impose no more than minimal limitations on their daily activities.« less

The association of genetic polymorphisms of hypoxia inducible factor-1 alpha and vascular endothelial growth factor with increased risk of chronic obstructive pulmonary disease: A case-control study.

PubMed

Yu, Zhen-Gang; Wang, Bing-Zhe; Cheng, Zhao-Zhong

2017-09-01

Accumulated data over the years have suggested that hypoxia inducible factor-1 alpha (HIF-1α) and its downstream vascular endothelial growth factor (VEGF) gene may be linked with chronic obstructive pulmonary disease (COPD). This study aims to investigate the association of HIF-1α and VEGF genetic polymorphisms and their correlated risks with COPD. COPD patients (case group) and healthy individuals (control group) were recruited. DNA was extracted to detect HIF-1α and VEGF genetic polymorphisms. Basal lung volume and forced expiratory capacity in 1st second (FEV1)/forced vital capacity (FVC) and FEV 1 /predicted value (pred)% were calculated. Genotype and allele distributions in HIF-1α and VEGF genes were analyzed. Kaplan-Meier curves and logistic regression model were used for analysis of survival and COPD risk factors. Haplotypes for HIF-1α rs11549465 and rs11549467 were analyzed. FEV 1 /FVC and FEV1/pred% in the case group were lower than the control group. Frequencies of HIF-1α rs11549465 CT + TT genotype and T allele, and rs11549467 GA + AA genotype and A allele were higher in the case group than the control group. Patients with rs11549465 CT + TT had higher COPD risk than those with the CC genotype. Patients with rs11549467 GA + AA showed higher COPD risk and lower FEV 1 /FVC and FEV 1 /pred% than those with the GG genotype. Patients with HIF-1α TA haplotype showed higher COPD risk than those with the CG haplotype. Survival rate of patients with HIF-1α rs11549467 GG genotype was higher than those with the GA + AA genotype. HIF-1α rs11549467 polymorphism may be associated with COPD risk. Copyright © 2017. Published by Elsevier Taiwan.

Size-based emphysema cluster analysis on low attenuation area in 3D volumetric CT: comparison with pulmonary functional test

NASA Astrophysics Data System (ADS)

Lee, Minho; Kim, Namkug; Lee, Sang Min; Seo, Joon Beom; Oh, Sang Young

2015-03-01

To quantify low attenuation area (LAA) of emphysematous regions according to cluster size in 3D volumetric CT data of chronic obstructive pulmonary disease (COPD) patients and to compare these indices with their pulmonary functional test (PFT). Sixty patients with COPD were scanned by a more than 16-multi detector row CT scanner (Siemens Sensation 16 and 64) within 0.75mm collimation. Based on these LAA masks, a length scale analysis to estimate each emphysema LAA's size was performed as follows. At first, Gaussian low pass filter from 30mm to 1mm kernel size with 1mm interval on the mask was performed from large to small size, iteratively. Centroid voxels resistant to the each filter were selected and dilated by the size of the kernel, which was regarded as the specific size emphysema mask. The slopes of area and number of size based LAA (slope of semi-log plot) were analyzed and compared with PFT. PFT parameters including DLco, FEV1, and FEV1/FVC were significantly (all p-value< 0.002) correlated with the slopes (r-values; -0.73, 0.54, 0.69, respectively) and EI (r-values; -0.84, -0.60, -0.68, respectively). In addition, the D independently contributed regression for FEV1 and FEV1/FVC (adjust R sq. of regression study: EI only, 0.70, 0.45; EI and D, 0.71, 0.51, respectively). By the size based LAA segmentation and analysis, we evaluated the Ds of area, number, and distribution of size based LAA, which would be independent factors for predictor of PFT parameters.

Chronic effects of air pollution on lung function after lung transplantation in the Systems prediction of Chronic Lung Allograft Dysfunction (SysCLAD) study.

PubMed

Benmerad, Meriem; Slama, Rémy; Botturi, Karine; Claustre, Johanna; Roux, Antoine; Sage, Edouard; Reynaud-Gaubert, Martine; Gomez, Carine; Kessler, Romain; Brugière, Olivier; Mornex, Jean-François; Mussot, Sacha; Dahan, Marcel; Boussaud, Véronique; Danner-Boucher, Isabelle; Dromer, Claire; Knoop, Christiane; Auffray, Annick; Lepeule, Johanna; Malherbe, Laure; Meleux, Frederik; Nicod, Laurent; Magnan, Antoine; Pison, Christophe; Siroux, Valérie

2017-01-01

An irreversible loss in lung function limits the long-term success in lung transplantation. We evaluated the role of chronic exposure to ambient air pollution on lung function levels in lung transplant recipients (LTRs).The lung function of 520 LTRs from the Cohort in Lung Transplantation (COLT) study was measured every 6 months. The levels of air pollutants (nitrogen dioxide (NO 2 ), particulate matter with an aerodynamic cut-off diameter of x µm (PM x ) and ozone (O 3 )) at the patients' home address were averaged in the 12 months before each spirometry test. The effects of air pollutants on forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC) in % predicted were estimated using mixed linear regressions. We assessed the effect modification of macrolide antibiotics in this relationship.Increased 12-month levels of pollutants were associated with lower levels of FVC % pred (-2.56%, 95% CI -3.86--1.25 for 5 µg·m -3 of PM 10 ; -0.75%, 95% CI -1.38--0.12 for 2 µg·m -3 of PM 2.5 and -2.58%, 95% CI -4.63--0.53 for 10 µg·m -3 of NO 2 ). In patients not taking macrolides, the deleterious association between PM and FVC tended to be stronger and PM 10 was associated with lower FEV 1 Our study suggests a deleterious effect of chronic exposure to air pollutants on lung function levels in LTRs, which might be modified with macrolides. Copyright ©ERS 2017.

Respiratory function in healthy ever-smokers is impaired by smoking habits in a dose-dependent manner.

PubMed

Osanai, Shinobu; Ogasa, Toshiyuki; Sumitomo, Kazuhiro; Hasebe, Naoyuki

2018-01-01

There is limited information about the respiratory function of ever-smokers without lung disorders. We sought to assess the effects of smoking habits on respiratory function in subjects without lung disorders. Subjects were recruited from among patients without any evidence of respiratory disorders who visited rural primary care clinics. Each participant was asked to answer a questionnaire that included questions smoking history. Their forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured. We analyzed 802 subjects (364 men and 438 women). The means of the lambda-mu-sigma method derived z-score of FEV1 (zFEV1) both in current-smokers and ex-smokers were lower than that in never-smokers. The mean zFEV1 in the ever-smokers with more than 30 pack-years of smoking history were lower than that in the ever-smokers with less smoking history. Univariate analysis showed that there were significant negative correlations between pack-years and zFEV1 both in the ex-smokers and current-smokers. There was no significant correlation between the duration of smoking cessation and zFEV1 in the ex-smokers. Our data suggests that respiratory function in healthy ever-smokers is decreased based on smoking habits in a dose-dependent manner. Even after a long period of smoking cessation, the decreased respiratory function seems to be maintained in ex-smokers. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Outcomes of Childhood Asthma and Wheezy Bronchitis. A 50-Year Cohort Study.

PubMed

Tagiyeva, Nara; Devereux, Graham; Fielding, Shona; Turner, Stephen; Douglas, Graham

2016-01-01

Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD. To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade. A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used. FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC <0.7. Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73-10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12-2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline. Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.

Socioeconomic impact of asthma, chronic obstructive pulmonary disease and asthma-COPD overlap syndrome.

PubMed

Kim, Jinhee; Kim, Young Sam; Kim, Kyungjoo; Oh, Yeon-Mok; Yoo, Kwang Ha; Rhee, Chin Kook; Lee, Jin Hwa

2017-06-01

Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is defined as having both features of asthma and COPD, which are airway hyper-responsiveness and incompletely reversible airway obstruction. However, socioeconomic impact of ACOS have not been well appreciated. Adults with available wheezing history and acceptable spirometry were selected from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV) in 2007-2009. Their data were merged with the Korean National Health Insurance claim data. 'Asthma group' was defined as having self-reported wheezing history and FEV 1 /FVC ≥0.7, 'COPD group' was defined as having FEV 1 /FVC <0.7 and no wheezing, 'ACOS group' was defined as having both wheezing and FEV 1 /FVC <0.7, and 'no airway disease (NAD) group' was defined as having no wheezing and FEV 1 /FVC ≥0.7. Among a total of 11,656 subjects, ACOS comprise 2.2%; COPD, 8.4%; asthma, 5.8% and NAD, 83.6%. Total length of healthcare utilization and medical costs of ACOS group was the top among four groups (P<0.001), though inpatient medical cost was the highest in COPD group (P=0.025). Multiple linear regression analyses showed that ACOS group (β=12.63, P<0.001) and asthma group (β=6.14, P<0.001) were significantly associated with longer duration of healthcare utilization and ACOS group (β=350,475.88, P=0.008) and asthma group (β=386,876.81, P<0.001) were associated with higher medical costs. This study demonstrated that ACOS independently influences healthcare utilization after adjusting several factors. In order to utilize limited medical resources efficiently, it may be necessary to find and manage ACOS patients.

A multicenter family practitioners' research on Chronic Obstructive Pulmonary Disease screening using the COPD Assessment Test.

PubMed

Demirci, Hakan; Eniste, Koncuy; Basaran, Ebru Onuker; Ocakoglu, Gokhan; Yilmaz, Zeynep; Tuna, Sumeyye

2017-11-01

Spirometry is known to be a gold standard for the diagnosis of chronic obstructive pulmonary disease (COPD). COPD Assessment Test (CAT) is an eight-item questionnaire currently in use to evaluate patients with COPD. In the present study, we aimed to evaluate if CAT is an adequate tool for screening COPD. In total, 600 persons aging ⩾40 years old were randomly selected from three different family practice units located in the city center. CAT was asked to the participants and a spirometry was used to assess pulmonary obstruction. Pulmonary obstruction was defined as forced expiratory volume in first second/forced vital capacity (FEV1/FVC)<70% and then COPD diagnosis was confirmed with the reversibility test. The relationship between CAT results and pulmonary function test values was evaluated. In this sampling, the prevalence of COPD was 4.2%. Reliability of the CAT in the study group was acceptable (Cronbach's α: 0.84). The CAT scores was significantly higher in patients with COPD (P<0.001). There was a significant negative correlation between CAT score and FEV1, FVC and FEV1/FVC ratio (r=-0.31, P<0.001; r=-0.26, P<0.001; r=0.18, P=0.001). Among smokers, phlegm was the predominating symptom (P=0.01). Sensitivity of CAT was 66.67% and its specificity was 75.15% to determine COPD. CAT is a reliable questionnaire and there is an apparent relationship between the total CAT scores and COPD. However, CAT's ability to screen COPD is limited since it may miss the symptom-free cases.

Airflow obstruction among street vendors who refill cigarette lighters with liquefied petroleum gas.

PubMed

Moitra, S; Blanc, P D; Brashier, B B

2014-09-01

Manual cigarette lighter refilling with butane/propane admixed liquefied petroleum gas (LPG) is a common low-income occupation in India. This practice may cause adverse health effects from LPG exposure among such workers. To assess respiratory status among LPG-exposed workers and non-exposed controls. We quantified the exposure and evaluated respiratory symptoms and lung function among 113 LPG refilling workers (aged 41.9±9.9 years) and 79 controls (aged 40.8±7.2 years). We used multiple linear regression analysis to estimate the LPG exposure response within the group of refilling workers, adjusting for age, height and smoking status. Compared to the controls, the LPG-exposed lighter refillers manifested a 190 ml decrement in 1-second forced expiratory volume (FEV1) (2.55±0.4 vs. 2.26±0.3 l) and a 6% decrement in FEV1/forced vital capacity (FVC) (both P < 0.05). We found a significantly negative exposure response among the LPG workers: for FVC and FEV1, 44 ml per ml of reported daily LPG use in refilling (P < 0.05). Likely heavy exposure to LPG through manually refilling cigarette lighters is associated with airflow decrements. This adverse effect may be relevant to other occupational groups heavily exposed to volatile hydrocarbons, especially those in marginal employment sectors.

Evaluation of the association of acute overshift change in pulmonary function and atopy using OSHA cotton dust surveillance data.

PubMed

Jennison, E; Jacobs, R R

1994-05-01

OSHA surveillance data were collected for 769 individuals employed in four different cotton textile mills. Current workers were asked to complete a questionnaire about personal and family history of atopy or asthma. Both surveillance and survey data were available for 502 individuals. The prevalence of atopy in the population as reported by questionnaire was 18%, while asthma was reported by 4%. Dust levels at the four mills were in compliance with the cotton dust standard during the period of surveillance. No relationship was found between a self-reported history of atopy or asthma and the magnitude or frequency of acute overshift declines in forced expiratory volume during 1 second (FEV1). Nonsmokers had annual changes in FEV1 and forced vital capacity (FVC) comparable to nonexposed populations. In one of the four mills surveyed, annual declines in FEV1 and FVC for current smokers were significantly greater than declines for smokers in the other mills or the general smoking population (p < 0.02). This mill effect was also observed for subjects who were categorized as atopic (p < 0.02). For nonsmokers there appears to be no significant adverse health effect from exposure to the levels of cotton dust observed in these mills.

Prevalence, determinants and clinical correlates of vitamin D deficiency in patients with Chronic Obstructive Pulmonary Disease in London, UK.

PubMed

Jolliffe, David A; James, Wai Yee; Hooper, Richard L; Barnes, Neil C; Greiller, Claire L; Islam, Kamrul; Bhowmik, Angshu; Timms, Peter M; Rajakulasingam, Raj K; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Walton, Robert T; Corrigan, Christopher J; Griffiths, Christopher J; Martineau, Adrian R

2018-01-01

Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years in London, UK. Details of potential environmental determinants of vitamin D status and COPD symptom control and severity were collected by questionnaire, and blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction. All participants performed spirometry and underwent measurement of weight and height. Quadriceps muscle strength (QS) was measured in 134 participants, and sputum induction with enumeration of lower airway eosinophil and neutrophil counts was performed for 44 participants. Thirty-seven single nucleotide polymorphisms (SNP) in 11 genes in the vitamin D pathway (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, CYP27A1, CYP3A4, LRP2, CUBN, RXRA, and VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration and to determine whether vitamin D status or genetic factors independently associated with % predicted forced expiratory volume in one second (FEV 1 ), % predicted forced vital capacity (FVC), the ratio of FEV 1 to FVC (FEV 1 :FVC), daily inhaled corticosteroid (ICS) dose, respiratory quality of life (QoL), QS, and the percentage of eosinophils and neutrophils in induced sputum. Mean serum 25(OH)D concentration was 45.4nmol/L (SD 25.3); 171/278 (61.5%) participants were vitamin D deficient (serum 25[OH]D concentration <50nmol/L). Lower vitamin D status was independently associated with higher body mass index (P=0.001), lower socio-economic position (P=0.037), lack of vitamin D supplement consumption (P<0.001), sampling in Winter or Spring (P for trend=0.006) and lack of a recent sunny holiday (P=0.002). Vitamin D deficiency associated with reduced % predicted FEV 1 (P for trend=0.060) and % predicted FVC (P for trend=0.003), but it did not associate with FEV 1 :FVC, ICS dose, QoL, QS, or the percentage of eosinophils or neutrophils in induced sputum. After correction for multiple comparisons testing, genetic variation in the vitamin D pathway was not found to associate with serum 25(OH)D concentration or clinical correlates of COPD severity. Vitamin D deficiency was common in this group of COPD patients in the UK, and it associated independently with reduced % predicted FEV1 and FVC. However, genetic variation in the vitamin D pathway was not associated with vitamin D status or severity of COPD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Respiratory parameters in elite athletes--does sport have an influence?

PubMed

Mazic, S; Lazovic, B; Djelic, M; Suzic-Lazic, J; Djordjevic-Saranovic, S; Durmic, T; Soldatovic, I; Zikic, D; Gluvic, Z; Zugic, V

2015-01-01

Unlike large population studies about cardiovascular components and how they adapt to intensive physical activity, there is less research into the causes of enlargement of the respiratory system in athletes (e.g. vital capacity, maximum flow rates and pulmonary diffusion capacity). The purpose of this research was to study and compare pulmonary function in different types of sports and compare them with controls in order to find out which sports improve lung function the most. Pulmonary functional capacities, vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximum voluntary ventilation (MVV) of 493 top athletes belonging to 15 different sports disciplines and of 16 sedentary individuals were studied. Pulmonary function test was performed according to ATS/ERS guidelines. Basketball, water polo players and rowers had statistically higher vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) than the healthy sedentary control individuals. Football and volleyball players had lower VC while FVC was higher in the football group compared to controls. Peak expiratory flow was lower in boxing, kayak, rugby, handball, taekwondo and tennis. The maximum voluntary ventilation (MVV) was significantly higher in water polo players and rowers. Boxers had statistically lower MVV than the controls. Players of other sports did not differ from the control group. The study suggests that specific type of training used in basketball, water polo or rowing could have potential for improving pulmonary function and rehabilitation. Copyright © 2014 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Differences in spirometry interpretation algorithms: influence on decision making among primary-care physicians

PubMed Central

He, Xiao-Ou; D’Urzo, Anthony; Jugovic, Pieter; Jhirad, Reuven; Sehgal, Prateek; Lilly, Evan

2015-01-01

Background: Spirometry is recommended for the diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in international guidelines and may be useful for distinguishing asthma from COPD. Numerous spirometry interpretation algorithms (SIAs) are described in the literature, but no studies highlight how different SIAs may influence the interpretation of the same spirometric data. Aims: We examined how two different SIAs may influence decision making among primary-care physicians. Methods: Data for this initiative were gathered from 113 primary-care physicians attending accredited workshops in Canada between 2011 and 2013. Physicians were asked to interpret nine spirograms presented twice in random sequence using two different SIAs and touch pad technology for anonymous data recording. Results: We observed differences in the interpretation of spirograms using two different SIAs. When the pre-bronchodilator FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio was >0.70, algorithm 1 led to a ‘normal’ interpretation (78% of physicians), whereas algorithm 2 prompted a bronchodilator challenge revealing changes in FEV1 that were consistent with asthma, an interpretation selected by 94% of physicians. When the FEV1/FVC ratio was <0.70 after bronchodilator challenge but FEV1 increased >12% and 200 ml, 76% suspected asthma and 10% suspected COPD using algorithm 1, whereas 74% suspected asthma versus COPD using algorithm 2 across five separate cases. The absence of a post-bronchodilator FEV1/FVC decision node in algorithm 1 did not permit consideration of possible COPD. Conclusions: This study suggests that differences in SIAs may influence decision making and lead clinicians to interpret the same spirometry data differently. PMID:25763716

[Pulmonary function in patients with focal pulmonary tuberculosis].

PubMed

Nefedov, V B; Popova, L A; Shergina, E A

2008-01-01

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), Raw, Rin, Rcx, DLCO-SB, DLCO-SS/VA, PaO2, and PaCO2 were determined in 40 patients with focal pulmonary tuberculosis. Changes were found in lung volumes and capacities in 75%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 57.5 and 25%, respectively. The lung volume and capacity changes appeared mainly as increased TGV and PRV; impaired bronchial patency presented as decreased MEF50, MEF75, and FEV1/VC%; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, PaO2, and PaCO2. The magnitude of the observed functional changes was generally slight. TGV and PRL increased up to 148-187 and 142-223% of the normal values, respectively; MEF50, MEF75, FEV1/VC%, and DLCO decreased to 59-24, 58-26, 78-57, and 78-67% of the normal values and PaO2 and PaCO2 did to 79-69 and 34-30 cm Hg.

DISTRIBUTION OF FORCED VITAL CAPACITY AND FORCED EXPIRATORY VOLUME IN ONE SECOND IN CHILDREN 6 TO 11 YEARS OF AGE

EPA Science Inventory

The authors analyzed 44,664 annual measurements of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) in 12,258 white children and 1,041 black children between 6 and 11 years of age in 6 communities. Sex and race-specific lung function development is de...

African ancestry, lung function and the effect of genetics

PubMed Central

Wehrmeister, Fernando C.; Hartwig, Fernando P.; Perez-Padilla, Rogelio; Gigante, Denise P.; Barros, Fernando C.; Oliveira, Isabel O.; Ferreira, Gustavo D.; Horta, Bernardo L.

2015-01-01

African-Americans have smaller lung function compared with European-Americans. The aim of this study was to disentangle the contribution of genetics from other variables on lung function. A cohort was followed from birth to 30 years of age in Brazil. Several variables were collected: genomic analysis based on DNA; forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) obtained by spirometry; height measured by anthropometrists; and thorax circumference evaluated by photonic scanner. Crude and adjusted linear regression models were calculated according to African ancestry. The sample comprised 2869 participants out of 3701 members of the cohort. Males with higher African ancestry by DNA analysis had a smaller FEV1 (−0.13 L, 95% CI −0.23– −0.03 L) and FVC (−0.21 L, 95% CI −0.32– −0.09 L) compared with those with less African ancestry, having accounted for height, sitting to standing height ratio and other confounders. Similar effects were seen in females. After adjustment, ancestry remained significantly associated with lung function, but the large effect of adjustment for confounding among males (but not females) does not allow us to exclude the possibility that residual confounding may still account for these findings. PMID:25700383

Genome-Wide Association Studies Identify CHRNA5/3 and HTR4 in the Development of Airflow Obstruction

PubMed Central

Shrine, Nick R. G.; Loehr, Laura R.; Zhao, Jing Hua; Manichaikul, Ani; Lopez, Lorna M.; Smith, Albert Vernon; Heckbert, Susan R.; Smolonska, Joanna; Tang, Wenbo; Loth, Daan W.; Curjuric, Ivan; Hui, Jennie; Latourelle, Jeanne C.; Henry, Amanda P.; Aldrich, Melinda; Bakke, Per; Beaty, Terri H.; Bentley, Amy R.; Borecki, Ingrid B.; Brusselle, Guy G.; Burkart, Kristin M.; Chen, Ting-hsu; Couper, David; Crapo, James D.; Davies, Gail; Dupuis, Josée; Franceschini, Nora; Gulsvik, Amund; Hancock, Dana B.; Harris, Tamara B.; Hofman, Albert; Imboden, Medea; James, Alan L.; Khaw, Kay-Tee; Lahousse, Lies; Launer, Lenore J.; Litonjua, Augusto; Liu, Yongmei; Lohman, Kurt K.; Lomas, David A.; Lumley, Thomas; Marciante, Kristin D.; McArdle, Wendy L.; Meibohm, Bernd; Morrison, Alanna C.; Musk, Arthur W.; Myers, Richard H.; North, Kari E.; Postma, Dirkje S.; Psaty, Bruce M.; Rich, Stephen S.; Rivadeneira, Fernando; Rochat, Thierry; Rotter, Jerome I.; Artigas, María Soler; Starr, John M.; Uitterlinden, André G.; Wareham, Nicholas J.; Wijmenga, Cisca; Zanen, Pieter; Province, Michael A.; Silverman, Edwin K.; Deary, Ian J.; Palmer, Lyle J.; Cassano, Patricia A.; Gudnason, Vilmundur; Barr, R. Graham; Loos, Ruth J. F.; Strachan, David P.; London, Stephanie J.; Boezen, H. Marike; Probst-Hensch, Nicole; Gharib, Sina A.; Hall, Ian P.; O’Connor, George T.; Tobin, Martin D.; Stricker, Bruno H.

2012-01-01

Rationale: Genome-wide association studies (GWAS) have identified loci influencing lung function, but fewer genes influencing chronic obstructive pulmonary disease (COPD) are known. Objectives: Perform meta-analyses of GWAS for airflow obstruction, a key pathophysiologic characteristic of COPD assessed by spirometry, in population-based cohorts examining all participants, ever smokers, never smokers, asthma-free participants, and more severe cases. Methods: Fifteen cohorts were studied for discovery (3,368 affected; 29,507 unaffected), and a population-based family study and a meta-analysis of case-control studies were used for replication and regional follow-up (3,837 cases; 4,479 control subjects). Airflow obstruction was defined as FEV1 and its ratio to FVC (FEV1/FVC) both less than their respective lower limits of normal as determined by published reference equations. Measurements and Main Results: The discovery meta-analyses identified one region on chromosome 15q25.1 meeting genome-wide significance in ever smokers that includes AGPHD1, IREB2, and CHRNA5/CHRNA3 genes. The region was also modestly associated among never smokers. Gene expression studies confirmed the presence of CHRNA5/3 in lung, airway smooth muscle, and bronchial epithelial cells. A single-nucleotide polymorphism in HTR4, a gene previously related to FEV1/FVC, achieved genome-wide statistical significance in combined meta-analysis. Top single-nucleotide polymorphisms in ADAM19, RARB, PPAP2B, and ADAMTS19 were nominally replicated in the COPD meta-analysis. Conclusions: These results suggest an important role for the CHRNA5/3 region as a genetic risk factor for airflow obstruction that may be independent of smoking and implicate the HTR4 gene in the etiology of airflow obstruction. PMID:22837378

Effects of occupational exposures and smoking on lung function in tile factory workers.

PubMed

Jaakkola, Maritta S; Sripaiboonkij, Penpatra; Jaakkola, Jouni J K

2011-02-01

The aims of this study were to investigate the relations of occupational exposures in tile industry to lung function and to evaluate potential interaction between smoking and tile dust exposure containing silica. A cross-sectional study of 232 workers (response rate 100%) in a tile factory and 76 office workers (response rate 73%) from four factories in Thailand was conducted in 2006-2007. Participants answered a questionnaire and performed spirometry. Factory workers had lower spirometric functions than office workers, especially those with high dust exposure. There was a dose-response relation between duration of dust exposure and FEV1 and FVC, the adjusted effect of ≥ 21 years of exposure on FEV1 being -240 ml (-100 to -380) and on FVC -300 ml (-140 to -460). The adverse effect of dust on lung function was larger in current smokers suggesting synergism between smoking and tile dust exposure. This study provides evidence that long-term exposure to dust in tile industry is related to lung function reduction. There was a suggestion of synergistic effect between dust exposure and smoking. Tile factories should consider measures to reduce dust exposure and arrange spirometry surveillance for workers with such exposure. Smoking cessation should be promoted to prevent harmful effects of occupational tile dust exposure.

Genetic regulation of gene expression in the lung identifies CST3 and CD22 as potential causal genes for airflow obstruction.

PubMed

Lamontagne, Maxime; Timens, Wim; Hao, Ke; Bossé, Yohan; Laviolette, Michel; Steiling, Katrina; Campbell, Joshua D; Couture, Christian; Conti, Massimo; Sherwood, Karen; Hogg, James C; Brandsma, Corry-Anke; van den Berge, Maarten; Sandford, Andrew; Lam, Stephen; Lenburg, Marc E; Spira, Avrum; Paré, Peter D; Nickle, David; Sin, Don D; Postma, Dirkje S

2014-11-01

COPD is a complex chronic disease with poorly understood pathogenesis. Integrative genomic approaches have the potential to elucidate the biological networks underlying COPD and lung function. We recently combined genome-wide genotyping and gene expression in 1111 human lung specimens to map expression quantitative trait loci (eQTL). To determine causal associations between COPD and lung function-associated single nucleotide polymorphisms (SNPs) and lung tissue gene expression changes in our lung eQTL dataset. We evaluated causality between SNPs and gene expression for three COPD phenotypes: FEV(1)% predicted, FEV(1)/FVC and COPD as a categorical variable. Different models were assessed in the three cohorts independently and in a meta-analysis. SNPs associated with a COPD phenotype and gene expression were subjected to causal pathway modelling and manual curation. In silico analyses evaluated functional enrichment of biological pathways among newly identified causal genes. Biologically relevant causal genes were validated in two separate gene expression datasets of lung tissues and bronchial airway brushings. High reliability causal relations were found in SNP-mRNA-phenotype triplets for FEV(1)% predicted (n=169) and FEV(1)/FVC (n=80). Several genes of potential biological relevance for COPD were revealed. eQTL-SNPs upregulating cystatin C (CST3) and CD22 were associated with worse lung function. Signalling pathways enriched with causal genes included xenobiotic metabolism, apoptosis, protease-antiprotease and oxidant-antioxidant balance. By using integrative genomics and analysing the relationships of COPD phenotypes with SNPs and gene expression in lung tissue, we identified CST3 and CD22 as potential causal genes for airflow obstruction. This study also augmented the understanding of previously described COPD pathways. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Indacaterol and glycopyrronium versus indacaterol on body plethysmography measurements in COPD-a randomised controlled study.

PubMed

Salomon, Joerg; Stolz, Daiana; Domenighetti, Guido; Frey, Jean-Georges; Turk, Alexander J; Azzola, Andrea; Sigrist, Thomas; Fitting, Jean-William; Schmidt, Ulrich; Geiser, Thomas; Wild, Corinne; Kostikas, Konstantinos; Clemens, Andreas; Brutsche, Martin

2017-01-11

Dual bronchodilator therapy is recommended for symptomatic patients with chronic obstructive pulmonary disease (COPD). There are limited data on effects of a combination of two long-acting bronchodilators on lung function including body plethysmography. This multicentre, randomised, double-blind, single-dose, cross-over, placebo-controlled study evaluated efficacy and safety of the free combination of indacaterol maleate (IND) and glycopyrronium bromide (GLY) versus IND alone on spirometric and body plethysmography parameters, including inspiratory capacity (IC), forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), total lung capacity (TLC) and airway resistance (Raw) in moderate-to-severe COPD patients. Seventy-eight patients with FEV 1 % pred. (mean ± SD) 56 ± 13% were randomised. The combination of IND + GLY versus IND presented a numerically higher peak-IC (Δ = 0.076 L, 95% confidence interval [CI]: -0.010 - 0.161 L; p = 0.083), with a statistically significant difference in mean IC over 4 h (Δ = 0.054 L, 95%CI 0.022 - 0.086 L; p = 0.001). FEV 1 , FVC and Raw, but not TLC, were consistently significantly improved by IND + GLY compared to IND alone. Safety profiles of both treatments were comparable. The free combination of IND + GLY improved lung function parameters as evaluated by spirometry and body plethysmography, with a similar safety profile compared to IND alone. NCT01699685.

Cross sectional study on lung function of coke oven workers: a lung function surveillance system from 1978 to 1990

PubMed Central

Wu, J; Kreis, I; Griffiths, D; Darling, C

2002-01-01

Aims: To determine the association between lung function of coke oven workers and exposure to coke oven emissions. Methods: Lung function data and detailed work histories for workers in recovery coke ovens of a steelworks were extracted from a lung function surveillance system. Multiple regressions were employed to determine significant predictors for lung function indices. The first sets of lung function tests for 613 new starters were pooled to assess the selection bias. The last sets of lung function tests for 834 subjects with one or more year of coke oven history were pooled to assess determinants of lung function. Results: Selection bias associated with the recruitment process was not observed among the exposure groups. For subjects with a history of one or more years of coke oven work, each year of working in the most exposed "operation" position was associated with reductions in FEV1 of around 9 ml (p = 0.006, 95% CI: 3 ml to 16 ml) and in FVC of around 12 ml (p = 0.002, 95% CI: 4 ml to 19 ml). Negative effects of smoking on lung function were also observed. Conclusions: Exposure to coke oven emissions was found to be associated with lower FEV1 and FVC. Effects of work exposure on lung function are similar to those found in other studies. PMID:12468747

Genome-wide association and large scale follow-up identifies 16 new loci influencing lung function

PubMed Central

Artigas, María Soler; Loth, Daan W; Wain, Louise V; Gharib, Sina A; Obeidat, Ma’en; Tang, Wenbo; Zhai, Guangju; Zhao, Jing Hua; Smith, Albert Vernon; Huffman, Jennifer E; Albrecht, Eva; Jackson, Catherine M; Evans, David M; Cadby, Gemma; Fornage, Myriam; Manichaikul, Ani; Lopez, Lorna M; Johnson, Toby; Aldrich, Melinda C; Aspelund, Thor; Barroso, Inês; Campbell, Harry; Cassano, Patricia A; Couper, David J; Eiriksdottir, Gudny; Franceschini, Nora; Garcia, Melissa; Gieger, Christian; Gislason, Gauti Kjartan; Grkovic, Ivica; Hammond, Christopher J; Hancock, Dana B; Harris, Tamara B; Ramasamy, Adaikalavan; Heckbert, Susan R; Heliövaara, Markku; Homuth, Georg; Hysi, Pirro G; James, Alan L; Jankovic, Stipan; Joubert, Bonnie R; Karrasch, Stefan; Klopp, Norman; Koch, Beate; Kritchevsky, Stephen B; Launer, Lenore J; Liu, Yongmei; Loehr, Laura R; Lohman, Kurt; Loos, Ruth JF; Lumley, Thomas; Al Balushi, Khalid A; Ang, Wei Q; Barr, R Graham; Beilby, John; Blakey, John D; Boban, Mladen; Boraska, Vesna; Brisman, Jonas; Britton, John R; Brusselle, Guy G; Cooper, Cyrus; Curjuric, Ivan; Dahgam, Santosh; Deary, Ian J; Ebrahim, Shah; Eijgelsheim, Mark; Francks, Clyde; Gaysina, Darya; Granell, Raquel; Gu, Xiangjun; Hankinson, John L; Hardy, Rebecca; Harris, Sarah E; Henderson, John; Henry, Amanda; Hingorani, Aroon D; Hofman, Albert; Holt, Patrick G; Hui, Jennie; Hunter, Michael L; Imboden, Medea; Jameson, Karen A; Kerr, Shona M; Kolcic, Ivana; Kronenberg, Florian; Liu, Jason Z; Marchini, Jonathan; McKeever, Tricia; Morris, Andrew D; Olin, Anna-Carin; Porteous, David J; Postma, Dirkje S; Rich, Stephen S; Ring, Susan M; Rivadeneira, Fernando; Rochat, Thierry; Sayer, Avan Aihie; Sayers, Ian; Sly, Peter D; Smith, George Davey; Sood, Akshay; Starr, John M; Uitterlinden, André G; Vonk, Judith M; Wannamethee, S Goya; Whincup, Peter H; Wijmenga, Cisca; Williams, O Dale; Wong, Andrew; Mangino, Massimo; Marciante, Kristin D; McArdle, Wendy L; Meibohm, Bernd; Morrison, Alanna C; North, Kari E; Omenaas, Ernst; Palmer, Lyle J; Pietiläinen, Kirsi H; Pin, Isabelle; Polašek, Ozren; Pouta, Anneli; Psaty, Bruce M; Hartikainen, Anna-Liisa; Rantanen, Taina; Ripatti, Samuli; Rotter, Jerome I; Rudan, Igor; Rudnicka, Alicja R; Schulz, Holger; Shin, So-Youn; Spector, Tim D; Surakka, Ida; Vitart, Veronique; Völzke, Henry; Wareham, Nicholas J; Warrington, Nicole M; Wichmann, H-Erich; Wild, Sarah H; Wilk, Jemma B; Wjst, Matthias; Wright, Alan F; Zgaga, Lina; Zemunik, Tatijana; Pennell, Craig E; Nyberg, Fredrik; Kuh, Diana; Holloway, John W; Boezen, H Marike; Lawlor, Debbie A; Morris, Richard W; Probst-Hensch, Nicole; Kaprio, Jaakko; Wilson, James F; Hayward, Caroline; Kähönen, Mika; Heinrich, Joachim; Musk, Arthur W; Jarvis, Deborah L; Gläser, Sven; Järvelin, Marjo-Riitta; Stricker, Bruno H Ch; Elliott, Paul; O’Connor, George T; Strachan, David P; London, Stephanie J; Hall, Ian P; Gudnason, Vilmundur; Tobin, Martin D

2011-01-01

Pulmonary function measures reflect respiratory health and predict mortality, and are used in the diagnosis of chronic obstructive pulmonary disease (COPD). We tested genome-wide association with the forced expiratory volume in 1 second (FEV1) and the ratio of FEV1 to forced vital capacity (FVC) in 48,201 individuals of European ancestry, with follow-up of top associations in up to an additional 46,411 individuals. We identified new regions showing association (combined P<5×10−8) with pulmonary function, in or near MFAP2, TGFB2, HDAC4, RARB, MECOM (EVI1), SPATA9, ARMC2, NCR3, ZKSCAN3, CDC123, C10orf11, LRP1, CCDC38, MMP15, CFDP1, and KCNE2. Identification of these 16 new loci may provide insight into the molecular mechanisms regulating pulmonary function and into molecular targets for future therapy to alleviate reduced lung function. PMID:21946350

The reliability and utility of spirometry performed on people with asthma in community pharmacies.

PubMed

Lei Burton, Deborah; LeMay, Kate S; Saini, Bandana; Smith, Lorraine; Bosnic-Anticevich, Sinthia; Southwell, Phillipa; Cooke, Julie; Emmerton, Lynne; Stewart, Kay; Krass, Ines; Reddel, Helen; Armour, Carol

2015-01-01

To investigate the reliability and the utility of spirometry generated by community pharmacists participating in two large asthma intervention trials of 892 people. The Pharmacy Asthma Care Program (PACP) and the Pharmacy Asthma Management Service (PAMS) involved up to four visits to the pharmacy over 6 months for counseling and goal setting. Pharmacists performed spirometry according to ATS/ERS guidelines to inform management. The proportion of A-E, F quality tests, as per EasyOne QC grades, were recorded. Lung function results between visits and for participants referred/not referred to their general practitioner on the basis of spirometry were compared. Complete data from 2593 spirometry sessions were recorded, 68.5% of spirometry sessions achieved three acceptable tests with between-test repeatability of 150 ml or less (A or B quality), 96% of spirometry sessions included at least one test that met ATS/ERS acceptability criteria. About 39.1% of participants had FEV1/FVC values below the lower limit of normal (LNN), indicating a respiratory obstruction. As a result of the service, there was a significant increase in FEV1 and FEV1/FVC and asthma control. Lung function values were significantly poorer for participants referred to their general practitioner, compared with those not referred, on the basis of spirometry. Community pharmacists are able to reliably achieve spirometry results meeting ATS/ERS guidelines in people with asthma. Significant improvements in airway obstruction were demonstrated with the pharmacy services. Pharmacists interpreted lung function results to identify airway obstruction for referral, making this a useful technique for review of people with asthma in the community.

Relationship between lung function and grip strength in older hospitalized patients: a pilot study

PubMed Central

Holmes, Sarah J; Allen, Stephen C; Roberts, Helen C

2017-01-01

Objective Older people with reduced respiratory muscle strength may be misclassified as having COPD on the basis of spirometric results. We aimed to evaluate the relationship between lung function and grip strength in older hospitalized patients without known airways disease. Methods Patients in acute medical wards were recruited who were aged ≥70 years; no history, symptoms, or signs of respiratory disease; Mini Mental State Examination ≥24; willing and able to consent to participate; and able to perform hand grip and forced spirometry. Data including lung function (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC, peak expiratory flow rate [PEFR], and slow vital capacity [SVC]), grip strength, age, weight, and height were recorded. Data were analyzed using descriptive statistics and linear regression unadjusted and adjusted (for age, height, and weight). Results A total of 50 patients (20 men) were recruited. Stronger grip strength in men was significantly associated with greater FEV1, but this was attenuated by adjustment for age, height, and weight. Significant positive associations were found in women between grip strength and both PEFR and SVC, both of which remained robust to adjustment. Conclusion The association between grip strength and PEFR and SVC may reflect stronger patients generating higher intrathoracic pressure at the start of spirometry and pushing harder against thoracic cage recoil at end-expiration. Conversely, patients with weaker grip strength had lower PEFR and SVC. These patients may be misclassified as having COPD on the basis of spirometric results. PMID:28458532

Silicosis and lung function decrements among female ceramic workers in Italy.

PubMed

Forastiere, Francesco; Goldsmith, David F; Sperati, Alessandra; Rapiti, Elisabetta; Miceli, Maria; Cavariani, Fulvio; Perucci, Carlo A

2002-11-01

It is well known that male ceramic workers have elevated risks of chronic silicosis. The objective of this study was to assess whether female ceramic workers also have an increased risk of silicosis and whether these women have decreased lung function related to silica exposure. Ceramic workers from Civitacastellana, Italy, were enrolled in health surveillance during the 1970s. A total of 642 women were under surveillance; a respiratory monitoring program was conducted from 1974 to 1987, with follow-up through 1991 that included annual chest radiography and measurement of lung function. Radiography findings were defined as silicosis if the chest films were > or =1/0 with small, rounded opacities. Multiple linear regression models for repeated measures (generalized estimating equations) were run to evaluate associations of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV(1)) with years of exposure and radiograph opacities. Nine cases of silicosis were identified on the basis of radiographic evidence. Silicosis risk was not associated with smoking but was related to employment before 1970 and demonstrated a dose-response gradient for years of exposure. FVC and FEV(1) both showed significant (p < 0.05) associations with duration of exposure and with positive radiography findings. The results for female ceramic workers are consistent with those for male employees regarding exposure to fibrogenic dusts.

Chronic Airflow Obstruction in a Black African Population: Results of BOLD Study, Ile-Ife, Nigeria.

PubMed

Obaseki, Daniel O; Erhabor, Gregory E; Gnatiuc, Louisa; Adewole, Olufemi O; Buist, Sonia A; Burney, Peter G

2016-01-01

Global estimates suggest that Chronic Obstructive Pulmonary Disease (COPD) is emerging as a leading cause of death in developing countries but there are few spirometry-based general population data on its prevalence and risk factors in sub-Saharan Africa. We used the Burden of Obstructive Lung Disease (BOLD) protocol to select a representative sample of adults aged 40 years and above in Ile-Ife, Nigeria. All the participants underwent spirometry and provided information on smoking history, biomass and occupational exposures as well as diagnosed respiratory diseases and symptoms. Chronic Airflow Obstruction (CAO) was defined as the ratio of post-bronchodilator (BD) one second Forced Expiratory Volume (FEV1) to Forced Vital Capacity (FVC) below the lower limit of normal (LLN) of the population distribution for FEV1/FVC. The overall prevalence of obstruction (post-BD FEV1/FVC < LLN) was 7.7% (2.7% above LLN) using Global Lung Function Initiative (GLI) equations. It was associated with few respiratory symptoms; 0.3% reported a previous doctor-diagnosed chronic bronchitis, emphysema or COPD. Independent predictors included a lack of education (OR 2.5, 95% CI: 1.0, 6.4) and a diagnosis of either TB (OR 23.4, 95% CI: 2.0, 278.6) or asthma (OR 35.4, 95%CI: 4.9, 255.8). There was no association with the use of firewood or coal for cooking or heating. The vast majority of this population (89%) are never smokers. We conclude that the prevalence of CAO is low in Ile-Ife, Nigeria and unrelated to biomass exposure. The key independent predictors are poor education, and previous diagnosis of tuberculosis or asthma.

Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests

PubMed Central

2009-01-01

Introduction Bronchial challenge tests by inhalation of aerosolized methacholine (MCH) are commonly used in the clinical diagnosis of airway hyperresponsiveness (AHR). While the detection of airway narrowing relies on the patient's cooperation performing forced spirometry, body plethysmographic measurements of airway resistance are less depending on the patient's cooperation and do not alter the respiratory tract by maximal maneuvers. Hence we compared both methods concerning their clinical value and correlation during MCH challenges in patients with asthma. Materials and Methods Cumulative MCH challenges test, consisting of up to 5 steps, evaluated with body plethysmography on each step were performed in 155 patients with bronchial asthma. Airway responses were recorded at each step of MCH application (Master-Screen Body, Cardinal Health, Höchberg). At the baseline test and after crossing the provocation dose (PD) threshold in body plethysmography (PD+100 sReff), forced expirations were performed and FEV1, FVC, and FEV1 %FVC were measured. Using regression analysis of the airway parameters and taking the MCH dose as the covariate, we could extrapolate to missing spirometric values and interpolate the estimated MCH dose when crossing the PD threshold (PD-20 FEV1) between two consecutive measurements. The administered PD+100 MCH doses for specific airway resistance, sRtot, and sReff were compared with resistance parameters Rtot and Reff, and to PD-20 of FEV1 and FEV1 %FVC. Results Regarding sReff we found a mild, moderate, or severe AHR in 114 patients (75%), but only 50 (32%) according to FEV1. A statistical analysis showed strongly linear correlated parameters of airway resistance, but no significant correlation between the results of body plethysmography and forced spirometry Conclusions Using MCH challenges, we found specific airway resistance to be the most sensitive parameter to detect AHR. Raw is largely independent of height and gender facilitating the interpretation of measurements carried out longitudinally. PMID:20156751

Occupational exposure to wood dust and health effects on the respiratory system in a minor industrial estate in Bursa, Turkey.

PubMed

Osman, Erdinç; Pala, Kayihan

2009-01-01

The aim of this study was to estimate occupational exposure to wood dust in the furniture industry in a minor industrial estate in Bursa, Turkey. The study was conducted between October 2006 and May 2007. In this study, a total of 656 persons, 328 woodworkers and 328 controls were included. A questionnaire was used in the study. Physical examination and the pulmonary function tests (MIR-Spirobank G) of the workers were performed. A portable Aircheck 2000 pump was used to collect the specimens of wood dust from the workplaces. NIOSH Method 0500 was employed for the gravimetric measurements of dust. The average dust concentration at the workplace was 2.04+/-1.53 mg/m3. It was reported that 176 of workers (53.7%) had blocked nose while working, 141 (43.0%) had redness of the eyes, 135 (41.2%) had itching eyes and 78 (23.8%) had runny nose. No symptoms were observed in the control group while they were working at the workplace. The mean FEV1 and FVC values of woodworkers, among both smokers and non smokers, were significantly low, although the FEV1/FVC value was high (p < 0.05). An increase both in FEV1 and FVC values was detected among the woodworkers who had a working period less than 10 years and were exposed to wood dust at concentrations over 4 mg/m3 compared to the woodworkers who were exposed to wood dust at less than 4 mg/m3 (p < 0.05). As a result, in this study it was pointed out that the exposure to wood dust adversely influenced the workers respiratory functions. Besides, in this study a question associated with the healthy worker effect that can adversely influence health of workers exposed to wood dust at less than (4 mg/m3) is revealed.

Challenges in Collating Spirometry Reference Data for South-Asian Children: An Observational Study

PubMed Central

Lum, Sooky; Bountziouka, Vassiliki; Quanjer, Philip; Sonnappa, Samatha; Wade, Angela; Beardsmore, Caroline; Chhabra, Sunil K.; Chudasama, Rajesh K.; Cook, Derek G.; Harding, Seeromanie; Kuehni, Claudia E.; Prasad, K. V. V.; Whincup, Peter H.; Lee, Simon; Stocks, Janet

2016-01-01

Availability of sophisticated statistical modelling for developing robust reference equations has improved interpretation of lung function results. In 2012, the Global Lung function Initiative(GLI) published the first global all-age, multi-ethnic reference equations for spirometry but these lacked equations for those originating from the Indian subcontinent (South-Asians). The aims of this study were to assess the extent to which existing GLI-ethnic adjustments might fit South-Asian paediatric spirometry data, assess any similarities and discrepancies between South-Asian datasets and explore the feasibility of deriving a suitable South-Asian GLI-adjustment. Methods Spirometry datasets from South-Asian children were collated from four centres in India and five within the UK. Records with transcription errors, missing values for height or spirometry, and implausible values were excluded(n = 110). Results Following exclusions, cross-sectional data were available from 8,124 children (56.3% male; 5–17 years). When compared with GLI-predicted values from White Europeans, forced expired volume in 1s (FEV1) and forced vital capacity (FVC) in South-Asian children were on average 15% lower, ranging from 4–19% between centres. By contrast, proportional reductions in FEV1 and FVC within all but two datasets meant that the FEV1/FVC ratio remained independent of ethnicity. The ‘GLI-Other’ equation fitted data from North India reasonably well while ‘GLI-Black’ equations provided a better approximation for South-Asian data than the ‘GLI-White’ equation. However, marked discrepancies in the mean lung function z-scores between centres especially when examined according to socio-economic conditions precluded derivation of a single South-Asian GLI-adjustment. Conclusion Until improved and more robust prediction equations can be derived, we recommend the use of ‘GLI-Black’ equations for interpreting most South-Asian data, although ‘GLI-Other’ may be more appropriate for North Indian data. Prospective data collection using standardised protocols to explore potential sources of variation due to socio-economic circumstances, secular changes in growth/predictors of lung function and ethnicities within the South-Asian classification are urgently required. PMID:27119342

A Fuzzy Rule-Base Model for Classification of Spirometric FVC Graphs in Chronical Obstructive Pulmonary Diseases

DTIC Science & Technology

2001-10-25

questionnaire was filled out before test which is very important criteria for each subject for investigating are smoking cigarettes, having asthma, chronic...9, 12]. Secondly, observed FVC and FEV1 data plotted are taken under investigation. According to the questionnaire filled out, subjects... questionnaire filled in by each subject on the result of the diagnosing (categorizing FVC graphs) COPD, elimination of erroneous factors affecting

Case identification of subjects with airflow limitations using the handheld spirometer "Hi-Checker™" : comparison against an electronic desktop spirometer.

PubMed

Nishimura, Koichi; Nakayasu, Kazuhito; Kobayashi, Atsuko; Mitsuma, Satoshi

2011-12-01

Systematic case identification has been proposed as a strategy to improve diagnosis rates and to enable the early detection of subjects with COPD. We hypothesized that case identification could be possible using the handheld spirometer Hi-Checker™. To determine how to modify the FEV(1)/FEV(6) values obtained using the Hi-Checker™ to screen for cases with airflow limitation. Spirometry was performed with both an electronic desktop spirometer and with the Hi-Checker™ in 312 male subjects. The average FEV(1) (mean ± SD) measured using a conventional spirometer and the Hi-Checker™ was 2.99 ± 0.56L and 3.07 ± 0.57L, respectively. These results were significantly different (P<0.001, paired t-test for both). This difference of -0.08 ± 0.13L (95% confidence interval: -0.094-0.066L) was normally distributed, and thought to be random. Statistically significant correlations were found for all measurements between the spirometer and the Hi-Checker™ ; the Pearson's correlation coefficient (R) between the FEV(1)/FVC and FEV(1)/FEV(6) values was 0.881. If one defines a FEV(1/)FVC smaller than 0.7 measured by the spirometer as airflow limitation, then a FEV(1)/FEV(6) smaller than 0.746 measured by the Hi-Checker™ best matches this definition, and Cohen's kappa coefficient was 0.672. Although the Hi-Checker™ estimates resembled those from conventional spirometry, it should be emphasized that the two methods did not produce identical results due to random measurement error. Although one must be careful about overinterpreting these results, since the Hi-Checker™ is small and inexpensive, it could make a significant contribution in facilitating the case selection of patients with airflow limitation.

T2* measurements of 3-T MRI with ultrashort TEs: capabilities of pulmonary function assessment and clinical stage classification in smokers.

PubMed

Ohno, Yoshiharu; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Keiko; Takahashi, Masaya; Van Cauteren, Marc; Sugimura, Kazuro

2011-08-01

The purpose of this study was to determine the usefulness of MRI with ultrashort TEs on a 3-T system and of thin-section MDCT for pulmonary function assessment and clinical stage classification of chronic obstructive pulmonary disease (COPD) in smokers. Forty smokers (24 men and 16 women; mean age ± SD, 68.0 ± 9.3 years) underwent MRI with ultrashort TEs and thin-section MDCT. Pulmonary function testing was also performed to determine the following: the ratio of forced expiratory volume in 1 second to forced vital capacity (percentage predicted) (FEV(1/)FVC%), percentage predicted forced expiratory volume in 1 second (%FEV(1)), and percentage predicted diffusing capacity of lung for carbon monoxide corrected for alveolar volume (%DLCO/V(A)). All subjects were classified into one of four groups as follows: smokers without COPD, with mild COPD, with moderate COPD, and with severe or very severe COPD. T2(*) maps were expressed using proprietary software. Regional T2(*) values were determined by region of interest measurements and were averaged to determine a mean T2(*) value for each subject. CT-based functional lung volume and the ratio of the wall area to the total airway area were also determined. All indexes were statistically correlated with pulmonary function parameters. Then, all indexes were compared among all groups by means of Tukey's honest significance test. All indexes had significant correlation with FEV(1)/FVC%, %FEV(1), and % DLCO/V(A) (p < 0.05). All indexes except WA% of smokers without COPD and smokers with mild COPD differed significantly from those of smokers with moderate COPD and smokers with severe or very severe COPD (p < 0.05). Moreover, the mean T2(*) value of the moderate COPD group was significantly different from that of the severe or very severe COPD group (p < 0.05). MRI with ultrashort TEs is potentially as useful as quantitatively assessed MDCT for pulmonary function loss assessment and clinical stage classification of COPD in smokers.

Biopersistent Granular Dust and Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

PubMed Central

Brüske, Irene; Thiering, Elisabeth; Heinrich, Joachim; Huster, Katharina; Nowak, Dennis

2013-01-01

Objective Applying a systematic review to identify studies eligible for meta-analysis of the association between occupational exposure to inorganic dust and the development of chronic obstructive pulmonary disease (COPD), and conducting a meta-analysis. Data Sources Searches of PubMed and Embase for the time period 1970–2010 yielded 257 cross-sectional and longitudinal studies on people exposed to inorganic dust at the workplace with data on lung function. These studies were independently abstracted and evaluated by two authors; any disagreement was resolved by a third reviewer. Of 55 publications accepted for meta-analysis, 27 investigated the effects of occupational exposure to biopersistent granular dust (bg-dust). Methods A random effects meta-analysis allowed us to provide an estimate of the average exposure effect on spirometric parameters presented in forest plots. Between-study heterogeneity was assessed by using I2 statistics, with I2>25% indicating significant heterogeneity. Publication bias was investigated by visual inspection of funnel plots. The influence of individual studies was assessed by dropping the respective study before pooling study-specific estimates. Results The mean FEV1 of workers exposed to bg-dust was 160 ml lower or 5.7% less than predicted compared to workers with no/low exposure. The risk of an obstructive airway disease—defined as FEV1/FVC < 70%—increased by 7% per 1 mg· m-3 respirable bg-dust. Conclusion Occupational inhalative exposure to bg-dust was associated with a statistically significant decreased FEV1 and FEV1/FVC revealing airway obstruction consistent with COPD. PMID:24278358

Telemetric Detection of Chronic Obstructive Pulmonary Disease and Investigation of Quality of Life for People Working in Shipbuilding Industry

PubMed Central

Koulouri, Agoritsa; Gourgoulianis, Konstantinos; Hatzoglou, Chryssi; Roupa, Zoe

2014-01-01

ABSTRACT Introduction: Chronic Obstructive Pulmonary Disease (COPD) has a significant impact on quality of life-related health. Aim: It was the detection of Chronic Obstructive Pulmonary Disease by using telemetric methods and the investigation of the quality of life for people working in Shipbuilding Industry compared with a control group. Methods: A group of one hundred men working in the shipbuilding industry aged 51.8 ± 8.2 years old and a control group of one hundred men of the general population aged 51.1 ± 6.4 years were studied. All participants completed the General Health Questionnaire – 28, the Fagerstrom test and a form with demographic characteristics. Pulmonary function test results were electronically sent to a specialist for evaluation. Results: People working in the shipbuilding zone had significantly lower values (p<0.001) in FVC, FEV1 and FEV1/FVC compared with the general population participants. Worse social functionality was exhibited by workers in the shipbuilding zone, people with elementary education, unemployed and by those suffering from comorbidities (p <0.001). Conclusions: Health level and its individual dimensions are both associated with health self-assessment and occupational and economic status. The coexistence of chronic diseases and smoking dependence affects emotion and social functioning of individuals. PMID:25568580

Telemetric detection of chronic obstructive pulmonary disease and investigation of quality of life for people working in shipbuilding industry.

PubMed

Koulouri, Agoritsa; Gourgoulianis, Konstantinos; Hatzoglou, Chryssi; Roupa, Zoe

2014-10-01

Chronic Obstructive Pulmonary Disease (COPD) has a significant impact on quality of life-related health. It was the detection of Chronic Obstructive Pulmonary Disease by using telemetric methods and the investigation of the quality of life for people working in Shipbuilding Industry compared with a control group. A group of one hundred men working in the shipbuilding industry aged 51.8 ± 8.2 years old and a control group of one hundred men of the general population aged 51.1 ± 6.4 years were studied. All participants completed the General Health Questionnaire - 28, the Fagerstrom test and a form with demographic characteristics. Pulmonary function test results were electronically sent to a specialist for evaluation. People working in the shipbuilding zone had significantly lower values (p<0.001) in FVC, FEV1 and FEV1/FVC compared with the general population participants. Worse social functionality was exhibited by workers in the shipbuilding zone, people with elementary education, unemployed and by those suffering from comorbidities (p <0.001). Health level and its individual dimensions are both associated with health self-assessment and occupational and economic status. The coexistence of chronic diseases and smoking dependence affects emotion and social functioning of individuals.

Determinants of underdiagnosis of COPD in national and international surveys.

PubMed

Lamprecht, Bernd; Soriano, Joan B; Studnicka, Michael; Kaiser, Bernhard; Vanfleteren, Lowie E; Gnatiuc, Louisa; Burney, Peter; Miravitlles, Marc; García-Rio, Francisco; Akbari, Kaveh; Ancochea, Julio; Menezes, Ana M; Perez-Padilla, Rogelio; Montes de Oca, Maria; Torres-Duque, Carlos A; Caballero, Andres; González-García, Mauricio; Buist, Sonia

2015-10-01

COPD ranks within the top three causes of mortality in the global burden of disease, yet it remains largely underdiagnosed. We assessed the underdiagnosis of COPD and its determinants in national and international surveys of general populations. We analyzed representative samples of adults aged ≥ 40 years randomly selected from well-defined administrative areas worldwide (44 sites from 27 countries). Postbronchodilator FEV1/FVC < lower limit of normal (LLN) was used to define chronic airflow limitation consistent with COPD. Undiagnosed COPD was considered when participants had postbronchodilator FEV1/FVC < LLN but were not given a diagnosis of COPD. Among 30,874 participants with a mean age of 56 years, 55.8% were women, and 22.9% were current smokers. Population prevalence of (spirometrically defined) COPD ranged from 3.6% in Barranquilla, Colombia, to 19.0% in Cape Town, South Africa. Only 26.4% reported a previous lung function test, and only 5.0% reported a previous diagnosis of COPD, whereas 9.7% had a postbronchodilator FEV1/FVC < LLN. Overall, 81.4% of (spirometrically defined) COPD cases were undiagnosed, with the highest rate in Ile-Ife, Nigeria (98.3%) and the lowest rate in Lexington, Kentucky (50.0%). In multivariate analysis, a greater probability of underdiagnosis of COPD was associated with male sex, younger age, never and current smoking, lower education, no previous spirometry, and less severe airflow limitation. Even with substantial heterogeneity in COPD prevalence, COPD underdiagnosis is universally high. Because effective management strategies are available for COPD, spirometry can help in the diagnosis of COPD at a stage when treatment will lead to better outcomes and improved quality of life.

Decreased lung function with mediation of blood parameters linked to e-waste lead and cadmium exposure in preschool children.

PubMed

Zeng, Xiang; Xu, Xijin; Boezen, H Marike; Vonk, Judith M; Wu, Weidong; Huo, Xia

2017-11-01

Blood lead (Pb) and cadmium (Cd) levels have been associated with lower lung function in adults and smokers, but whether this also holds for children from electronic waste (e-waste) recycling areas is still unknown. To investigate the contribution of blood heavy metals and lung function levels, and the relationship among living area, the blood parameter levels, and the lung function levels, a total of 206 preschool children from Guiyu (exposed area), and Haojiang and Xiashan (reference areas) were recruited and required to undergo blood tests and lung function tests during the study period. Preschool children living in e-waste exposed areas were found to have a 1.37 μg/dL increase in blood Pb, 1.18 μg/L increase in blood Cd, and a 41.00 × 10 9 /L increase in platelet counts, while having a 2.82 g/L decrease in hemoglobin, 92 mL decrease in FVC and 86 mL decrease in FEV 1 . Each unit of hemoglobin (1 g/L) decline was associated with 5 mL decrease in FVC and 4 mL decrease in FEV 1 . We conclude that children living in e-waste exposed area have higher levels of blood Pb, Cd and platelets, and lower levels of hemoglobin and lung function. Hemoglobin can be a good predictor for lung function levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pulmonary function derangements in isolated or predominant mitral stenosis - Preoperative evaluation with clinico-hemodynamic correlation.

PubMed

Parvathy, Usha T; Rajan, Rajesh; Faybushevich, Alexander Georgevich

2014-06-01

It is well known that mitral stenosis (MS) is complicated by pulmonary hypertension (PH) of varying degrees. The hemodynamic derangement is associated with structural changes in the pulmonary vessels and parenchyma and also functional derangements. This article analyzes the pulmonary function derangements in 25 patients with isolated/predominant mitral stenosis of varying severity. THE AIM OF THE STUDY WAS TO CORRELATE THE PULMONARY FUNCTION TEST (PFT) DERANGEMENTS (DONE BY SIMPLE METHODS) WITH: a) patient demographics and clinical profile, b) severity of the mitral stenosis, and c) severity of pulmonary artery hypertension (PAH) and d) to evaluate its significance in preoperative assessment. This cross-sectional study was conducted in 25 patients with mitral stenosis who were selected for mitral valve (MV) surgery. The patients were evaluated for clinical class, echocardiographic severity of mitral stenosis and pulmonary hypertension, and with simple methods of assessment of pulmonary function with spirometry and blood gas analysis. The diagnosis and classification were made on standardized criteria. The associations and correlations of parameters, and the difference in groups of severity were analyzed statistically with Statistical Package for Social Sciences (SPSS), using nonparametric measures. THE SPIROMETRIC PARAMETERS SHOWED SIGNIFICANT CORRELATION WITH INCREASING NEW YORK HEART ASSOCIATION (NYHA) FUNCTIONAL CLASS (FC): forced vital capacity (FVC, r = -0.4*, p = 0.04), forced expiratory volume in one second (FEV1, r = -0.5*, p = 0.01), FEV1/FVC (r = -0.44*, p = 0.02), and with pulmonary venous congestion (PVC): FVC (r = -0.41*, p = 0.04) and FEV1 (r = -0.41*, p = 0.04). Cardiothoracic ratio (CTR) correlated only with FEV1 (r = -0.461*, p = 0.02) and peripheral saturation of oxygen (SPO2, r = -0.401*, p = 0.04). There was no linear correlation to duration of symptoms, mitral valve orifice area, or pulmonary hypertension, except for MV gradient with PCO2 (r = 0.594**, p = 0.002). The decreased oxygenation status correlated significantly with FC, CTR, PVC, and with deranged spirometry (r = 0.495*, p = 0.02). PFT derangements are seen in all grades of severity of MS and correlate well with the functional class, though no significant linear correlation with grades of severity of stenosis or pulmonary hypertension. Even the early or mild derangements in pulmonary function such as small airway obstruction in the less severe cases of normal or mild PH can be detected by simple and inexpensive methods when the conventional parameters are normal. The supplementary data from baseline arterial blood gas analysis is informative and relevant. This reclassified pulmonary function status might be prognostically predictive.

Lung function and left ventricular hypertrophy in morbidly obese candidates for bariatric surgery

PubMed Central

Müller, Paulo de Tarso; Domingos, Hamilton; Patusco, Luiz Armando Pereira; Rapello, Gabriel Victor Guimarães

2015-01-01

Objective: To look for correlations between lung function and cardiac dimension variables in morbidly obese patients, in order to test the hypothesis that the relative size of the small airways is independently correlated with left ventricular hypertrophy. Methods: This was a retrospective study involving 192 medical records containing a clinical protocol employed in candidates for bariatric surgery between January of 2006 and December of 2010. Results: Of the 192 patients evaluated, 39 (10 males and 29 females) met the inclusion criteria. The mean BMI of the patients was 49.2 ± 7.6 kg/m2, and the mean age was 35.5 ± 7.7 years. The FEF25-75/FVC, % correlated significantly with left ventricular posterior wall thickness and relative left ventricular posterior wall thickness, those correlations remaining statistically significant (r = −0.355 and r = −0.349, respectively) after adjustment for weight, gender, and history of systemic arterial hypertension. Stepwise multivariate linear regression analysis showed that FVC and FEV1 were the major determinants of left ventricular mass (in grams or indexed to body surface area). Conclusions: A reduction in the relative size of the small airways appears to be independently correlated with obesity-related cardiac hypertrophy, regardless of factors affecting respiratory mechanics (BMI and weight), gender, or history of systemic arterial hypertension. However, FEV1 and FVC might be important predictors of left ventricular mass in morbidly obese individuals. PMID:26578134

Effects of breathing exercises on lung capacity and muscle activities of elderly smokers.

PubMed

Jun, Hyun-Ju; Kim, Ki-Jong; Nam, Ki-Won; Kim, Chang-Heon

2016-06-01

[Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength.

Effects of breathing exercises on lung capacity and muscle activities of elderly smokers

PubMed Central

Jun, Hyun-Ju; Kim, Ki-Jong; Nam, Ki-Won; Kim, Chang-Heon

2016-01-01

[Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength. PMID:27390394

Indoor Air Quality and Respiratory Health among Malay Preschool Children in Selangor.

PubMed

Rawi, Nur Azwani Mohd Nor; Jalaludin, Juliana; Chua, Poh Choo

2015-01-01

Indoor air quality (IAQ) has been the object of several studies due to its adverse health effects on children. Methods. A cross-sectional comparative study was carried out among Malay children in Balakong (2 studied preschools) and Bangi (2 comparative preschools), Selangor, with the aims of determining IAQ and its association with respiratory health. 61 and 50 children aged 5-6 years were selected as studied and comparative groups. A questionnaire was used to obtain an exposure history and respiratory symptoms. Lung function test was carried out. IAQ parameters obtained include indoor concentration of particulate matter (PM), volatile organic compounds (VOCs), carbon monoxide (CO), carbon dioxide (CO2), temperature, air velocity (AV), and relative humidity. Results. There was a significant difference between IAQ in studied and comparative preschools for all parameters measured (P < 0.001) except for CO2 and AV. Studied preschools had higher PM and CO concentration. FVC, FEV1, FVC% and FEV1% predicted values were significantly lower among studied group. Exposures to PM, VOCs, and CO were associated with wheezing. Conclusion. The finding concluded that exposures to poor IAQ might increase the risk of getting lung function abnormality and respiratory problems among study respondents.

Indoor Air Quality and Respiratory Health among Malay Preschool Children in Selangor

PubMed Central

Chua, Poh Choo

2015-01-01

Indoor air quality (IAQ) has been the object of several studies due to its adverse health effects on children. Methods. A cross-sectional comparative study was carried out among Malay children in Balakong (2 studied preschools) and Bangi (2 comparative preschools), Selangor, with the aims of determining IAQ and its association with respiratory health. 61 and 50 children aged 5-6 years were selected as studied and comparative groups. A questionnaire was used to obtain an exposure history and respiratory symptoms. Lung function test was carried out. IAQ parameters obtained include indoor concentration of particulate matter (PM), volatile organic compounds (VOCs), carbon monoxide (CO), carbon dioxide (CO2), temperature, air velocity (AV), and relative humidity. Results. There was a significant difference between IAQ in studied and comparative preschools for all parameters measured (P < 0.001) except for CO2 and AV. Studied preschools had higher PM and CO concentration. FVC, FEV1, FVC% and FEV1% predicted values were significantly lower among studied group. Exposures to PM, VOCs, and CO were associated with wheezing. Conclusion. The finding concluded that exposures to poor IAQ might increase the risk of getting lung function abnormality and respiratory problems among study respondents. PMID:25984527

Spirometry and volumetric capnography in lung function assessment of obese and normal-weight individuals without asthma.

PubMed

Ferreira, Mariana S; Mendes, Roberto T; Marson, Fernando A L; Zambon, Mariana P; Antonio, Maria A R G M; Paschoal, Ilma A; Toro, Adyléia A D C; Severino, Silvana D; Ribeiro, Maria A G O; Ribeiro, José D

To analyze and compare lung function of obese and healthy, normal-weight children and adolescents, without asthma, through spirometry and volumetric capnography. Cross-sectional study including 77 subjects (38 obese) aged 5-17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV 1 /FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p<0.05). Volumetric capnography showed that obese individuals had a higher volume of produced carbon dioxide and alveolar tidal volume (p<0.05). Additionally, the associations between dead space volume and tidal volume, as well as phase-3 slope normalized by tidal volume, were lower in healthy subjects (p<0.05). These data suggest that obesity does not alter ventilation homogeneity, but flow homogeneity. After subdividing the groups by age, a greater difference in lung function was observed in obese and healthy individuals aged >11 years (p<0.05). Even without the diagnosis of asthma by clinical criteria and without response to bronchodilator use, obese individuals showed lower FEV 1 /FVC values and forced expiratory flow, indicating the presence of an obstructive process. Volumetric capnography showed that obese individuals had higher alveolar tidal volume, with no alterations in ventilation homogeneity, suggesting flow alterations, without affecting lung volumes. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Effects of Exercise Rehab on Male Asthmatic Patients: Aerobic Verses Rebound Training

PubMed Central

Zolaktaf, Vahid; Ghasemi, Gholam A; Sadeghi, Morteza

2013-01-01

Background: There are some auspicious records on applying aerobic exercise for asthmatic patients. Recently, it is suggested that rebound exercise might even increase the gains. This study was designed to compare the effects of rebound therapy to aerobic training in male asthmatic patients. Methods: Sample included 37 male asthmatic patients (20-40 years) from the same respiratory clinic. After signing the informed consent, subjects volunteered to take part in control, rebound, or aerobic groups. There was no change in the routine medical treatment of patients. Supervised exercise programs continued for 8 weeks, consisting of two sessions of 45 to 60 minutes per week. Criteria measures were assessed pre- and post exercise program. Peak exercise capacity (VO2peak) was estimated by modified Bruce protocol, Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), and FEV1% were measured by spirometer. Data were analyzed by repeated measure analysis of variance (ANOVA). Results: Significant interactions were observed for all 4 criteria measures (P < 0.01), meaning that both the exercise programs were effective in improving FVC, FEV1, FEV1%, and VO2peak. Rebound exercise produced more improvement in FEV1, FEV1%, and VO2peak. Conclusions: Regular exercise strengthens the respiratory muscles and improves the cellular respiration. At the same time, it improves the muscular, respiratory, and cardio-vascular systems. Effects of rebound exercise seem to be promising. Findings suggest that rebound exercise is a useful complementary means for asthmatic male patients. PMID:23717762

Indoor NO2 air pollution and lung function of professional cooks.

PubMed

Arbex, M A; Martins, L C; Pereira, L A A; Negrini, F; Cardoso, A A; Melchert, W R; Arbex, R F; Saldiva, P H N; Zanobetti, A; Braga, A L F

2007-04-01

Studies of cooking-generated NO2 effects are rare in occupational epidemiology. In the present study, we evaluated the lung function of professional cooks exposed to NO2 in hospital kitchens. We performed spirometry in 37 cooks working in four hospital kitchens and estimated the predicted FVC, FEV1 and FEF(25-75), based on age, sex, race, weight, and height, according to Knudson standards. NO2 measurements were obtained for 4 consecutive days during 4 different periods at 20-day intervals in each kitchen. Measurements were performed inside and outside the kitchens, simultaneously using Palm diffusion tubes. A time/exposure indicator was defined as representative of the cumulative exposure of each cook. No statistically significant effect of NO2 exposure on FVC was found. Each year of work as a cook corresponded to a decrease in predicted FEV1 of 2.5% (P = 0.046) for the group as a whole. When smoking status and asthma were included in the analysis the effect of time/exposure decreased about 10% and lost statistical significance. On predicted FEF(25-75), a decrease of 3.5% (P = 0.035) was observed for the same group and the inclusion of controllers for smoking status and asthma did not affect the effects of time/exposure on pulmonary function parameter. After a 10-year period of work as cooks the participants of the study may present decreases in both predicted FEV1 and FEF(25-75) that can reach 20 and 30%, respectively. The present study showed small but statistically significant adverse effects of gas stove exposure on the lung function of professional cooks.

Effects of ambient ozone on respiratory function and symptoms in Mexico City schoolchildren

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castillejos, M.; Gold, D.R.; Dockery, D.

1992-02-01

The effects of ambient ozone (O3) on respiratory function and acute respiratory symptoms were evaluated in 143 7- to 9-yr-old schoolchildren followed longitudinally at 1- to 2-wk intervals over a period of 6 months at three schools in Pedregal, Mexico City. The maximum O3 level exceeded the World Health Organization guideline of 80 ppb and the U.S. standard of 120 ppb in every week. For an increase from lowest to highest in the mean O3 level during the 48 hr before spirometry (53 ppb), logistic regression estimated relative odds of 1.7 for a child reporting cough/phlegm on the day ofmore » spirometry. For the full population, the mean O3 level during the hour before spirometry, not adjusted for temperature and humidity, predicted a significant decrement in FVC but not in FEV1 or FEF25-75. In contrast, the mean O3 level during the previous 24-, 48-, and 168-h periods predicted significant decrements in FEV1 and FEF25-75 but not in FVC. Ozone was consistently associated with a greater decrement in lung function for the 15 children with chronic phlegm as compared with the children without chronic cough, chronic phlegm, or wheeze. Ozone in the previous 24-, 48-, and 168-h periods predicted decrements in FEV1 for children of mothers who were current or former smokers, but not for children of mothers who were never smokers. Many of these effects were reduced in multiple regression analyses including temperature and humidity, as temperature and O3 were highly correlated.« less

Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome.

PubMed

Bui, Dinh S; Burgess, John A; Lowe, Adrian J; Perret, Jennifer L; Lodge, Caroline J; Bui, Minh; Morrison, Stephen; Thompson, Bruce R; Thomas, Paul S; Giles, Graham G; Garcia-Aymerich, Judith; Jarvis, Debbie; Abramson, Michael J; Walters, E Haydn; Matheson, Melanie C; Dharmage, Shyamali C

2017-07-01

The burden of chronic obstructive pulmonary disease (COPD) is increasing, yet there are limited data on early life risk factors. To investigate the role of childhood lung function in adult COPD phenotypes. Prebronchodilator spirometry was performed for a cohort of 7-year-old Tasmanian children (n = 8,583) in 1968 who were resurveyed at 45 years, and a selected subsample (n = 1,389) underwent prebronchodilator and post-bronchodilator spirometry. For this analysis, COPD was spirometrically defined as a post-bronchodilator FEV 1 /FVC less than the lower limit of normal. Asthma-COPD overlap syndrome (ACOS) was defined as the coexistence of both COPD and current asthma. Associations between childhood lung function and asthma/COPD/ACOS were examined using multinomial regression. At 45 years, 959 participants had neither current asthma nor COPD (unaffected), 269 had current asthma alone, 59 had COPD alone, and 68 had ACOS. The reweighted prevalence of asthma alone was 13.5%, COPD alone 4.1%, and ACOS 2.9%. The lowest quartile of FEV 1 at 7 years was associated with ACOS (odds ratio, 2.93; 95% confidence interval, 1.32-6.52), but not COPD or asthma alone. The lowest quartile of FEV 1 /FVC ratio at 7 years was associated with ACOS (odds ratio, 16.3; 95% confidence interval, 4.7-55.9) and COPD (odds ratio, 5.76; 95% confidence interval, 1.9-17.4), but not asthma alone. Being in the lowest quartile for lung function at age 7 may have long-term consequences for the development of COPD and ACOS by middle age. Screening of lung function in school age children may identify a high-risk group that could be targeted for intervention. Further research is needed to understand possible modifiers of these associations and develop interventions for children with impaired lung function.

The effect of scoliosis surgery on pulmonary function in spinal muscular atrophy type II patients.

PubMed

Chou, Shih-Hsiang; Lin, Gau-Tyan; Shen, Po-Chih; Lue, Yi-Jing; Lu, Cheng-Chang; Tien, Yin-Chun; Lu, Yen-Mou

2017-06-01

Various results of the previous literature related to surgical effect on pulmonary function of spinal muscular atrophy (SMA) patients might be due to different SMA type, different fusion level and technique. The aim of this study was to determine the value of scoliosis surgery for SMA type II patients with regard to pulmonary function, under the same fusion level, fusion technique and average long-term follow-up. Ten SMA II patients who underwent spinal correction procedures from 1993 to 2010 were identified. Data on clinical features and pulmonary function, including forced vital capacity (FVC) and forced expiratory volume in 1st second (FEV 1 ), were collected. The data on pulmonary function were divided into preoperative, postoperative short-term (0-5 years), mid-term (5-10 years), and long-term (>10 years). Statistical comparisons were made using the Wilcoxon test for pulmonary function and body weight analysis. Questions were answered by parents on how surgery influenced the frequency of respiratory infection and the ability to sit at school. The average length of postoperative pulmonary function follow-up was 12.3 years (range 4.9-15.9 years). There was no significant difference in FVC or FEV 1 between preoperative and each postoperative period. However, a significant decline from mid-term to long-term was observed (p = 0.028). Body weight increased significantly in all postoperative periods and was moderately correlated to pulmonary function (r = 0.526 for FVC). The answers to the questionnaire revealed that 80% of the patients had obvious improvement in the frequency of respiratory infection and 100% were tolerable sitting at school. Surgical correction for scoliosis in SMA II patients results in pulmonary function being maintained during long-term follow-up. In addition, the advantages of surgery also include body weight gain, better sitting tolerance, and reduced frequency of respiratory infection.

Factors Affecting Lung Function: A Review of the Literature.

PubMed

Talaminos Barroso, Alejandro; Márquez Martín, Eduardo; Roa Romero, Laura María; Ortega Ruiz, Francisco

2018-06-01

Lung function reference values are traditionally based on anthropometric factors, such as weight, height, sex, and age. FVC and FEV 1 decline with age, while volumes and capacities, such as RV and FRC, increase. TLC, VC, RV, FVC and FEV 1 are affected by height, since they are proportional to body size. This means that a tall individual will experience greater decrease in lung volumes as they get older. Some variables, such as FRC and ERV, decline exponentially with an increase in weight, to the extent that tidal volume in morbidly obese patients can be close to that of RV. Men have longer airways than women, causing greater specific resistance in the respiratory tract. The increased work of breathing to increase ventilation among women means that their consumption of oxygen is higher than men under similar conditions of physical intensity. Lung volumes are higher when the subject is standing than in other positions. DLCO is significantly higher in supine positions than in sitting or standing positions, but the difference between sitting and standing positions is not significant. Anthropometric characteristics are insufficient to explain differences in lung function between different ethnic groups, underlining the importance of considering other factors in addition to the conventional anthropometric measurements. Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Lung function and blood markers of nutritional status in non-COPD aging men with smoking history: a cross-sectional study.

PubMed

Shiozawa, Nobuyoshi; Hayashimoto, Kanae; Suzuki, Etsuji; Kikuchi, Hiroshi; Takata, Shingo; Ashida, Kozo; Watanabe, Masutaka; Hosaki, Yasuhiro; Mitsunobu, Fumihiro

2010-08-09

Cigarette smoking and advanced age are well known as risk factors for chronic obstructive pulmonary disease (COPD), and nutritional abnormalities are important in patients with COPD. However, little is known about the nutritional status in non-COPD aging men with smoking history. We therefore investigated whether reduced lung function is associated with lower blood markers of nutritional status in those men. This association was examined in a cross-sectional study of 65 Japanese male current or former smokers aged 50 to 80 years: 48 without COPD (non-COPD group), divided into tertiles according to forced expiratory volume in one second as percent of forced vital capacity (FEV(1)/FVC), and 17 with COPD (COPD group). After adjustment for potential confounders, lower FEV(1)/FVC was significantly associated with lower red blood cell count (RBCc), hemoglobin, and total protein (TP); not with total energy intake. The difference in adjusted RBCc and TP among the non-COPD group tertiles was greater than that between the bottom tertile in the non-COPD group and the COPD group. In non-COPD aging men with smoking history, trends toward reduced nutritional status and anemia may independently emerge in blood components along with decreased lung function even before COPD onset.

Maintenance of stellite and tungsten carbide saw tips: respiratory health and exposure-response evaluations.

PubMed Central

Kennedy, S M; Chan-Yeung, M; Marion, S; Lea, J; Teschke, K

1995-01-01

OBJECTIVE--To study exposure to cobalt and chromium in saw maintenance rooms and test respiratory health among saw filers at lumber mills. Hard-metal lung disease is associated with cobalt in the manufacture of tungsten carbide tools; recently it has also been reported among tool maintenance workers. Lumber mills often use saws tipped with tungsten carbide or with a newer alloy, stellite (containing more cobalt, as well as chromium). METHODS--A cross sectional study of 118 saw filers at eight lumber mills was carried out that included a standardised questionnaire, spirometry, personal air sampling, and examination of tasks every 10 minutes (by observation). Comparison data were from a study of bus mechanics tested with similar methods. RESULTS AND CONCLUSION--Cobalt exposure was associated with tungsten carbide grinding but not with stellite grinding. Chromium exposure was associated mainly with stellite welding. Saw filers had a twofold increase in phlegm and wheeze (P < 0.01) and a threefold increase in cough, phlegm, and wheeze related to work (P < 0.001), but no increase in breathlessness. Stellite welding was associated with a significant increase in nasal symptoms and cough related to work and a small decrease in airflow (forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), P < 0.05). Saw filers wet grinding with tungsten carbide had significant reductions in forced expiratory lung volumes (FEV1 and FVC, P < 0.05) and were significantly more likely to have FEV1 and FVC values in the abnormal range. Cobalt exposure (in wet grinding) and duration of work that involved tungsten carbide grinding were both associated with significant reductions in FEV1 and FVC. Average cobalt exposures in this study were about 5 micrograms/m3, well below the currently accepted permissible concentration, which suggests that the current workplace limit for cobalt may be too high. PMID:7735392

Ozone exposure, antioxidant genes, and lung function in an elderly cohort: VA Normative Aging Study

PubMed Central

Alexeeff, Stacey E.; Litonjua, Augusto A.; Wright, Robert O.; Baccarelli, Andrea; Suh, Helen; Sparrow, David; Vokonas, Pantel S.; Schwartz, Joel

2008-01-01

Background Ozone exposure is known to cause oxidative stress. We investigated the acute effects of ozone (O3) on lung function in the elderly, a suspected risk group. We then investigated whether genetic polymorphisms of antioxidant genes (heme oxygenase-1 [HMOX1] and glutathione S-transferase pi [GSTP1]) modified these associations. Methods We studied 1,100 elderly men from the Normative Aging Study whose lung function (forced vital capacity [FVC] and forced expiratory volume in one second [FEV1]) was measured every 3 years from 1995–2005. We genotyped the GSTP1 Ile105Val and Ala114Val polymorphisms and the (GT)n repeat polymorphism in the HMOX1 promoter, classifying repeats as short (n<25) or long (n 25). Ambient O3 was measured continuously at locations in the Greater Boston area. We used mixed linear models, adjusting for known confounders. Results A 15 ppb increase in O3 during the previous 48 hours was associated with a 1.25% decrease in FEV1 (95% CI: −1.96%, −0.54%). This estimated effect was worsened with either the presence of a long (GT)n repeat in HMOX1 (−1.38%, 95% CI: −2.11%, −0.65) or the presence of an allele coding for Val105 in GSTP1 (−1.69%, 95% CI: −2.63%, −0.75). A stronger estimated effect of O3 on FEV1 was found in subjects carrying both the GSTP1 105Val variant and the HMOX1 long (GT)n repeat (−1.94%, 95% CI: −2.89%, −0.98%). Similar associations were also found between FVC and ozone exposure. Conclusions Our results suggest that ozone has an acute effect on lung function in the elderly, and the effects may be modified by the presence of specific polymorphisms in antioxidant genes. PMID:18524839

Spirometric reference values in urban children in Madagascar: poverty is a risk factor for low lung function.

PubMed

Wolff, Peter Th; Arison, Lala; Rahajamiakatra, Abel; Raserijaona, Francis; Niggemann, Bodo

2014-01-01

Studies about children with respiratory diseases in Africa are impeded by the dearth of reliable data for the vast majority of countries on the continent. This study was conducted to establish representative reference values, therefore allowing a more accurate evaluation of lung function in Malagasy children. One thousand two hundred thirty-six students from three public and five private schools aged 8-12 years were recruited. A total of 1,093 children were healthy, had a valid lung function measurement and were thus deemed evaluable for this study. Lung function data were collected on consecutive days in Antananarivo, Madagascar's capital, using spirometry and a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The lung volumes found were substantially lower compared to Caucasian and African equations. The mean Z-score (Stanojevic) for the forced vital capacity (FVC) found was -1.45 and -0.93 for the forced expiratory volume in 1 sec (FEV1) with significant differences between private and public schools (FVC: P = 0.0023, FEV1: P = 0.0004). The equations established for school children in Madagascar's capital Antananarivo showed lung function values were lower than reference values for the same age group seen not only in European, but also in African American and African children. The unique ethnicity of the Malagasy people, which combines Southeast-Asian with substantial African influences, the heavy burden of pollution and poverty may explain these differences. © 2013 Wiley Periodicals, Inc.

Impact of continuous positive airway pressure on the pulmonary changes promoted by immersion in water

PubMed Central

Rizzetti, Danize Aparecida; Quadros, Janayna Rodembuch Borba; Ribeiro, Bruna Esmerio; Callegaro, Letícia; Veppo, Aline Arebalo; Wiggers, Giulia Alessandra; Peçanha, Franck Maciel

2017-01-01

ABSTRACT Objective: To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. Methods: This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP); CPAP5 (CPAP at 5 cmH2O); and CPAP10 (CPAP at 10 cmH2O). We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expiratory flow rate (PEFR), and FEF25-75%) at three time points: pre-immersion; 10 min after immersion; and 10 min after the end of each protocol. Results: We evaluated 13 healthy volunteers. The CPAP10 protocol reversed the restrictive pattern of lung function induced by immersion in water, maintaining pulmonary volumes and capacities for a longer period than did the CPAP5 protocol. Conclusions: When the hemodynamic change causing a persistent lung disorder, only the application of higher positive pressures is effective in maintaining long-term improvements in the pulmonary profile. PMID:29340488

Effects of Pilates mat exercises on muscle strength and on pulmonary function in patients with cystic fibrosis*

PubMed Central

Franco, Caroline Buarque; Ribeiro, Antonio Fernando; Morcillo, André Moreno; Zambon, Mariana Porto; Almeida, Marina Buarque; Rozov, Tatiana

2014-01-01

OBJECTIVE: To analyze the effects of Pilates mat exercises in patients with cystic fibrosis (CF). METHODS: This was a clinical trial involving 19 CF patients recruited from either the CF Outpatient Clinic of the State University at Campinas Hospital de Clínicas or the Children's Institute of the University of São Paulo School of Medicine Hospital das Clínicas. All of the patients performed Pilates mat exercises for four months (one 60-min session per week). The variables studied (before and after the intervention) were respiratory muscle strength, MIP, MEP, FVC, and FEV1. RESULTS: After the intervention, MIP was significantly higher in the male patients (p = 0.017), as were MIP and MEP in the female patients (p = 0.005 and p = 0.007, respectively). There were no significant differences between the pre- and post-intervention values of FVC or FEV1, neither in the sample as a whole nor among the patients of either gender. CONCLUSIONS: Our results show that Pilates mat exercises have beneficial effects on respiratory muscle strength in CF patients. PMID:25410840

Impact of continuous positive airway pressure on the pulmonary changes promoted by immersion in water.

PubMed

Rizzetti, Danize Aparecida; Quadros, Janayna Rodembuch Borba; Ribeiro, Bruna Esmerio; Callegaro, Letícia; Veppo, Aline Arebalo; Wiggers, Giulia Alessandra; Peçanha, Franck Maciel

2017-01-01

To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP); CPAP5 (CPAP at 5 cmH2O); and CPAP10 (CPAP at 10 cmH2O). We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expiratory flow rate (PEFR), and FEF25-75%) at three time points: pre-immersion; 10 min after immersion; and 10 min after the end of each protocol. We evaluated 13 healthy volunteers. The CPAP10 protocol reversed the restrictive pattern of lung function induced by immersion in water, maintaining pulmonary volumes and capacities for a longer period than did the CPAP5 protocol. When the hemodynamic change causing a persistent lung disorder, only the application of higher positive pressures is effective in maintaining long-term improvements in the pulmonary profile.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Archer, V.E.; Fullmer, C.D.; Castle, C.H.

Although acute effects from exposure to SO/sub 2/ have frequently been observed at low levels in acute exposure experimental studies, it was not known whether or not such effects occur among workers chronically exposed at ranges of 0.3 to 4 ppM of SO/sub 2/. Measurements of FVC, FEV/sub 1/, FEF/sub 50/, FEF/sub 75/ and FEF/sub 50-75/, and closing volume were made before and after the workshift for copper smelter workers and controls. Sputum samples for cytological examination were collected. Mean FEV/sub 1/ and FVC were significantly decreased during a day's work in the smelter. Significantly more smelter workers had amore » decrease in FEV/sub 1/ and FEF/sub 50/ during the day than did controls. More of the smelter workers felt chest tightness. No change in closing volumes was seen. Smelter workers tended to have a higher percentage of sputum samples with moderate and marked atypia than did controls but the difference was not statistically significant.« less

Pulmonary testing using peak flow meters of very low birth weight children born in the perisurfactant era and school controls at age 10 years.

PubMed

Palta, Mari; Sadek-Badawi, Mona; Madden, Kathleen; Green, Christopher

2007-09-01

We determined lung function at age 10 years in very low birthweight (VLBW,

Sarcoidosis in children: HRCT findings and correlation with pulmonary function tests.

PubMed

Sileo, C; Epaud, R; Mahloul, M; Beydon, N; Elia, D; Clement, A; Le Pointe, H Ducou

2014-12-01

High-resolution computed tomography (HRCT) plays an important role in the diagnosis and staging of pulmonary sarcoidosis, but implies radiation exposure. In this light, we aimed to describe HRCT findings as well as their relationship with pulmonary function tests (PFT) in children with pulmonary sarcoidosis. In a retrospective study, 18 pediatric patients with sarcoidosis, including 12 with pulmonary abnormalities (PA group) and 6 without pulmonary abnormalities (APA group) were followed over a 16-year period. Relationships between HRCT scores and PFT were studied by non-parametric Spearman's test at diagnosis and by restricted maximum likelihood (REML) analysis during follow-up. Forty-three HRCT were scored. Twelve patients showed abnormal HRCT findings at diagnosis with multiple nodules or micronodules, while ground-glass opacities were seen in 11 patients. Ten patients exhibited pleural thickening or thickening of the fissure and 6 had interlobular septal thickening at diagnosis. No correlation between HRCT and forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), forced expiratory flow during the mid-half of the FVC (FEF(25-75)) and specific dynamical compliance (SpecC(Ldyn)) was found at diagnosis. However, linear mixed models showed that changes in total HRCT scores over time were significantly associated with SpecC(Ldyn), FVC, and FEV1 modifications. Radiologic findings in children with pulmonary sarcoidosis were similar to those in adults. HRCT and PFT are both essential investigations at diagnosis; however, the correlation between HRCT pulmonary parenchymal findings and PFT over time suggests the possibility of reducing the number of HRCT during follow-up to decrease unnecessary radiation exposure. © 2013 Wiley Periodicals, Inc.

Pulmonary functions in patients with subclinical hypothyroidism.

PubMed

Cakmak, Gulfidan; Saler, Tayyibe; Saglam, Zuhal Aydan; Yenigun, Mustafa; Ataoglu, Esra; Demir, Tuncalp; Temiz, Levent Umit

2011-10-01

To determine whether alterations in pulmonary function takes place in subclinical hypothyroidism by examining the diffusion lung capacity and muscle strength of such patients. This is a descriptive study conducted in 2009 at Haseki Training and Research Hospital, Istanbul, Turkey. Hundred and twenty-six patients with subclinical hypothyroidism and 58 age and sex matched individuals were recruited. Simple spirometry tests were performed, and pulmonary diffusion capacity (DLco) and muscle strength were measured. ScH patients showed a significant reduciton of the following pulmonary function tests (% predicted value) as compared with control subjects: FVC, FEV1, FEV1%, FEF25-75, FEF25-75%, DLco, DLco/VA, Pimax, Pimax% and Pemax%. These data indicate that pulmonary functions are effected in subclinical hypothyrodism. Therefore patients with or who are at high risk of having subclinical hypothyroidism, should be subjected to evaluation of pulmonary functions with simple spirometry.

Improved correlation between CT emphysema quantification and pulmonary function test by density correction of volumetric CT data based on air and aortic density.

PubMed

Kim, Song Soo; Seo, Joon Beom; Kim, Namkug; Chae, Eun Jin; Lee, Young Kyung; Oh, Yeon Mok; Lee, Sang Do

2014-01-01

To determine the improvement of emphysema quantification with density correction and to determine the optimal site to use for air density correction on volumetric computed tomography (CT). Seventy-eight CT scans of COPD patients (GOLD II-IV, smoking history 39.2±25.3 pack-years) were obtained from several single-vendor 16-MDCT scanners. After density measurement of aorta, tracheal- and external air, volumetric CT density correction was conducted (two reference values: air, -1,000 HU/blood, +50 HU). Using in-house software, emphysema index (EI) and mean lung density (MLD) were calculated. Differences in air densities, MLD and EI prior to and after density correction were evaluated (paired t-test). Correlation between those parameters and FEV1 and FEV1/FVC were compared (age- and sex adjusted partial correlation analysis). Measured densities (HU) of tracheal- and external air differed significantly (-990 ± 14, -1016 ± 9, P<0.001). MLD and EI on original CT data, after density correction using tracheal- and external air also differed significantly (MLD: -874.9 ± 27.6 vs. -882.3 ± 24.9 vs. -860.5 ± 26.6; EI: 16.8 ± 13.4 vs. 21.1 ± 14.5 vs. 9.7 ± 10.5, respectively, P<0.001). The correlation coefficients between CT quantification indices and FEV1, and FEV1/FVC increased after density correction. The tracheal air correction showed better results than the external air correction. Density correction of volumetric CT data can improve correlations of emphysema quantification and PFT. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Comparative study of lung functions in women working in different fibre industries.

PubMed

Khanam, F; Islam, N; Hai, M A

2008-07-01

A cross sectional work has been done on Bangladeshi females, working in different fibre industries, to study the effect of exposure to fibre dust on pulmonary functions. The ventilatory capacities were measured by VMI ventilometer in 653 apparently healthy women (160, 162 and 167 were jute, textile and garment industry workers, respectively). For the controls 164 females were recruited who never worked in any fibre industry. The observed FVC, FEV1 and PEFR were lower in all groups of fibre industry workers than those of the control. Among the industry workers, the jute mill workers had the lowest ventilatory capacities and garment industry workers had the highest values. The jute and textile mill workers had also significantly lower FEV1 and PEFR than those of garment industry workers. The FEV1 and PEFR were significantly lower in jute mill workers than those of textile ill workers. The low ventilatory capacities were almost proportionate with the length of service of the workers. Thus, the present study indicates that the fibre dust, on regular exposure for longer duration, may limit the lung functions.

Clinical relevance of fixed ratio vs lower limit of normal of FEV1/FVC in COPD: patient-reported outcomes from the CanCOLD cohort.

PubMed

van Dijk, Wouter; Tan, Wan; Li, Pei; Guo, Best; Li, Summer; Benedetti, Andrea; Bourbeau, Jean

2015-01-01

The way in which spirometry is interpreted can lead to misdiagnosis of chronic obstructive pulmonary disease (COPD) resulting in inappropriate treatment. We compared the clinical relevance of 2 criteria for defining a low ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC): the fixed ratio and the lower limit of normal. We analyzed data from the cross-sectional phase of the population-based Canadian Cohort of Obstructive Lung Disease (CanCOLD) study. We determined associations of the spirometric criteria for airflow limitation with patient-reported adverse outcomes, including respiratory symptoms, disability, health status, exacerbations, and cardiovascular disease. Sensitivity analyses were used to explore the impact of age and severity of airflow limitation on these associations. We analyzed data from 4,882 patients aged 40 years and older. The prevalence of airflow limitation was 17% by fixed ratio and 11% by lower limit of normal. Patients classified as having airflow limitation by fixed ratio only had generally small, nonsignificant increases in the odds of adverse outcomes. Patients having airflow limitation based on both fixed ratio and lower limit of normal had larger, significant increases in odds. But strongest associations were seen for patients who had airflow limitation by both fixed ratio and lower limit of normal and also had a low FEV1, defined as one less than 80% of the predicted value. Our results suggest that use of the fixed ratio alone may lead to misdiagnosis of COPD. A diagnosis established by both a low FEV1/FVC (according to fixed ratio and/or lower limit of normal) and a low FEV1 is strongly associated with clinical outcomes. Guidelines should be reconsidered to require both spirometry abnormalities so as to reduce overdiagnosis of COPD. © 2015 Annals of Family Medicine, Inc.

Plasma pro-surfactant protein B and lung function decline in smokers.

PubMed

Leung, Janice M; Mayo, John; Tan, Wan; Tammemagi, C Martin; Liu, Geoffrey; Peacock, Stuart; Shepherd, Frances A; Goffin, John; Goss, Glenwood; Nicholas, Garth; Tremblay, Alain; Johnston, Michael; Martel, Simon; Laberge, Francis; Bhatia, Rick; Roberts, Heidi; Burrowes, Paul; Manos, Daria; Stewart, Lori; Seely, Jean M; Gingras, Michel; Pasian, Sergio; Tsao, Ming-Sound; Lam, Stephen; Sin, Don D

2015-04-01

Plasma pro-surfactant protein B (pro-SFTPB) levels have recently been shown to predict the development of lung cancer in current and ex-smokers, but the ability of pro-SFTPB to predict measures of chronic obstructive pulmonary disease (COPD) severity is unknown. We evaluated the performance characteristics of pro-SFTPB as a biomarker of lung function decline in a population of current and ex-smokers. Plasma pro-SFTPB levels were measured in 2503 current and ex-smokers enrolled in the Pan-Canadian Early Detection of Lung Cancer Study. Linear regression was performed to determine the relationship of pro-SFTPB levels to changes in forced expiratory volume in 1 s (FEV1) over a 2-year period as well as to baseline FEV1 and the burden of emphysema observed in computed tomography (CT) scans. Plasma pro-SFTPB levels were inversely related to both FEV1 % predicted (p=0.024) and FEV1/forced vital capacity (FVC) (p<0.001), and were positively related to the burden of emphysema on CT scans (p<0.001). Higher plasma pro-SFTPB levels were also associated with a more rapid decline in FEV1 at 1 year (p=0.024) and over 2 years of follow-up (p=0.004). Higher plasma pro-SFTPB levels are associated with increased severity of airflow limitation and accelerated decline in lung function. Pro-SFTPB is a promising biomarker for COPD severity and progression. Copyright ©ERS 2015.

The Effect of Defining Chronic Obstructive Pulmonary Disease by the Lower Limit of Normal of FEV1/FVC Ratio in Tiotropium Safety and Performance in Respimat Participants.

PubMed

Calverley, Peter M A; Mueller, Achim; Fowler, Andrew; Metzdorf, Norbert; Wise, Robert A

2018-02-01

There is continuing debate about whether to define airflow obstruction by a post-bronchodilator ratio of forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity (FVC) below 0.70, or by ratio values falling below the age-dependent lower limit of normal (LLN) derived from general population data. To determine whether using the LLN criterion affects the classification and outcomes of patients previously defined as having chronic obstructive pulmonary disease by the fixed FEV 1 /FVC ratio. We applied the LLN definition to pooled data from the Tiotropium Safety and Performance in Respimat study that used the fixed FEV 1 /FVC ratio for the clinical diagnosis of chronic obstructive pulmonary disease. A total of 17,072 patients were analyzed; of these, 1,807 (10.6%) patients had a ratio greater than or equal to LLN. Patients with a ratio greater than or equal to LLN had similar risks of death from any cause and fatal major adverse cardiovascular (CV) event as those below LLN. Patients with a ratio below LLN had a significantly lower risk of major adverse CV events (hazard ratio = 0.69; 95% confidence interval [CI] = 0.55-0.86; P = 0.001), and had significantly greater risks of moderate to severe exacerbation (rate ratio = 1.48; 95% CI = 1.36-1.61; P < 0.0001) and severe exacerbation (rate ratio = 2.01; 95% CI = 1.68-2.40; P < 0.0001) when compared with patients greater than or equal to LLN. Study outcomes by treatment arm (5 μg tiotropium Respimat vs. 18 μg HandiHaler) were comparable. Using the LLN to define airflow obstruction would have excluded patients in the Tiotropium Safety and Performance in Respimat study with a higher risk of nonfatal major adverse CV events and a lower risk of exacerbation; study outcomes by treatment arm (2.5 μg/5 μg tiotropium Respimat vs. 18 μg HandiHaler) remained similar. Clinical trial registered with www.clinicaltrials.gov (NCT01126437).

Association between cytochrome P450 3A5 polymorphism and the lung function in Saskatchewan grain workers.

PubMed

Seo, Takayuki; Pahwa, Punam; McDuffie, Helen H; Yurube, Keigo; Egoshi, Masayoshi; Umemoto, Yuichiro; Ghosh, Sunita; Fukushima, Yumi; Nakagawa, Kazuko

2008-06-01

The activity of the enzymes that metabolize tobacco smoke may affect the susceptibility to chronic obstructive pulmonary disease (COPD). Cytochrome P450 (CYP) 3A5 is expressed selectively over CYP3A4 in human lung, but the association between the CYP3A5 polymorphisms and the airway injury is unknown. Two hundred and six male Saskatchewan grain workers participated in this longitudinal study, and their lung function values of forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC), respiratory symptoms, smoking status, and the occupational history were analyzed. A significant interactive effect was observed between the CYP3A5 genotype and current smoking status on FEV1, and the annual decline rates of FEV1 and FVC in current smokers were greater among CYP3A5*1/*3 carriers than CYP3A5*3/*3 carriers (-48.7+/-16.4 vs. -31.5+/-4.7 ml/years, P=0.02; -27.4+/-18.9 vs. -5.8+/-6.5 ml/years, P=0.04). The incidences of chronic cough and COPD were also higher in current smokers with CYP3A5*1/*3 than in nonsmokers and current smokers with CYP3A5*3/*3. The adjusted odds ratios for chronic cough and COPD current smokers with CYP3A5*1/*3 versus nonsmokers with the CYP3A5*3/*3 genotype were 11.4 (P=0.009) and 4.3 (P=0.13), respectively. The results suggest that CYP3A5*1 may be a novel genetic risk factor for airway injury in smokers, and that CYP3A5 may play a role in airway injury owing to the bioactivation of chemicals in tobacco smoke.

The effect of medical clowns on performance of spirometry among preschool aged children.

PubMed

Nir, Vered; Schichter-Konfino, Vered; Kassem, Eias; Klein, Adi

2018-04-02

Medical clowns (MCs) are known to assist in reducing pain and alleviating anxiety. The objective of this study is to evaluate the ability of MCs to assist preschoolers in performing spirometry. A prospective, randomized controlled trial. Children aged 3-6 years participated. After a first spirometry, children were divided into two groups: the first performed a second spirometry with an MC. The second repeated spirometry with the technician. Primary outcome was second spirometry values compared between the groups. Secondary outcome were change in spirometry values within groups, and difference between the groups. A total of 140 children participated. The groups did not differ in age, sex, mother tongue, or weight. Nor in mean FVC (MC 89.2% ± 16.7, control 89.5% ± 16.3) mean FEV1 (MC 91.3% ± 15.6, control 94.2% ± 16.8), and expiratory time (MC 1.58 ± 0.43, control 1.7 ± 0.44) in first spirometry. In second spirometry the control group had a similar FVC, FEV1, and expiratory time. The MC group had a significant improvement in all parameters: FVC: MC 95.3% ± 15.5, control 89.3% ± 19.1, FEV1: MC 98.0% ± 15.6, control 91.8% ± 19.3, and expiratory time MC 1.96 ± 0.55, control 1.84 ± 0.52. The differences between the groups between first and second attempt were significant (P-value FVC 0.000, FEV1 0.000, expiratory time 0.003). MCs improved performance of spirometry among preschoolers. It is possible that laughter and relief of stress had a physiological effect. Further studies are required to better establish the ability of MCs to improve active participation and to better understand whether the mechanism of the improvement is better cooperation or true physiological change. © 2018 Wiley Periodicals, Inc.

Time course of lung function changes in atypical pneumonia.

PubMed Central

Benusiglio, L N; Stalder, H; Junod, A F

1980-01-01

We measured pulmonary function in each of 21 patients suffering from "atypical", non-bacterial pneumonia during the acute illness and during convalescence (two to 18 months) to study the course and the nature of functional impairment at different stages of the disease. In six patients, no aetiological agent was found. An aetiological agent was identified in 15 of the patients: Mycoplasma pneumoniae (seven patients), influenza A (three patients), parainfluenza 3 (one patient), varicella (two patients), Q fever (one patient), coxsackie B3 (one patient). At the time of admission we observed a restrictive pattern in 52%, an obstructive pattern (decreased FEV1/FVC ratio) in 52% abnormalities in distribution of ventilation (abnormal slope of phase 3) in 63%, and abnormalities in gas exchange (increased AaDO2) in 75% of the patients. The frequency of abnormalities in these pulmonary function tests decreased dramatically after two to four weeks and nearly disappeared in most patients during convalescence. The only major residual abnormality was a decreased FEV1/FVC ratio in five subjects, four of whom were smokers. However, when MMEF and V75 were measured at this stage, their average value for all the groups of patients with the exclusion of the Mycoplasma pneumoniae group, was markedly reduced. These data suggest that small airways involvement can be demonstrated during the convalescence of patients recovering from various types of atypical pneumonia other than those caused by Mycoplasma pneumoniae. PMID:7444825

Longitudinal and Cross-sectional Analyses of Lung Function in Toluene Diisocyanate Production Workers.

PubMed

Wang, Mei Lin; Storey, Eileen; Cassidy, Laura D; Doney, Brent; Conner, Patrick R; Collins, James J; Carson, Michael; Molenaar, Don

2017-12-01

The aim of this study was to investigate lung function among toluene diisocyanate (TDI) production workers. One hundred ninety-seven U.S workers performed spirometry from 2006 through 2012. Results were compared within the study cohort and with U.S. population measures. A mixed-effects model assessed factors affecting repeated forced expiratory volume in 1 second (FEV1) measurements. The cohort's mean FEV1 and forced vital capacity (FVC) percent reference values, although greater than 90%, were significantly lower and the prevalence of abnormal spirometry (predominantly restrictive pattern) was significantly higher than in the U.S. Differences in lung function among workers with higher cumulative TDI exposure were in the direction of an exposure effect, but not significant. We found little evidence of an adverse effect of TDI exposure on longitudinal spirometry in these workers. The association between TDI exposure and the increasing prevalence of a restrictive pattern needs further exploration.

Influence of emphysema distribution on pulmonary function parameters in COPD patients

PubMed Central

Bastos, Helder Novais e; Neves, Inês; Redondo, Margarida; Cunha, Rui; Pereira, José Miguel; Magalhães, Adriana; Fernandes, Gabriela

2015-01-01

ABSTRACT OBJECTIVE: To evaluate the impact that the distribution of emphysema has on clinical and functional severity in patients with COPD. METHODS: The distribution of the emphysema was analyzed in COPD patients, who were classified according to a 5-point visual classification system of lung CT findings. We assessed the influence of emphysema distribution type on the clinical and functional presentation of COPD. We also evaluated hypoxemia after the six-minute walk test (6MWT) and determined the six-minute walk distance (6MWD). RESULTS: Eighty-six patients were included. The mean age was 65.2 ± 12.2 years, 91.9% were male, and all but one were smokers (mean smoking history, 62.7 ± 38.4 pack-years). The emphysema distribution was categorized as obviously upper lung-predominant (type 1), in 36.0% of the patients; slightly upper lung-predominant (type 2), in 25.6%; homogeneous between the upper and lower lung (type 3), in 16.3%; and slightly lower lung-predominant (type 4), in 22.1%. Type 2 emphysema distribution was associated with lower FEV1, FVC, FEV1/FVC ratio, and DLCO. In comparison with the type 1 patients, the type 4 patients were more likely to have an FEV1 < 65% of the predicted value (OR = 6.91, 95% CI: 1.43-33.45; p = 0.016), a 6MWD < 350 m (OR = 6.36, 95% CI: 1.26-32.18; p = 0.025), and post-6MWT hypoxemia (OR = 32.66, 95% CI: 3.26-326.84; p = 0.003). The type 3 patients had a higher RV/TLC ratio, although the difference was not significant. CONCLUSIONS: The severity of COPD appears to be greater in type 4 patients, and type 3 patients tend to have greater hyperinflation. The distribution of emphysema could have a major impact on functional parameters and should be considered in the evaluation of COPD patients. PMID:26785956

Effect of indoor air pollution on the respiratory system of women using different fuels for cooking in an urban slum of Pondicherry.

PubMed

Dutt, D; Srinivasa, D K; Rotti, S B; Sahai, A; Konar, D

1996-01-01

Some of the highest exposures to air pollutants in developing countries occur inside homes where biofuels are used for daily cooking. Inhalation of these pollutants may cause deleterious effects on health. We studied the effects of exposure to indoor air pollution from the use of cooking fuels on lung functions and respiratory symptoms in women aged 15-60 years. The study was conducted in Kuruchikuppam, an urban slum in Pondicherry. The study participants were 105 women using biofuels, 105 using kerosene and 105 using liquid petroleum gas (LPG), selected from among 1117 women aged 15-60 years, by a stratified random sampling technique. These women were interviewed at home to collect information about exposure to fuel smoke and presence of respiratory symptoms. Lung functions were assessed by measuring forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEFR). Occurrence of respiratory symptoms over six months was noted by making monthly follow up visits. Women using biofuels experienced more respiratory symptoms (23%) than those using kerosene (13%;p > 0.05) or LPG (8%; p < 0.05). Lung functions-FVC, FEV1, FEV1% and PEFR-were significantly lower in biofuel users compared with both kerosene (p < 0.01) and LPG users (p < 0.001). Lung functions in kerosene users also were significantly poorer when compared with LPG users (p < 0.01). Predicted pulmonary functions using multiple regression equations, derived from the data set of the present study, indicated that women using biofuels were more liable to have reduced pulmonary functions than women using kerosene or LPG. Women exposed to biofuel smoke suffer more from respiratory illnesses and have decreased pulmonary functions compared with women exposed to kerosene or LPG smoke. To reduce pollutant exposures we recommend the use of smokeless chullas or cleaner fuels such as charcoal, biogas and kerosene.

Childhood-Onset Asthma in Smokers. Association between CT Measures of Airway Size, Lung Function, and Chronic Airflow Obstruction

PubMed Central

Hardin, Megan E.; Come, Carolyn E.; San José Estépar, Raúl; Ross, James C.; Kurugol, Sila; Okajima, Yuka; Han, MeiLan K.; Kim, Victor; Ramsdell, Joe; Silverman, Edwin K.; Crapo, James D.; Lynch, David A.; Make, Barry; Barr, R. Graham; Hersh, Craig P.; Washko, George R.

2014-01-01

Rationale and Objectives: Asthma is associated with chronic airflow obstruction. Our goal was to assess the association of computed tomographic measures of airway wall volume and lumen volume with the FEV1 and chronic airflow obstruction in smokers with childhood-onset asthma. Methods: We analyzed clinical, lung function, and volumetric computed tomographic airway volume data from 7,266 smokers, including 590 with childhood-onset asthma. Small wall volume and small lumen volume of segmental airways were defined as measures 1 SD below the mean. We assessed the association between small wall volume, small lumen volume, FEV1, and chronic airflow obstruction (post-bronchodilator FEV1/FVC ratio < 0.7) using linear and logistic models. Measurements and Main Results: Compared with subjects without childhood-onset asthma, those with childhood-onset asthma had smaller wall volume and lumen volume (P < 0.0001) of segmental airways. Among subjects with childhood-onset asthma, those with the smallest wall volume and lumen volume had the lowest FEV1 and greatest odds of chronic airflow obstruction. A similar tendency was seen in those without childhood-onset asthma. When comparing these two groups, both small wall volume and small lumen volume were more strongly associated with FEV1 and chronic airflow obstruction among subjects with childhood-asthma in multivariate models. Conclusion: In smokers with childhood-onset asthma, smaller airways are associated with reduced lung function and chronic airflow obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT00608764). PMID:25296268

Childhood-onset asthma in smokers. association between CT measures of airway size, lung function, and chronic airflow obstruction.

PubMed

Diaz, Alejandro A; Hardin, Megan E; Come, Carolyn E; San José Estépar, Raúl; Ross, James C; Kurugol, Sila; Okajima, Yuka; Han, MeiLan K; Kim, Victor; Ramsdell, Joe; Silverman, Edwin K; Crapo, James D; Lynch, David A; Make, Barry; Barr, R Graham; Hersh, Craig P; Washko, George R

2014-11-01

Asthma is associated with chronic airflow obstruction. Our goal was to assess the association of computed tomographic measures of airway wall volume and lumen volume with the FEV1 and chronic airflow obstruction in smokers with childhood-onset asthma. We analyzed clinical, lung function, and volumetric computed tomographic airway volume data from 7,266 smokers, including 590 with childhood-onset asthma. Small wall volume and small lumen volume of segmental airways were defined as measures 1 SD below the mean. We assessed the association between small wall volume, small lumen volume, FEV1, and chronic airflow obstruction (post-bronchodilator FEV1/FVC ratio < 0.7) using linear and logistic models. Compared with subjects without childhood-onset asthma, those with childhood-onset asthma had smaller wall volume and lumen volume (P < 0.0001) of segmental airways. Among subjects with childhood-onset asthma, those with the smallest wall volume and lumen volume had the lowest FEV1 and greatest odds of chronic airflow obstruction. A similar tendency was seen in those without childhood-onset asthma. When comparing these two groups, both small wall volume and small lumen volume were more strongly associated with FEV1 and chronic airflow obstruction among subjects with childhood-asthma in multivariate models. In smokers with childhood-onset asthma, smaller airways are associated with reduced lung function and chronic airflow obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT00608764).

Asthma treatment outcome in children is associated with vascular endothelial growth factor A (VEGFA) polymorphisms.

PubMed

Balantic, Mateja; Rijavec, Matija; Skerbinjek Kavalar, Maja; Suskovic, Stanislav; Silar, Mira; Kosnik, Mitja; Korosec, Peter

2012-06-01

Asthma is a common chronic disease characterized by airway inflammation and structural remodeling. Vascular endothelial growth factor (VEGF), a major regulator of angiogenesis, is elevated in asthma patients. VEGF contributes to airway responsiveness and remodeling. It has been shown that treatment of asthma patients decreases VEGF levels, and inhibition of VEGF diminishes asthma symptoms in mice. Therefore, polymorphisms in the vascular endothelial growth factor A (VEGFA) gene might be associated with asthma treatment response. This study enrolled 131 children with asthma treated with different therapies - specifically, the inhaled corticosteroid (ICS) fluticasone propionate or the leukotriene receptor antagonist (LTRA) montelukast. We performed an association analysis between improvement of lung function - assessed by measurement of the percentage of the predicted forced expiratory volume in 1 second (%predicted FEV(1)), the ratio between the FEV(1) and the forced vital capacity (FEV(1)/FVC) after 6 and 12 months of treatment, and asthma control after 12 months of treatment - and two polymorphisms, rs2146323 and rs833058, in the VEGFA gene. Polymorphism rs2146323 A>C in VEGFA was associated with response to ICS therapy. Asthma patients with the AA genotype had a greater improvement in the %predicted FEV(1) than those with the AC or CC genotype (p = 0.018). Conversely, the AA genotype in rs2146323 was associated with uncontrolled asthma in patients regularly receiving LTRA therapy (p = 0.020) and a worse FEV(1)/FVC ratio in patients who episodically used LTRA therapy (p = 0.044). Furthermore, polymorphism rs833058 C>T was associated with treatment response to episodically used LTRA therapy. A subgroup of patients with the TT genotype had an improvement in the %predicted FEV(1), compared with no improvement in patients with the CT or CC genotype (p = 0.029). Our results showed that treatment response to commonly used asthma therapies (ICS or LTRA) is associated with polymorphisms rs2146323 and rs833058 in VEGFA. With additional replication of this preliminary study, our findings could contribute to the development of individualized asthma therapy.

A new approach to assess COPD by identifying lung function break-points

PubMed Central

Eriksson, Göran; Jarenbäck, Linnea; Peterson, Stefan; Ankerst, Jaro; Bjermer, Leif; Tufvesson, Ellen

2015-01-01

Purpose COPD is a progressive disease, which can take different routes, leading to great heterogeneity. The aim of the post-hoc analysis reported here was to perform continuous analyses of advanced lung function measurements, using linear and nonlinear regressions. Patients and methods Fifty-one COPD patients with mild to very severe disease (Global Initiative for Chronic Obstructive Lung Disease [GOLD] Stages I–IV) and 41 healthy smokers were investigated post-bronchodilation by flow-volume spirometry, body plethysmography, diffusion capacity testing, and impulse oscillometry. The relationship between COPD severity, based on forced expiratory volume in 1 second (FEV1), and different lung function parameters was analyzed by flexible nonparametric method, linear regression, and segmented linear regression with break-points. Results Most lung function parameters were nonlinear in relation to spirometric severity. Parameters related to volume (residual volume, functional residual capacity, total lung capacity, diffusion capacity [diffusion capacity of the lung for carbon monoxide], diffusion capacity of the lung for carbon monoxide/alveolar volume) and reactance (reactance area and reactance at 5Hz) were segmented with break-points at 60%–70% of FEV1. FEV1/forced vital capacity (FVC) and resonance frequency had break-points around 80% of FEV1, while many resistance parameters had break-points below 40%. The slopes in percent predicted differed; resistance at 5 Hz minus resistance at 20 Hz had a linear slope change of −5.3 per unit FEV1, while residual volume had no slope change above and −3.3 change per unit FEV1 below its break-point of 61%. Conclusion Continuous analyses of different lung function parameters over the spirometric COPD severity range gave valuable information additional to categorical analyses. Parameters related to volume, diffusion capacity, and reactance showed break-points around 65% of FEV1, indicating that air trapping starts to dominate in moderate COPD (FEV1 =50%–80%). This may have an impact on the patient’s management plan and selection of patients and/or outcomes in clinical research. PMID:26508849

Evaluating How Post-Bronchodilator Vital Capacities Affect the Diagnosis of Obstruction in Pulmonary Function Tests.

PubMed

Blagev, Denitza P; Sorenson, Dean; Linares-Perdomo, Olinto; Bamberg, Stacy; Hegewald, Matthew; Morris, Alan H

2016-11-01

Although the ratio of FEV 1 to the vital capacity (VC) is universally accepted as the cornerstone of pulmonary function test (PFT) interpretation, FVC remains in common use. We sought to determine what the differences in PFT interpretation were when the largest measured vital capacity (VC max ) was used instead of the FVC. We included 12,238 consecutive PFTs obtained for routine clinical care. We interpreted all PFTs first using FVC in the interpretation algorithm and then again using the VC max , obtained either before or after administration of inhaled bronchodilator. Six percent of PFTs had an interpretive change when VC max was used instead of FVC. The most common changes were: new diagnosis of obstruction and exclusion of restriction (previously suggested by low FVC without total lung capacity measured by body plethysmography). A nonspecific pattern occurred in 3% of all PFT interpretations with FVC. One fifth of these 3% produced a new diagnosis of obstruction with VC max . The largest factors predicting a change in PFT interpretation with VC max were a positive bronchodilator response and the administration of a bronchodilator. Larger FVCs decreased the odds of PFT interpretation change. Surprisingly, the increased numbers of PFT tests did not increase odds of PFT interpretation change. Six percent of PFTs have a different interpretation when VC max is used instead of FVC. Evaluating borderline or ambiguous PFTs using the VC max may be informative in diagnosing obstruction and excluding restriction. Copyright © 2016 by Daedalus Enterprises.

Single and Concurrent Effects of Endurance and Resistance Training on Pulmonary Function

PubMed Central

Khosravi, Maryam; Tayebi, Seyed Morteza; Safari, Hamed

2013-01-01

Objective(s): As not only few evidences but also contradictory results exist with regard to the effects of resistance training (RT) and resistance plus endurance training (ERT) on respiratory system, so the purpose of this research was therefore to study single and concurrent effects of endurance and resistance training on pulmonary function. Materials and Methods: Thirty seven volunteer healthy inactive women were randomly divided into 4 groups: without training as control (C), Endurance Training (ET), RT, and ERT. A spirometry test was taken 24 hrs before and after the training course. The training period (8 weeks, 3 sessions/week) for ET was 20-26 min/session running with 60-80% maximum heart rate (HR max); for RT two circuits/session, 40-60s for each exercise with 60-80% one repetition maximum (1RM), and 1 and 3 minutes active rest between exercises and circuits respectively; and for ERT was in agreement with either ET or RT protocols, but the times of running and circuits were half of ET and RT. Results: ANCOVA showed that ET and ERT increased significantly (P< 0.05) vital capacity (VC), forced vital capacity (FVC), and forced expiratory flows to 25%-75%; ET, RT and ERT increased significantly (P< 0.05) maximum voluntary ventilation (MVV); and only ET increased significantly (P<0.05) peak expiratory flows (PEF); but ET, RT and ERT had no significant effect (P>0.05) on forced expiratory volume in one second (FEV1) and FEV1/FVC ratio. Conclusion: In conclusion, ET combined with RT (ERT) has greater effect on VC, FVC, FEF rating at25%-75%, and also on PEF except MVV, rather than RT, and just ET has greater effect rather than ERT. PMID:24250940

Genetic and Environmental Basis in Phenotype Correlation Between Physical Function and Cognition in Aging Chinese Twins.

PubMed

Xu, Chunsheng; Zhang, Dongfeng; Tian, Xiaocao; Wu, Yili; Pang, Zengchang; Li, Shuxia; Tan, Qihua

2017-02-01

Although the correlation between cognition and physical function has been well studied in the general population, the genetic and environmental nature of the correlation has been rarely investigated. We conducted a classical twin analysis on cognitive and physical function, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), handgrip strength, five-times-sit-to-stand test (FTSST), near visual acuity, and number of teeth lost in 379 complete twin pairs. Bivariate twin models were fitted to estimate the genetic and environmental correlation between physical and cognitive function. Bivariate analysis showed mildly positively genetic correlations between cognition and FEV1, r G = 0.23 [95% CI: 0.03, 0.62], as well as FVC, r G = 0.35 [95% CI: 0.06, 1.00]. We found that FTSST and cognition presented very high common environmental correlation, r C = -1.00 [95% CI: -1.00, -0.57], and low but significant unique environmental correlation, r E = -0.11 [95% CI: -0.22, -0.01], all in the negative direction. Meanwhile, near visual acuity and cognition also showed unique environmental correlation, r E = 0.16 [95% CI: 0.03, 0.27]. We found no significantly genetic correlation for cognition with handgrip strength, FTSST, near visual acuity, and number of teeth lost. Cognitive function was genetically related to pulmonary function. The FTSST and cognition shared almost the same common environmental factors but only part of the unique environmental factors, both with negative correlation. In contrast, near visual acuity and cognition may positively share part of the unique environmental factors.

Exploring the interaction among EPHX1, GSTP1, SERPINE2, and TGFB1 contributing to the quantitative traits of chronic obstructive pulmonary disease in Chinese Han population.

PubMed

An, Li; Lin, Yingxiang; Yang, Ting; Hua, Lin

2016-05-18

Currently, the majority of genetic association studies on chronic obstructive pulmonary disease (COPD) risk focused on identifying the individual effects of single nucleotide polymorphisms (SNPs) as well as their interaction effects on the disease. However, conventional genetic studies often use binary disease status as the primary phenotype, but for COPD, many quantitative traits have the potential correlation with the disease status and closely reflect pathological changes. Here, we genotyped 44 SNPs from four genes (EPHX1, GSTP1, SERPINE2, and TGFB1) in 310 patients and 203 controls which belonged to the Chinese Han population to test the two-way and three-way genetic interactions with COPD-related quantitative traits using recently developed generalized multifactor dimensionality reduction (GMDR) and quantitative multifactor dimensionality reduction (QMDR) algorithms. Based on the 310 patients and the whole samples of 513 subjects, the best gene-gene interactions models were detected for four lung-function-related quantitative traits. For the forced expiratory volume in 1 s (FEV1), the best interaction was seen from EPHX1, SERPINE2, and GSTP1. For FEV1%pre, the forced vital capacity (FVC), and FEV1/FVC, the best interactions were seen from SERPINE2 and TGFB1. The results of this study provide further evidence for the genotype combinations at risk of developing COPD in Chinese Han population and improve the understanding on the genetic etiology of COPD and COPD-related quantitative traits.

Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer

PubMed Central

Mafé, Juan J.; Planelles, Beatriz; Asensio, Santos; Cerezal, Jorge; Inda, María-del-Mar; Lacueva, Javier; Esteban, Maria-Dolores; Hernández, Luis; Martín, Concepción; Baschwitz, Benno

2017-01-01

Background Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. Methods A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed. Results One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63±9 years old, 57% males) or OPEN (n=75, 64%; age: 61±11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05). Conclusions The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile. PMID:28932560

The effect of the pulsatile electromagnetic field in children suffering from bronchial asthma.

PubMed

Sadlonova, J; Korpas, J; Salat, D; Miko, L; Kudlicka, J

2003-01-01

From the bibliography it is well known that pulsatile electromagnetic field has an anti-inflammatory and analgesic effect. It causes vasodilatation, myorelaxation, hyper-production of connective tissue and activation of the cell membrane. Therefore our aim was to study the possible therapeutic effect of pulsatile electromagnetic field in asthmatic children. Forty-two children participating in this study were divided in two groups. The 1st group consisting of 21 children (11 females, 10 males, aged 11.8 +/- 0.4 yr) was treated by pulsatile electromagnetic field and pharmacologically. The 2nd group served as control, consisting also of 21 children (11 females, 10 males, aged 11.7 +/- 0.3 yr) and was treated only pharmacologically. Therapeutic effect of the pulsatile electromagnetic field was assessed on the basis of pulmonary tests performed by means of a Spirometer 100 Handi (Germany). The indexes FVC, IVC, ERV, IRV, FEV1, FEV1/FVC%, MEF75,50,25, PEF, PIF and the changes of the flow-volume loop were also registered. The pulsatile electromagnetic field was applied by means of the device MTU 500H, Therapy System (Brno, Czech Republic) for 5 days, two times daily for 30 minutes (magnetic induction: 3 mT, frequency: 4 Hz as recommended by the manufacturer). The results in children of the 1st group showed an improvement of FVC of about 70 ml, IVC of about 110 ml, FEV1 of about 80 ml, MEF75 of about 30 ml, PEF of about 480 ml, PIF of about 550 ml. The increases of ERV, IRV and FEV1/FVC and decreases of MEF25,50 were statistically insignificant. The results in the 2nd group were less clear. The flow-volume loop showed a mild improvement in 14 children. This improvement in the 2nd group was less significant. The clinical status of children and their mood became better. We believe that the pulsatile electro-magnetotherapy in children suffering from asthma is effective. On the basis of our results we can recommend it as a complementary therapy.

Pulmonary function in men after short-term exposure to ozone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hazucha, M.; Silverman, F.; Parent, C.

1973-01-01

Volunteers were exposed to 0.37 or 0.75 ppm ozone for 2 hr in environmental chamber while doing light exercise and resting intermittently. Slight discomfort resulted: dry throat, cough, chest tightness. Reduction in flow rates, FVC, and FEV at 1 and 2 hr was noted. Thus, ozone reached terminal bronchioles and impaired their function. Reduction in pulmonary measurements of maximum flow results were probably due to decreased lung elastic recoil, increased airway resistence, and small airway obstruction.

Occupational allergy after exposure to caddis flies at a hydroelectric power plant.

PubMed Central

Kraut, A; Sloan, J; Silviu-Dan, F; Peng, Z; Gagnon, D; Warrington, R

1994-01-01

A cross sectional survey was conducted in a hydroelectric power plant in which the workforce was exposed to large numbers of caddis flies. 28 of 57 employees participated. About 50% of the participants reported work related eye, nose, and sinus symptoms and wheezing. Working in locations with greater exposure to caddis flies was significantly associated with work related symptoms. 17 workers (61%) were skin prick positive to a laboratory prepared caddis fly antigen (LCFA) made from the remains of caddis flies present in the plant and 11 (39%) had positive reactions to a commercial caddis fly antigen (CCFA). Workers stationed in heavily exposed areas were 3.7 times as likely to have a positive response to the LCFA (p = 0.009) and 5.3 times as likely to have a positive response to the CCFA (p = 0.036). 13 (46%) of survey respondents reported three or more work related symptoms. 10 (91%) CCFA positive workers reported three or more work related symptoms. Pulmonary function studies revealed slight, but not significantly decreased forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratios in workers who were skin test positive to either caddis fly preparation when compared with those who were negative. One worker who was skin test positive to both antigens had a cross shift fall in FEV1 of 20% predicted. Occupational allergy to caddis flies proved to be a significant health problem at this work site. PMID:8044233

Identification of sleep hypoventilation in young individuals with Becker muscular dystrophy: A pilot study.

PubMed

Nakamura, Yuko; Saito, Yoshiaki; Kubota, Norika; Matsumura, Wataru; Hosoda, Chika; Tamasaki-Kondo, Akiko; Nishimura, Yoko; Sunada, Yoshihide; Fukada, Masuyuki; Ohno, Takako; Maegaki, Yoshihiro; Matsuo, Masafumi; Tokita, Yasuko

2018-03-08

To report on sleep hypercapnia in Becker muscular dystrophy (BMD) at earlier stages than ever recognized. This retrospective study examined nocturnal hypercapnia in six young Becker muscular dystrophy (BMD) patients with deletions of one or more exons of DMD gene. Clinical information, consecutive data on forced vital capacity (FVC%), forced expiratory volume in one second (FEV1%), peak expiratory flow (PEF%), peak cough flow (PCF), average PCO 2 in all-night monitoring, and left ventricular ejection fraction (LVEF) were reviewed. In five BMD patients, including three who were still ambulant, nocturnal average PCO 2 was elevated to >45 mmHg at 12-31 years of age. Noninvasive positive pressure ventilation was initiated in four patients. Gradual declines in FVC% and PEF% were evident in one BMD patient with exon 3-7 deletion, whereas these functions did not change in the remaining BMD patients. PCF, FEV1%, and LVEF were less informative for the assessment of respiratory function in this patient series. Sleep hypercapnia was present in certain BMD patients, which was unexpected from the routine pulmonary function tests. Individualized assessment of nocturnal PCO 2 , partly based on the deletion types, should be further explored in the clinical practice of BMD patients. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Coexistence of Chronic Bronchitis in Chronic Obstructive Lung Disease.

PubMed

Mejza, Filip; Nastałek, Paweł; Mastalerz-Migas, Agnieszka; Doniec, Zbigniew; Skucha, Wojciech

2018-05-12

The incidence of chronic obstructive pulmonary disease (COPD) is on the rise worldwide. Chronic bronchitis is a frequent accompaniment of COPD, which increases the burden of COPD in affected individuals. The aim of this study was to characterize the phenotype of chronic bronchitis in COPD patients. The study was based on the survey data retrospectively retrieved from the Action Health-Lung Cancer Prophylaxis and Health Care Improvement screening program that concerned all the inhabitants, aged over 40, of the Proszowice administrative region situated in the Lesser Poland Voivodeship in southern Poland. Participants with the symptoms suggestive of a lung disease were subject to further evaluation. The findings were that 546 (13.3%) out of the 4105 individuals displayed spirometry features of COPD. Symptoms of chronic bronchitis were present in 92 (16.8%) out of the COPD afflicted persons. Chronic bronchitis was commoner in current smokers and its incidence increased with increasing severity of airway obstruction. In multivariate analysis, chronic bronchitis was independently related to lower FEV1, FVC, FEV1/FVC, and to dyspnea. In regression model, factors related to increased risk of chronic bronchitis were current smoking, asthma, and lower lung function. We conclude that COPD with coexisting chronic bronchitis is linked to severer dyspnea and worse lung function. Current smoking, asthma, and lower lung function are related to increased risk of chronic bronchitis accompanying COPD.

Ozone and PM2.5 Exposure and Acute Pulmonary Health Effects: A Study of Hikers in the Great Smoky Mountains National Park

PubMed Central

Girardot, Steven P.; Ryan, P. Barry; Smith, Susan M.; Davis, Wayne T.; Hamilton, Charles B.; Obenour, Richard A.; Renfro, James R.; Tromatore, Kimberly A.; Reed, Gregory D.

2006-01-01

To address the lack of research on the pulmonary health effects of ozone and fine particulate matter (≤ 2.5 μm in aerodynamic diameter; PM2.5) on individuals who recreate in the Great Smoky Mountains National Park (USA) and to replicate a study performed at Mt. Washington, New Hampshire (USA), we conducted an observational study of adult (18–82 years of age) day hikers of the Charlies Bunion trail during 71 days of fall 2002 and summer 2003. Volunteer hikers performed pre- and posthike pulmonary function tests (spirometry), and we continuously monitored ambient O3, PM2.5, temperature, and relative humidity at the trailhead. Of the 817 hikers who participated, 354 (43%) met inclusion criteria (nonsmokers and no use of bronchodilators within 48 hr) and gave acceptable and reproducible spirometry. For these 354 hikers, we calculated the posthike percentage change in forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), FVC/FEV1, peak expiratory flow, and mean flow rate between 25 and 75% of the FVC and regressed each separately against pollutant (O3 or PM2.5) concentration, adjusting for age, sex, hours hiked, smoking status (former vs. never), history of asthma or wheeze symptoms, hike load, reaching the summit, and mean daily temperature. O3 and PM2.5 concentrations measured during the study were below the current federal standards, and we found no significant associations of acute changes in pulmonary function with either pollutant. These findings are contrasted with those in the Mt. Washington study to examine the hypothesis that pulmonary health effects are associated with exposure to O3 and PM2.5 in healthy adults engaged in moderate exercise. PMID:16835057

Higher prevalence of wheezing and lower FEV1 and FVC percent predicted in adults with sickle cell anaemia: A cross-sectional study.

PubMed

Musa, Baba M; Galadanci, Najibah A; Rodeghier, Mark; Debaun, Michael R

2017-02-01

Respiratory symptoms including wheezing are common in adults with sickle cell anaemia (SCA), even in the absence of asthma. However, the prevalence of spirometry changes and respiratory symptoms in adults with SCA is unknown. Using a cross-sectional study design, we tested the hypothesis that adults with SCA (cases) would have higher rates of lower airway obstruction and wheezing than those without SCA (controls) using the American Thoracic Society Division of Lung Diseases' questionnaire. Patients were adults with SCA aged between 18 and 65 years. Controls were consecutive unselected individuals without SCA who presented to an outpatient general medicine clinic. We enrolled 150 adults with SCA and 287 consecutive controls without SCA. The median age was 23.0 and 27.0 years for adults with and without SCA, respectively. Cases were more likely to report cough without a cold (35.0% vs 18.6%, P < 0.001), lower forced expiratory volume in 1 s (FEV 1 ) % predicted (70.1% vs 82.1%, P = 0.001) and lower forced vital capacity (FVC) % predicted (67.4% vs 74.9%, P = 0.001) than controls. In the multivariable model, wheezing was significantly associated with SCA status (OR = 1.69, 95% CI = 1.08-2.65, P = 0.024). Similarly, FEV 1 % predicted was significantly associated with SCA status and wheezing (P = 0.001 for both). Adults with SCA experience a higher rate of wheezing and impaired respiratory functions compared with controls from the same region. © 2016 Asian Pacific Society of Respirology.

Recent Marijuana Use and Associations With Exhaled Nitric Oxide and Pulmonary Function in Adults in the United States.

PubMed

Papatheodorou, Stefania I; Buettner, Hannah; Rice, Mary B; Mittleman, Murray A

2016-06-01

The medical and recreational use of marijuana is now legal in some parts of the United States; the health effects are unknown. We aimed to evaluate associations between recent marijuana use and exhaled nitric oxide (eNO) and pulmonary function. We performed a cross-sectional study of 10,327 US adults participating in the National Health and Nutrition Examination Survey in the years 2007 to 2012. We examined associations between marijuana use and eNO, FEV1, FVC, the FEV1/FVC ratio, and forced expiratory flow (midexpiratory phase) (FEF25%-75%) by weighted linear regression. In the study population, there were 4,797 never users, 4,084 past marijuana users, 555 participants who used marijuana 5 to 30 days before the examination, and 891 participants who used marijuana 0 to 4 days before the examination. Current marijuana use in the past 4 days was associated with 13% lower eNO (95% CI, -18% to 8%). FVC was higher in past users (75 mL; 95% CI, 38-112) and current users in the past 5 to 30 days (159 mL; 95% CI, 80-237) and in users within 0 to 4 days of the examination (204 mL; 95% CI, 139-270) compared with never users. All associations remained unchanged and statistically significant in sensitivity analyses excluding current and past tobacco users. Current marijuana use was associated with lower levels of eNO and higher FVC. The lower eNO in marijuana smokers suggests that short-term exposure to marijuana may, like tobacco, acutely affect the pulmonary vascular endothelium and impair airflow through the small airways. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

α1-Antitrypsin Protease Inhibitor MZ Heterozygosity Is Associated With Airflow Obstruction in Two Large Cohorts

PubMed Central

Sørheim, Inga-Cecilie; Bakke, Per; Gulsvik, Amund; Pillai, Sreekumar G.; Johannessen, Ane; Gaarder, Per I.; Campbell, Edward J.; Agustí, Alvar; Calverley, Peter M. A.; Donner, Claudio F.; Make, Barry J.; Rennard, Stephen I.; Vestbo, Jørgen; Wouters, Emiel F. M.; Paré, Peter D.; Levy, Robert D.; Coxson, Harvey O.; Lomas, David A.; Hersh, Craig P.

2010-01-01

Background: Severe α1-antitrypsin deficiency is a known genetic risk factor for COPD. Heterozygous (protease inhibitor [PI] MZ) individuals have moderately reduced serum levels of α1-antitrypsin, but whether they have an increased risk of COPD is uncertain. Methods: We compared PI MZ and PI MM individuals in two large populations: a case-control study from Norway (n = 1,669) and a multicenter family-based study from Europe and North America (n = 2,707). We sought to determine whether PI MZ was associated with the specific COPD-related phenotypes of lung function and quantitative CT scan measurements of emphysema and airway disease. Results: PI MZ was associated with a 3.5% lower FEV1/FVC ratio in the case-control study (P = .035) and 3.9% lower FEV1/vital capacity (VC) ratio in the family study (P = .009). In the case-control study, PI MZ also was associated with 3.7% more emphysema on quantitative analysis of chest CT scans (P = .003). The emphysema result was not replicated in the family study. PI MZ was not associated with airway wall thickness or COPD status in either population. Among subjects with low smoking exposure (< 20 pack-years), PI MZ individuals had more severe emphysema on chest CT scan than PI MM individuals in both studies. Conclusions: Compared with PI MM individuals, PI MZ heterozygotes had lower FEV1/(F)VC ratio in two independent studies. Our results suggest that PI MZ individuals may be slightly more susceptible to the development of airflow obstruction than PI MM individuals. PMID:20595457

Differential respirable dust related lung function effects between current and former South African coal miners.

PubMed

Naidoo, Rajen N; Robins, Thomas G; Seixas, Noah; Lalloo, Umesh G; Becklake, Margaret

2005-05-01

Dust-related dose-response decrements in lung function among coal miners have been reported in several studies, with varying magnitudes across populations. Few studies have compared differences between current and former coal miners. No studies on dose response relationships with lung function have been conducted in South African coal mines, one of the top three producers of coal internationally. The objectives of this study were (1) to describe the relationship between respirable dust exposure and lung function among current and former South African coal miners and to determine whether differential dust related effects were present between these employment categories; (2) to examine dust related dose response relationships, controlling for potential confounding by smoking and a history of tuberculosis (TB). Six hundred and eighty-four current and 188 ex-miners from three bituminous coal mines in Mpumalanga Province were studied. Interviews assessing work histories, smoking profiles and other risk factors were conducted. Work histories were also obtained from company records. Standardised spirometry was performed by trained technicians. Cumulative respirable dust exposure (CDE) estimates were constructed from company-collected sampling and measurements conducted by the researchers. Regression models examined the associations of CDE with per cent predicted FEV(1) and FVC, controlling for smoking, past history of TB and employment status. A statistically significant decline in FEV(1) of 1.1 and 2.2 ml/mg-year/m(3) was found in representative 40-year-old, 1.7-m tall current and former miners, respectively. Significant differences were found between the highest and medium exposure categories. Ex-miners had a lower mean per cent predicted lung function than current miners for each cumulative exposure category, suggesting a "healthy worker" effect. Past history of TB contributed to 21 and 14% declines in per cent predicted FEV(1) and FVC, respectively. Thus, in this cohort, a dose-related decline in lung function was associated with respirable dust exposure, with a magnitude of effect similar to that seen in other studies and important differences between current and former employees. A "healthy worker" effect may have attenuated the magnitude of this relationship. TB was a significant contributor to lung function loss.

Effects of polymorphic variations in tumor necrosis factor alpha and occupational exposure to grain dust on longitudinal decline in pulmonary function.

PubMed

Pahwa, Punam; Nakagawa, Kazuko; Koehncke, Niels; McDuffie, Helen H

2009-01-01

Longitudinal declines in pulmonary function are associated with individuals experiencing occupational exposure to organic dusts in combination with lifestyle factors such as cigarette smoking and with genetic factors, and interactions between these factors. To investigate the relationship between polymorphism of genes encoding Tumor Necrosis Factor Alpha (TNF-alpha) and longitudinal lung function decline in grain workers exposed to grain dust. Male grain handlers who participated in the Saskatchewan Grain Workers Surveillance Program from 2002 through 2005 provided demographic, occupational, lifestyle, and respiratory symptoms information as well as pulmonary function measurements and DNA for genotyping. Marginal models using the generalized estimating equations approach were fitted by using a SAS PROC GENMOD to predict the annual decline in Forced Expired Volume in one second (FEV(1)) and Forced Vital Capacity (FVC). Smoking intensity contributed to the decline in FEV(1.)Among *1/*1 homozygotes and *1/*2 heterozygotes, grain workers with <10 years in the grain industry had significantly lower FEV(1)declines compared to those of the other two exposure groups (>10 and < or =20 years, and >20 years in the grain industry). The annual declines in FEV(1)for grain workers who were either *1/*1 homozygote or *1/*2 heterozygote and had been in the grain industry for <10 years were lower by comparison to those of grain workers who were *2/*2 genotype and had been in the industry for <10 years. This research demonstrates that years in the grain industry is an effect modifier between TNF-alpha 308 genotype and longitudinal decline in FEV(1)in male subjects exposed to grain dust.

Are Lung Disease and Function Related to Age-related Macular Degeneration?

PubMed Central

Moorthy, Sonia; Cheung, Ning; Klein, Ronald; Shahar, E; Wong, Tien Y

2010-01-01

Purpose To describe the relationship of lung disease and function with early age-related macular degeneration (AMD) in a population-based study. Design A population-based, cross-sectional study of 12,596 middle-aged participants from the Atherosclerosis Risk in Communities Study. Methods Lung function was assessed by spirometry. Physician diagnosis of asthma and lung disease was ascertained from a standardized questionnaire. AMD signs were graded from fundus photographs according to the Wisconsin grading protocol. Results Of our study population, 587 (4.7%) had early AMD, 638 (5.1%) had asthma and 581 (4.6%) had lung disease. After adjusting for age, gender, smoking and hypertension, each litre increase in predicted forced expiratory volume in one second (FEV1) (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 0.89, 1.80), forced vital capacity (FVC) (OR 1.18; 95% CI: 0.93, 1.51) and peak expiratory flow rate (OR 1.12; 95% CI: 0.95, 1.33) were not significantly associated with early AMD. FEV1/FVC ratio (second quartile OR 1.61; 95%CI 0.88–2.93, third quartile OR 1.65; CI 0.90–3.03, fourth quartile OR 1.28; 95%CI 0.68–2.40) was not significantly associated with early AMD. Similarly, asthma (OR 1.06; 95% CI: 0.86, 1.27) and other lung diseases (OR 1.08; 95% CI: 0.90, 1.29) were not associated with early AMD. Conclusion Our data do not support a cross-sectional association between lung disease and risk of early AMD. PMID:21168814

Global DNA hypomethylation has no impact on lung function or serum inflammatory and fibrosis cytokines in asbestos-exposed population.

PubMed

Yu, Min; Lou, Jianlin; Xia, Hailing; Zhang, Min; Zhang, Yixiao; Chen, Junqiang; Zhang, Xing; Ying, Shibo; Zhu, Lijin; Liu, Lihong; Jia, Guang

2017-04-01

To examine the effect of asbestos exposure on global DNA methylation and determine whether lung function and inflammatory and fibrosis biomarkers are correlated with the methylation state. A total of 26 healthy subjects without asbestos exposure (Group 1), 47 healthy subjects with exposure (Group 2), and 52 subjects with benign asbestos-related disorders (ARDs) (Group 3) participated in this cross-sectional study. Blood global 5-methylcytosine (5mC) and serum TNF-α, collagen IV, CCL5 and CC16 concentrations were analyzed using enzyme-linked immunosorbent assay-like assays. Spirometric maneuvers were performed to assess lung function. Decreased 5mC levels were observed in Groups 2 and 3 compared to Group 1, irrespective of lung function (p < 0.01). There was no significant change in 5mC between Groups 2 and 3. Overall, 5mC was negatively correlated with CCL5 and collagen IV (p < 0.05), but no significant inverse relationship was found between 5mC and CCL5 or collagen IV in each group. Additionally, both 5mC and CC16 were inversely associated with FEV1/FVC% (p = 0.001, adjusted R 2  = 0.145) for non-smokers, and consistently significant inverse relationships were found between CC16 and FEV1/FVC%, independent of asbestos exposure. Asbestos exposure causes global DNA hypomethylation. DNA hypomethylation has no influence on serum biomarkers and lung function in asbestos-exposed population with or without pleural and pulmonary parenchymal abnormalities.

Congruence Between Pulmonary Function and Computed Tomography Imaging Assessment of Cystic Fibrosis Severity.

PubMed

Rybacka, Anna; Goździk-Spychalska, Joanna; Rybacki, Adam; Piorunek, Tomasz; Batura-Gabryel, Halina; Karmelita-Katulska, Katarzyna

2018-05-04

In cystic fibrosis, pulmonary function tests (PFTs) and computed tomography are used to assess lung function and structure, respectively. Although both techniques of assessment are congruent there are lingering doubts about which PFTs variables show the best congruence with computed tomography scoring. In this study we addressed the issue by reinvestigating the association between PFTs variables and the score of changes seen in computed tomography scans in patients with cystic fibrosis with and without pulmonary exacerbation. This retrospective study comprised 40 patients in whom PFTs and computed tomography were performed no longer than 3 weeks apart. Images (inspiratory: 0.625 mm slice thickness, 0.625 mm interval; expiratory: 1.250 mm slice thickness, 10 mm interval) were evaluated with the Bhalla scoring system. The most frequent structural abnormality found in scans were bronchiectases and peribronchial thickening. The strongest relationship was found between the Bhalla sore and forced expiratory volume in 1 s (FEV1). The Bhalla sore also was related to forced vital capacity (FVC), FEV1/FVC ratio, residual volume (RV), and RV/total lung capacity (TLC) ratio. We conclude that lung structural data obtained from the computed tomography examination are highly congruent to lung function data. Thus, computed tomography imaging may supersede functional assessment in cases of poor compliance with spirometry procedures in the lederly or children. Computed tomography also seems more sensitive than PFTs in the assessment of cystic fibrosis progression. Moreover, in early phases of cystic fibrosis, computed tomography, due to its excellent resolution, may be irreplaceable in monitoring pulmonary damage.

The role of traffic noise on the association between air pollution and children's lung function.

PubMed

Franklin, Meredith; Fruin, Scott

2017-08-01

Although it has been shown that traffic-related air pollution adversely affects children's lung function, few studies have examined the influence of traffic noise on this association, despite both sharing a common source. Estimates of noise exposure (L dn, dB), and freeway and non-freeway emission concentrations of oxides of nitrogen (NO x , ppb) were spatially assigned to children in Southern California who were tested for forced vital capacity (FVC, n=1345), forced expiratory volume in 1s, (FEV 1, n=1332), and asthma. The associations between traffic-related NO x and these outcomes, with and without adjustment for noise, were examined using mixed effects models. Adjustment for noise strengthened the association between NO x and reduced lung function. A 14.5mL (95% CI -40.0, 11.0mL) decrease in FVC per interquartile range (13.6 ppb) in freeway NO x was strengthened to a 34.6mL decrease after including a non-linear function of noise (95% CI -66.3, -2.78mL). Similarly, a 6.54mL decrease in FEV 1 (95% CI -28.3, 15.3mL) was strengthened to a 21.1mL decrease (95% CI -47.6, 5.51) per interquartile range in freeway NO x . Our results indicate that where possible, noise should be included in epidemiological studies of the association between traffic-related air pollution on lung function. Without taking noise into account, the detrimental effects of traffic-related pollution may be underestimated. Copyright © 2017 Elsevier Inc. All rights reserved.

Chronic respiratory effects of exposure to diesel emissions in coal mines.

PubMed

Ames, R G; Hall, D S; Reger, R B

1984-01-01

A 5-yr prospective design was employed to test the hypothesis that exposure to diesel emissions leads to chronic respiratory effects among underground coal miners. Changes in respiratory function and development of chronic respiratory symptoms were measured during a 5-yr study period (i.e., 1977 to 1982) in 280 diesel-exposed and 838 control miners from Eastern and Western United States underground coal mines. Spirometry measures of respiratory function included forced expiratory volume in 1 sec (FEV1.0), forced vital capacity (FVC), and forced expiratory flow rate at 50% of FVC (FEF50). Chronic respiratory symptom measures, which included chronic cough, chronic phlegm, and breathlessness, were obtained by questionnaires, as were smoking status and occupational history. Based upon these data, the pattern of evidence did not support the hypothesis either in an age-adjusted comparison of diesel vs. nondiesel miners or in an internal analysis by cumulative years of diesel exposure.

Violence exposure, a chronic psychosocial stressor, and childhood lung function

PubMed Central

Suglia, Shakira Franco; Ryan, Louise; Laden, Francine; Dockery, Douglas; Wright, Rosalind J

2011-01-01

Background Chronic psychosocial stressors, including violence, have been linked to neuropsychological and behavioral development in children as well as physiologic alterations that may lead to broader health effects. Methods We examined the relationship between violence and childhood lung function in a prospective birth cohort of 313 urban children 6 and 7 years of age. Mothers reported on their child’s lifetime exposure to community violence (ETV) and interparental conflict in the home [Conflict Tactics Scale (CTS)] within one year of the lung function assessment. Results In linear regression analyses, adjusting for maternal education, child’s age, race, birthweight, tobacco smoke exposure, and medical history, girls in the highest CTS verbal aggression tertile had a 5.5% (95% CI: −9.6, −1.5) decrease in percent predicted FEV1 and a 5.4% (95% CI: −9.7, −1.1) decrease in FVC compared to girls in the lowest tertile. The CTS verbal aggression subscale was associated with lung function among boys in the same direction, albeit this was not statistically significant. Boys in the highest ETV tertile had a 3.4% (95% CI: −8.0, 1.1) lower FEV1 and 5.3% lower (95% CI: −10.2, −0.4) FVC compared to boys in the lowest tertile. The ETV score was not a significant predictor of girl’s lung function. Conclusions Interparental conflict, specifically verbal aggression, and exposure to community violence were associated with decreased childhood lung function independent of socioeconomic status, tobacco smoke exposure, birthweight and respiratory illness history. Gender differences were noted based on the type of violence exposure which may warrant further exploration. PMID:18158365

Design of the exhale airway stents for emphysema (EASE) trial: an endoscopic procedure for reducing hyperinflation

PubMed Central

2011-01-01

Background Airway Bypass is a catheter-based, bronchoscopic procedure in which new passageways are created that bypass the collapsed airways, enabling trapped air to exit the lungs. The Exhale Airway Stents for Emphysema (EASE) Trial was designed to investigate whether Exhale® Drug-Eluting Stents, placed in new passageways in the lungs, can improve pulmonary function and reduce breathlessness in severely hyperinflated, homogeneous emphysema patients (NCT00391612). Methods/Design The multi-center, randomized, double-blind, sham-controlled trial design was posted on http://www.clinicaltrials.gov in October 2006. Because Bayesian statistics are used for the analysis, the proposed enrollment ranged from 225 up to 450 subjects at up to 45 institutions. Inclusion criteria are: high resolution CT scan with evidence of homogeneous emphysema, post-bronchodilator pulmonary function tests showing: a ratio of FEV1/FVC < 70%, FEV1≤50% of predicted or FEV1 < 1 liter, RV/TLC≥0.65 at screening, marked dyspnea score ≥2 on the modified Medical Research Council scale of 0-4, a smoking history of at least 20 pack years and stopped smoking for at least 8 weeks prior to enrollment. Following 16 to 20 supervised pulmonary rehabilitation sessions, subjects were randomized 2:1 to receive either a treatment (Exhale® Drug-Eluting Stent) or a sham bronchoscopy. A responder analysis will evaluate the co-primary endpoints of an FVC improvement ≥12% of the patient baseline value and modified Medical Research Council dyspnea scale improvement (reduction) ≥1 point at the 6-month follow-up visit. Discussion If through the EASE Trial, Airway Bypass is shown to improve pulmonary function and reduce dyspnea while demonstrating an acceptable safety profile, then homogeneous patients will have a minimally invasive treatment option with meaningful clinical benefit. Trial Registration ClinicalTrials.gov: NCT00391612 PMID:21214899

Air pollution, airway inflammation, and lung function in a cohort study of Mexico City schoolchildren.

PubMed

Barraza-Villarreal, Albino; Sunyer, Jordi; Hernandez-Cadena, Leticia; Escamilla-Nuñez, Maria Consuelo; Sienra-Monge, Juan Jose; Ramírez-Aguilar, Matiana; Cortez-Lugo, Marlene; Holguin, Fernando; Diaz-Sánchez, David; Olin, Anna Carin; Romieu, Isabelle

2008-06-01

The biological mechanisms involved in inflammatory response to air pollution are not clearly understood. In this study we assessed the association of short-term air pollutant exposure with inflammatory markers and lung function. We studied a cohort of 158 asthmatic and 50 nonasthmatic school-age children, followed an average of 22 weeks. We conducted spirometric tests, measurements of fractional exhaled nitric oxide (Fe(NO)), interleukin-8 (IL-8) in nasal lavage, and pH of exhaled breath condensate every 15 days during follow-up. Data were analyzed using linear mixed-effects models. An increase of 17.5 microg/m(3) in the 8-hr moving average of PM(2.5) levels (interquartile range) was associated with a 1.08-ppb increase in Fe(NO) [95% confidence interval (CI), 1.01-1.16] and a 1.07-pg/mL increase in IL-8 (95% CI 0.98-1.19) in asthmatic children and a 1.16 pg/ml increase in IL-8 (95% CI, 1.00-1.36) in nonasthmatic children. The 5-day accumulated average of exposure to particulate matter <2.5 microm in aerodynamic diamter (PM(2.5)) was significantly inversely associated with forced expiratory volume in 1 sec (FEV(1)) (p=0.048) and forced vital capacity (FVC) (p=0.012) in asthmatic children and with FVC (p=0.021) in nonasthmatic children. Fe(NO) and FEV(1) were inversely associated (p=0.005) in asthmatic children. Exposure to PM(2.5) resulted in acute airway inflammation and decrease in lung function in both asthmatic and nonasthmatic children.

Restrictive pattern on spirometry: association with cardiovascular risk and level of physical activity in asymptomatic adults

PubMed Central

Sperandio, Evandro Fornias; Arantes, Rodolfo Leite; Matheus, Agatha Caveda; da Silva, Rodrigo Pereira; Lauria, Vinícius Tonon; Romiti, Marcello; Gagliardi, Antônio Ricardo de Toledo; Dourado, Victor Zuniga

2016-01-01

Objective : To determine whether a restrictive pattern on spirometry is associated with the level of physical activity in daily life (PADL), as well as with cardiovascular disease (CVD) risk factors, in asymptomatic adults. Methods : A total of 374 participants (mean age, 41 ± 14 years) underwent spirometry, which included the determination of FVC and FEV1. A restrictive pattern on spirometry was defined as an FEV1/FVC ratio > 0.7 and an FVC < 80% of the predicted value. After conducting demographic, anthropometric, and CVD risk assessments, we evaluated body composition, muscle function, and postural balance, as well as performing cardiopulmonary exercise testing and administering the six-minute walk test. The PADL was quantified with a triaxial accelerometer. Results : A restrictive pattern on spirometry was found in 10% of the subjects. After multivariate logistic regression, adjusted for confounders (PADL and cardiorespiratory fitness), the following variables retained significance (OR; 95% CI) as predictors of a restrictive pattern: systemic arterial hypertension (17.5; 1.65-184.8), smoking (11.6; 1.56-87.5), physical inactivity (8.1; 1.43-46.4), larger center-of-pressure area while standing on a force platform (1.34; 1.05-1.71); and dyslipidemia (1.89; 1.12-1.98). Conclusions : A restrictive pattern on spirometry appears to be common in asymptomatic adults. We found that CVD risk factors, especially systemic arterial hypertension, smoking, and physical inactivity, were directly associated with a restrictive pattern, even when the analysis was adjusted for PADL and cardiorespiratory fitness. Longitudinal studies are needed in order to improve understanding of the etiology of a restrictive pattern as well as to aid in the design of preventive strategies. PMID:26982037

Pulmonary function outcomes for assessing cystic fibrosis care.

PubMed

Wagener, Jeffrey S; Elkin, Eric P; Pasta, David J; Schechter, Michael S; Konstan, Michael W; Morgan, Wayne J

2015-05-01

Assessing cystic fibrosis (CF) patient quality of care requires the choice of an appropriate outcome measure. We looked systematically and in detail at pulmonary function outcomes that potentially reflect clinical practice patterns. Epidemiologic Study of Cystic Fibrosis data were used to evaluate six potential outcome variables (2002 best FVC, FEV(1), and FEF(25-75) and rate of decline for each from 2000 to 2002). We ranked CF care sites by outcome measure and then assessed any association with practice patterns and follow-up pulmonary function. Sites ranked in the top quartile had more frequent monitoring, treatment of exacerbations, and use of chronic therapies and oral corticosteroids. The follow-up rate of pulmonary function decline was not predicted by site ranking. Different pulmonary function outcomes associate slightly differently with practice patterns, although annual FEV(1) is at least as good as any other measure. Current site ranking only moderately predicts future ranking. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

A population-based prospective cohort study examining the influence of early-life respiratory tract infections on school-age lung function and asthma.

PubMed

van Meel, Evelien R; den Dekker, Herman T; Elbert, Niels J; Jansen, Pauline W; Moll, Henriëtte A; Reiss, Irwin K; de Jongste, Johan C; Jaddoe, Vincent W V; Duijts, Liesbeth

2018-02-01

Early-life respiratory tract infections could affect airway obstruction and increase asthma risk in later life. However, results from previous studies are inconsistent. We examined the associations of early-life respiratory tract infections with lung function and asthma in school-aged children. This study among 5197 children born between April 2002 and January 2006 was embedded in a population-based prospective cohort study. Information on physician-attended upper and lower respiratory tract infections until age 6 years (categorised into ≤ 3 and >3-6 years) was obtained by annual questionnaires. Spirometry measures and physician-diagnosed asthma were assessed at age 10 years. Upper respiratory tract infections were not associated with adverse respiratory outcomes. Compared with children without lower respiratory tract infections ≤3 years, children with lower respiratory tract infections ≤3 years had a lower FEV 1 , FVC, FEV 1 :FVC and forced expiratory flow at 75% of FVC (FEF 75 ) (Z-score (95% CI): ranging from -0.22 (-0.31 to -0.12) to -0.12 (-0.21 to -0.03)) and an increased risk of asthma (OR (95% CI): 1.79 (1.19 to 2.59)). Children with lower respiratory tract infections >3-6 years had an increased risk of asthma (3.53 (2.37 to 5.17)) only. Results were not mediated by antibiotic or paracetamol use and not modified by inhalant allergic sensitisation. Cross-lagged modelling showed that results were not bidirectional and independent of preschool wheezing patterns. Early-life lower respiratory tract infections ≤3 years are most consistently associated with lower lung function and increased risk of asthma in school-aged children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Blood Leukocyte Concentrations, FEV1 Decline, and Airflow Limitation. A 15-Year Longitudinal Study of World Trade Center-exposed Firefighters.

PubMed

Zeig-Owens, Rachel; Singh, Ankura; Aldrich, Thomas K; Hall, Charles B; Schwartz, Theresa; Webber, Mayris P; Cohen, Hillel W; Kelly, Kerry J; Nolan, Anna; Prezant, David J; Weiden, Michael D

2018-02-01

Rescue/recovery work at the World Trade Center disaster site (WTC) caused a proximate decline in lung function in Fire Department of the City of New York firefighters. A subset of this cohort experienced an accelerated rate of lung function decline over 15 years of post-September 11, 2001 (9/11) follow-up. To determine if early postexposure blood leukocyte concentrations are biomarkers for subsequent FEV 1 decline and incident airflow limitation. Individual rates of forced expiratory volume in 1 second (FEV 1 ) change were calculated for 9,434 firefighters using 88,709 spirometric measurements taken between September 11, 2001, and September 10, 2016. We categorized FEV 1 change rates into three trajectories: accelerated FEV 1 decline (FEV 1 loss >64 ml/yr), expected FEV 1 decline (FEV 1 loss between 0 and 64 ml/yr), and improved FEV 1 (positive rate of change >0 ml/yr). Occurrence of FEV 1 /FVC less than 0.70 after 9/11 defined incident airflow limitation. Using regression models, we assessed associations of post-9/11 blood eosinophil and neutrophil concentrations with subsequent FEV 1 decline and airflow limitation, adjusted for age, race, smoking, height, WTC exposure level, weight change, and baseline lung function. Accelerated FEV 1 decline occurred in 12.7% of participants (1,199 of 9,434), whereas post-9/11 FEV 1 improvement occurred in 8.3% (780 of 9,434). Higher blood eosinophil and neutrophil concentrations were each associated with accelerated FEV 1 decline after adjustment for covariates (odds ratio [OR], 1.10 per 100 eosinophils/μl; 95% confidence interval [CI], 1.05-1.15; and OR, 1.10 per 1,000 neutrophils/μl; 95% CI, 1.05-1.15, respectively). Multivariable-adjusted linear regression models showed that a higher blood neutrophil concentration was associated with a faster rate of FEV 1 decline (1.14 ml/yr decline per 1,000 neutrophils/μl; 95% CI, 0.69-1.60 ml/yr; P < 0.001). Higher blood eosinophil concentrations were associated with a faster rate of FEV 1 decline in ever-smokers (1.46 ml/yr decline per 100 eosinophils/μl; 95% CI, 0.65-2.26 ml/yr; P < 0.001) but not in never-smokers (P for interaction = 0.004). Higher eosinophil concentrations were also associated with incident airflow limitation (adjusted hazard ratio, 1.10 per 100 eosinophils/μl; 95% CI, 1.04-1.15). Compared with the expected FEV 1 decline group, individuals experiencing accelerated FEV 1 decline were more likely to have incident airflow limitation (adjusted OR, 4.12; 95% CI, 3.30-5.14). Higher post-9/11 blood neutrophil and eosinophil concentrations were associated with subsequent accelerated FEV 1 decline in WTC-exposed firefighters. Both higher blood eosinophil concentrations and accelerated FEV 1 decline were associated with incident airflow limitation in WTC-exposed firefighters.

Intrapulmonary percussive ventilation improves lung function in cystic fibrosis patients chronically colonized with Pseudomonas aeruginosa: a pilot cross-over study.

PubMed

Dingemans, Jozef; Eyns, Hanneke; Willekens, Julie; Monsieurs, Pieter; Van Houdt, Rob; Cornelis, Pierre; Malfroot, Anne; Crabbé, Aurélie

2018-06-01

High levels of shear stress can prevent and disrupt Pseudomonas aeruginosa biofilm formation in vitro. Intrapulmonary percussive ventilation (IPV) could be used to introduce shear stress into the lungs of cystic fibrosis (CF) patients to disrupt biofilms in vivo. We performed a first-of-its-kind pilot clinical study to evaluate short-term IPV therapy at medium (200 bursts per minute, bpm) and high frequency (400 bpm) as compared to autogenic drainage (AD) on lung function and the behavior of P. aeruginosa in the CF lung in four patients who are chronically colonized by P. aeruginosa. A significant difference between the three treatment groups was observed for both the forced expiratory volume in 1 s (FEV1) and the forced vital capacity (FVC) (p < 0.05). More specifically, IPV at high frequency significantly increased FEV1 and FVC compared to AD (p < 0.05) and IPV at medium frequency (p < 0.001). IPV at high frequency enhanced the expression levels of P. aeruginosa planktonic marker genes, which was less pronounced with IPV at medium frequency or AD. In conclusion, IPV at high frequency could potentially alter the behavior of P. aeruginosa in the CF lung and improve lung function. The trail was retrospectively registered at the ISRCTN registry on 6 June 2013, under trial registration number ISRCTN75391385.

Transfer factor, lung volumes, resistance and ventilation distribution in healthy adults.

PubMed

Verbanck, Sylvia; Van Muylem, Alain; Schuermans, Daniel; Bautmans, Ivan; Thompson, Bruce; Vincken, Walter

2016-01-01

Monitoring of chronic lung disease requires reference values of lung function indices, including putative markers of small airway function, spanning a wide age range.We measured spirometry, transfer factor of the lung for carbon monoxide (TLCO), static lung volume, resistance and ventilation distribution in a healthy population, studying at least 20 subjects per sex and per decade between the ages of 20 and 80 years.With respect to the Global Lung Function Initiative reference data, our subjects had average z-scores for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC of -0.12, 0.04 and -0.32, respectively. Reference equations were obtained which could account for a potential dependence of index variability on age and height. This was done for (but not limited to) indices that are pertinent to asthma and chronic obstructive pulmonary disease studies: forced expired volume in 6 s, forced expiratory flow, TLCO, specific airway conductance, residual volume (RV)/total lung capacity (TLC), and ventilation heterogeneity in acinar and conductive lung zones.Deterioration in acinar ventilation heterogeneity and lung clearance index with age were more marked beyond 60 years, and conductive ventilation heterogeneity showed the greatest increase in variability with age. The most clinically relevant deviation from published reference values concerned RV/TLC values, which were considerably smaller than American Thoracic Society/European Respiratory Society-endorsed reference values. Copyright ©ERS 2016.

Effect of added mass on treadmill performance and pulmonary function.

PubMed

Walker, Rachel E; Swain, David P; Ringleb, Stacie I; Colberg, Sheri R

2015-04-01

Military personnel engage in strenuous physical activity and load carriage. This study evaluated the role of body mass and of added mass on aerobic performance (uphill treadmill exercise) and pulmonary function. Performance on a traditional unloaded run test (4.8 km) was compared with performance on loaded tasks. Subjects performed an outdoor 4.8-km run and 4 maximal treadmill tests wearing loads of 0, 10, 20, and 30 kg. Subjects' pulmonary function (forced expired volume in 1 second [FEV1], forced vital capacity [FVC], and maximal voluntary ventilation [MVV]) was tested with each load, and peak values of heart rate, oxygen consumption ((Equation is included in full-text article.)), ventilation (VE), and respiratory exchange ratio (RER) were measured during each treadmill test. Performance on the 4.8-km run was correlated with treadmill performance, measured as time to exhaustion (TTE), with the strength of the correlation decreasing with load (r = 0.87 for 0 kg to 0.76 for 30 kg). Body mass was not correlated with TTE, other than among men with the 30-kg load (r = 0.48). During treadmill exercise, all peak responses other than RER decreased with load. Pulmonary function measures (FEV1, FVC, and MVV) decreased with load. Body mass was poorly correlated with treadmill performance, but added mass decreased performance. The decreased performance may be in part because of decreased pulmonary function. Unloaded 4.8-km run performance was correlated to unloaded uphill treadmill performance, but less so as load increased. Therefore, traditional run tests may not be an effective means of evaluating aerobic performance for military field operations.

Acceleration of lung disease in children with cystic fibrosis after Pseudomonas aeruginosa acquisition.

PubMed

Kosorok, M R; Zeng, L; West, S E; Rock, M J; Splaingard, M L; Laxova, A; Green, C G; Collins, J; Farrell, P M

2001-10-01

As part of the ongoing Wisconsin Cystic Fibrosis (CF) Neonatal Screening Project, we had the unique opportunity to study the longitudinal relationship between Pseudomonas aeruginosa (Pa) acquisition and infection and developing lung disease in children with CF. The primary objective was to determine whether acquisition of Pa was associated with a measurable change in the progression of lung disease. Two outcome measures were used to study 56 patients who were diagnosed through newborn screening: 1) Wisconsin additive chest radiograph score (WCXR), based on the average of scores from a pulmonologist and a radiologist, and 2) the highest forced expired volume in 1 sec (FEV(1))/forced vital capacity (FVC) ratio. We used two measures of Pa acquisition: 1) time of first positive protocol-determined oropharyngeal (with cough) culture, and 2) the magnitude of antibody titer detected by ELISA assays, using as antigen a crude cell lysate, purified exotoxin A, or an elastase toxoid prepared from three Pa strains. Other predictor variables included age, pancreatic status, height-for age, and weight-for-age-percentiles. The best regression model for predicting changes in the WCXR included time to first positive culture and antibody titer for Pa elastase. Prior to Pa acquisition, WCXR worsened by 0.45 points/year (P > 0.25); after Pa acquisition, the rate of worsening increased significantly (P < 0.001) to 1.40 points/year. Each antibody titer level (log base 2) increased the score by 0.48 points (P < 0.001). The best regression model for predicting change in the FEV(1)/FVC included only time to first positive culture. Prior to Pa acquisition, the FEV(1)/FVC ratio declined by 1.29%/year; after Pa infection, the rate of decrease significantly accelerated to 1.81%/year (P = 0.001). Our data show that Pa acquisition is associated with declining pulmonary status in children with CF, and that this effect is probably gradual rather than precipitous. Because these patients were diagnosed and treated aggressively, our estimates of the effects of Pa acquisition may be conservative. We also conclude that the WCXR appears to be more sensitive than FEV(1)/FVC in detecting early changes in lung disease associated with CF. Copyright 2001 Wiley-Liss, Inc.

Pulmonary function levels as predictors of mortality in a national sample of US adults.

PubMed

Neas, L M; Schwartz, J

1998-06-01

Single breath pulmonary diffusing capacity for carbon monoxide (DL(CO)) was examined as a predictor of all-cause mortality among 4,333 subjects who were aged 25-74 years at baseline in the First National Health and Nutrition Examination Survey (NHANES I) conducted from 1971 to 1975. The relation of the percentage of predicted DL(CO) to all-cause mortality was examined in a Cox proportional hazard model that included age, sex, race, current smoking status, systolic blood pressure, serum cholesterol, alcohol consumption, body mass index, percentage of predicted forced vital capacity (FVC), and the ratio of forced expiratory volume at 1 second (FEV1) to FVC. Mortality had a linear association with the percentage of predicted FVC (rate ratio (RR) = 1.12, 95% confidence interval (CI) 1.08-1.17, for a 10% decrement) and a significantly nonlinear association with the percentage of predicted DL(CO) with an adverse effect that was clearly evident for levels below 85% of those predicted (RR = 1.24, 95% CI 1.12-1.37 for a 10% decrement). The relative hazard for the percentage of predicted DL(CO) below 85% was not modified by sex, smoking status, or exclusion of subjects with clinical respiratory disease on the initial examination. This association with the percentage of predicted DL(CO) was present among 3,005 subjects with FEV1 levels above 90% of those predicted. Thus, pulmonary diffusing capacity below 85% of predicted levels is a significant predictor of the all-cause mortality rate within the general US population independent of standard spirometry measures and even in the absence of apparent clinical respiratory disease.

Benefits of pulmonary rehabilitation in patients with COPD and normal exercise capacity.

PubMed

Lan, Chou-Chin; Chu, Wen-Hua; Yang, Mei-Chen; Lee, Chih-Hsin; Wu, Yao-Kuang; Wu, Chin-Pyng

2013-09-01

Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. We aimed to investigate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. Twenty-six subjects with COPD and normal exercise capacity were studied. All subjects participated in 12-week, 2 sessions per week, hospital-based, out-patient PR. Baseline and post-PR status were evaluated by spirometry, the St George's Respiratory Questionnaire, cardiopulmonary exercise test, respiratory muscle strength, and dyspnea scores. The mean FEV1 in the subjects was 1.29 ± 0.47 L/min, 64.8 ± 23.0% of predicted. After PR there was significant improvement in maximal oxygen uptake and work rate. Improvements in St George's Respiratory Questionnaire scores of total, symptoms, activity, and impact were accompanied by improvements of exercise capacity, respiratory muscle strength, maximum oxygen pulse, and exertional dyspnea scores (all P < .05). There were no significant changes in pulmonary function test results (FEV1, FVC, and FEV1/FVC), minute ventilation, breathing frequency, or tidal volume at rest or exercise after PR. Exercise training can result in significant improvement in health-related quality of life, exercise capacity, respiratory muscle strength, and exertional dyspnea in subjects with COPD and normal exercise capacity. Exercise training is still indicated for patients with normal exercise capacity.

Analysis of antigen-induced changes in pulmonary mechanics in sensitized inbred rats.

PubMed

Holroyde, M C; Smith, S Y; Holme, G

1982-05-01

An inbred line of rats was derived which develop marked and consistent dyspnea following sensitization and then exposure to aerosolized antigen. This pulmonary response was investigated in detail by determining forced pulmonary mechanics to derive respiratory rate, peak expiratory flow rate (PEFR), forced vital capacity (FVC), forced expiratory volume in 0.1 s (FEV0.1), and maximal midexpiratory flow rate (MMFR). Challenging anesthetized rats for 5 min with an aerosol of 3% egg albumin produced minimal change in respiratory rate, a 20% fall in PEFR, a 50% fall in FVC, and a 30% decrease in FEV0.1 and MMFR. The response could be inhibited or reversed by salbutamol (0.5 mg/kg, i.v.) and aminophylline (25 mg/kg, i.v.) administered either before or after challenge. The pulmonary changes are consistent with antigen-induced asthma in the rats. The response shows similarities to human asthma and may provide a relevant experimental model.

The Changes of Pulmonary Function in COPD During Four-Year Period

PubMed Central

Cukic, Vesna; Lovre, Vladimir; Ustamujic, Aida

2013-01-01

Conflict of interest: none declared. Introduction COPD (chronic obstructive pulmonary disease) is characterized by airflow limitation that is not fully reversible. OBJECTIVE: to show the changes of pulmonary function in COPD during the 4 -year evolution of illness. Material and Methods The research was done on patients suffering from COPD treated at the Clinic “Podhrastovi” during 2006 and 2007. The tested parameters were examined from the date of receiving patient with COPD to hospital treatment in 2006 and 2007 and then followed prospectively until 2010 or 2011 (the follow-up period was 4 years). There were total 199 treated patients who were chosen at random and regularly attended the control examinations. The study was conducted on adult patients of both sexes, different age group. In each patient the duration of illness was recorded so is sex, age, data of smoking habits, information about the regularity of taking bronchodilator therapy during remissions of disease, about the treatment of disease exacerbations, results of pulmonary functional tests as follows: FVC (forced vital capacity), FEV1 (forced expiratory volume in one second) and bronchodilator reversibility testing. All these parameters were measured at the beginning and at the end of each hospital treatment on the apparatuses of Clinic “Podhrastovi”. We took in elaboration those data obtained in the beginning of the first hospitalization and at the end of the last hospitalization or at the last control in outpatient department when patient was in stable state. Patients were divided into three groups according to the number of exacerbations per year. Results airflow limitation in COPD is progressive; both FVC and FEV1 shows the statistically significant decrease during follow-up period of 4 years (p values / for both parameters/ =0.05) . But in patients regularly treated in phases of remission and exacerbations of illness the course of illness is slower. The fall of FVC and FEV1 is statistically significantly smaller in those received regular treatment in phases of remissions and exacerbations of illness (p values / for both parameters/ =0.01). The number of patients responding properly to bronchodilators decreased statistically significantly in patients with COPD during follow-up period (p=0.05). Conclusion COPD is characterized with airflow limitation which is progressive in the course of illness, but that course may be made slower using appropriate treatment during remission and exacerbations of diseases. PMID:24082829

Effect of cervical epidural blockade with 2% lidocaine plus epinephrine on respiratory function.

PubMed

Huang, Chih-Hung

2007-12-01

Cervical epidural anesthesia has been used widely for surgery of upper limbs. Although cervical epidural anesthesia with local anesthetic of 2% lidocaine (plain) has demonstrated the safety in respiratory function in spite of unavoidable phrenic and intercostal palsies to certain extent, the replacement of local anesthetics with 2% lidocaine plus epinephrine has not been investigated yet. I conducted this study to look into the effect of 2% lidocaine plus epinephrine on respiratory function. I collected data from 50 patients with mean age of 24 +/- 3 yrs, mean weight of 65 +/- 10 kg, ASA status: I-II without preoperative pulmonary dysfunction undergoing orthropedic open-reduction with internal fixation because of fractures of upper limbs. Cervical epidural space (C7-T1) was approached by hanging-drop method, using a 17G Tuohy needle. A catheter was inserted craniad to a distance of 12 cm. Pulmonary function measurement and arterial blood gas data were obstained before, 20 min, 50 min and 105 min after injection of 12 mL 2% lidocaine with 1:200,000 epinephrine. The anesthesia levels were between C3-T3 and obtained 15 +/- 2 min after injection. Mean arterial blood gas analysis showed mild respiratory acidosis at 20 min (PaCO2: 48 +/- 3 mmHg) and 50 min (PaCO2: 44 +/- 2 mmHg). The measured values of inspiratory vital capacity (IVC), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), peak expiratory flow (PEF) when compaired with control values, were decreased about 18.0% and 12.1% of the control values at 20 min and 50 min respectively. The ratios of FEV1/VC, FEV1/FVC were still within normal limits (> 80%). The results were significantly compatible with the criteria of mild restrictive type of pulmonary function. Cervical epidural anesthesia with 2% lidocaine plus epinephrine could reduce lung volumes and capacities, resulting from partially paralytic intercostal muscles and diaphragm innervated respectively by thoracic intercostal nerve and phrenic nerve. Without inadvertant total spinal or intravenous anesthesia or pre-existing pulmonary dysfunction, the patients with normal lungs could tolerate these changes well with the procedure.

Effects of ambient ozone on respiratory function in active, normal children

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spektor, D.M.; Lippmann, M.; Lioy, P.J.

1988-02-01

Respiratory functions were measured on a daily basis by spirometry over a period of 4 wk at a summer camp at Fairview Lake in northwestern New Jersey. Fifty-three boys and 38 girls 8 to 15 yr of age participated in the study on at least 7 days; 37 children were in residence for 4 wk, 34 for the first 2 wk only; and 20 for the last 2 wk. There were 72 whites, 15 blacks, 3 Asians, and 1 Hispanic in the study group. Multiple regression analyses indicated that the O/sub 3/ concentration in the previous hour, the cumulative dailymore » O/sub 3/ exposure during the hours between 9 A.M. and the function measurement, ambient temperature, and humidity were the most explanatory environmental variables for daily variations in function, with the 1 - h O/sub 3/ concentration having the strongest influence. Linear regressions were performed for each child between O/sub 3/ concentration and function, and all average slopes were significantly negative (p less than 0.05) for FVC, FEV1, PEFR, and FEF25-75 for all children, and for boys and girls separately. Comparable results were obtained in data subsets (i.e., children studied during the first or second 2 wk only, and for data sets truncated at O/sub 3/ less than 80 and O/sub 3/ less than 60 ppb). The average regression slopes (+/- SE) for FVC and FEV1, respectively, were -1.03 +/- 0.24 and -1.42 +/- 0.17 ml/ppb, whereas for PEFR and FEF25-75 they were -6.78 +/- 0.73 and -2.48 +/- 0.26 ml/s/ppb.« less

Associations between Ambient Particulate Matter and Nitrogen Dioxide and Chronic Obstructive Pulmonary Diseases in Adults and Effect Modification by Demographic and Lifestyle Factors

PubMed Central

Leem, Jong Han; Kim, Hwan Cheol

2018-01-01

This study was undertaken to investigate the associations between chronic exposure to particulate matter of medium aerodynamic diameter ≤10 or ≤2.5 µm (PM10 or PM2.5) and nitrogen dioxide (NO2) levels and lung function and to examine a possible change in these relationships by demographic and lifestyle factors. Chronic obstructive pulmonary disease (COPD) was defined using the Global Initiative for COPD criteria (forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70%). Associations of lung function and COPD with PM10 or PM2.5 or NO2 were examined using linear and logistic regression analyses among 1264 Korean adults. The highest tertiles of PM2.5 (≥37.1 μg/m3) and NO2 (≥53.8 μg/m3) exposure were significantly associated with COPD (highest versus lowest tertile of PM2.5: adjusted odds ratio (OR) = 1.79, 95% CI: 1.02–3.13; highest versus lowest tertile of NO2: adjusted OR = 1.83, 95% CI: 1.04–3.21). A 10 μg/m3 increase in PM10 concentration was associated with a 1.85 L (95% CI –3.65 to –0.05) decrease in FEV1 and a 1.73 L (95% CI –3.35 to –0.12) decrease in FVC, with the strongest negative association among older people and those with less education. Reduced lung function was associated with PM2.5 exposure in subjects with no physical activity. This study provides evidence that exposure to ambient air pollution has adverse effects on lung function in adults. PMID:29463050

Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

PubMed Central

Kim, Song Soo; Lee, Ho Yun; Nevrekar, Dipti V.; Forssen, Anna V.; Crapo, James D.; Schroeder, Joyce D.; Lynch, David A.

2013-01-01

Purpose: To provide a new detailed visual assessment scheme of computed tomography (CT) for chronic obstructive pulmonary disease (COPD) by using standard reference images and to compare this visual assessment method with quantitative CT and several physiologic parameters. Materials and Methods: This research was approved by the institutional review board of each institution. CT images of 200 participants in the COPDGene study were evaluated. Four thoracic radiologists performed independent, lobar analysis of volumetric CT images for type (centrilobular, panlobular, and mixed) and extent (on a six-point scale) of emphysema, the presence of bronchiectasis, airway wall thickening, and tracheal abnormalities. Standard images for each finding, generated by two radiologists, were used for reference. The extent of emphysema, airway wall thickening, and luminal area were quantified at the lobar level by using commercial software. Spearman rank test and simple and multiple regression analyses were performed to compare the results of visual assessment with physiologic and quantitative parameters. Results: The type of emphysema, determined by four readers, showed good agreement (κ = 0.63). The extent of the emphysema in each lobe showed good agreement (mean weighted κ = 0.70) and correlated with findings at quantitative CT (r = 0.75), forced expiratory volume in 1 second (FEV1) (r = −0.68), FEV1/forced vital capacity (FVC) ratio (r = −0.74) (P < .001). Agreement for airway wall thickening was fair (mean κ = 0.41), and the number of lobes with thickened bronchial walls correlated with FEV1 (r = −0.60) and FEV1/FVC ratio (r = −0.60) (P < .001). Conclusion: Visual assessment of emphysema and airways disease in individuals with COPD can provide reproducible, physiologically substantial information that may complement that provided by quantitative CT assessment. © RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120385/-/DC1 PMID:23220894

Long-term tolerance of airway silicone stent in patients with post-tuberculosis tracheobronchial stenosis.

PubMed

Verma, Akash; Um, Sang-Won; Koh, Won-Jung; Suh, Gee Young; Chung, Man Pyo; Kwon, O Jung; Kim, Hojoong

2012-01-01

Surgery is a well-recognized modality of treatment for benign tracheobronchial stenosis. However, in some benign disease groups, such as tuberculosis, sarcoidosis, war gas exposure, and inhalation burns, multiplicity of involvement or long length of stenosed segment heightens surgical challenge. We investigated the outcomes and long-term tolerability of the Natural stent (N-stent) in such patients with post-tuberculosis tracheobronchial stenosis. A retrospective review was done for 17 patients who underwent silicone stenting (N-stent) for post-tuberculosis tracheobronchial stenosis during January 2000-December 2003 but needed persistent stent placement and still require the stent. Significant increase in the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC), expressed as FEV1%, as well as in forced percentual vital capacity (FVC%) (Δ24% and Δ11%, respectively) in the short term and sustained increase in the FEV1% and FVC% (Δ26.5% and Δ16.5%, respectively) in the long term were noted at a median (range) interval of 1 (0.5-72) month and 72 (12-114) months, respectively, along with symptomatic relief. No procedure-related death occurred. Stent-related late complications included granulation tissue formation (76%), migration (70%), and mucostasis (17%). The median duration for which N-stents were tolerated was 7.9 (range, 3-11) years. N-stents are well-tolerated for a prolonged period. Stent-related complications occur, but are easily managed. These results might carry medical implications for those who have airway lesions difficult to correct surgically.

Decrements in lung function related to arsenic in drinking water in West Bengal, India.

PubMed

von Ehrenstein, Ondine S; Mazumder, D N Guha; Yuan, Yan; Samanta, Sambit; Balmes, John; Sil, Arabinda; Ghosh, Nilima; Hira-Smith, Meera; Haque, Reina; Purushothamam, Radhika; Lahiri, Sarbari; Das, Subhankar; Smith, Allan H

2005-09-15

During 1998-2000, the authors investigated relations between lung function, respiratory symptoms, and arsenic in drinking water among 287 study participants, including 132 with arsenic-caused skin lesions, in West Bengal, India. The source population involved 7,683 participants who had been surveyed for arsenic-related skin lesions in 1995-1996. Respiratory symptoms were increased among men with arsenic-caused skin lesions (versus those without lesions), particularly "shortness of breath at night" (odds ratio (OR) = 2.8, 95% confidence interval (CI): 1.1, 7.6) and "morning cough" (OR = 2.8, 95% CI: 1.2, 6.6) in smokers and "shortness of breath ever" (OR = 3.8, 95% CI: 0.7, 20.6) in nonsmokers. Among men with skin lesions, the average adjusted forced expiratory volume in 1 second (FEV1) was reduced by 256.2 ml (95% CI: 113.9, 398.4; p < 0.001) and the average adjusted forced vital capacity (FVC) was reduced by 287.8 ml (95% CI: 134.9, 440.8; p < 0.001). In men, a 100-microg/liter increase in arsenic level was associated with a 45.0-ml decrease (95% CI: 6.2, 83.9) in FEV1 (p = 0.02) and a 41.4-ml decrease (95% CI: -0.7, 83.5) in FVC (p = 0.054). Women had lower risks than men of developing skin lesions and showed little evidence of respiratory effects. In this study, consumption of arsenic-contaminated water was associated with respiratory symptoms and reduced lung function in men, especially among those with arsenic-related skin lesions.

Childhood pneumonia increases risk for chronic obstructive pulmonary disease: the COPDGene study.

PubMed

Hayden, Lystra P; Hobbs, Brian D; Cohen, Robyn T; Wise, Robert A; Checkley, William; Crapo, James D; Hersh, Craig P

2015-09-21

Development of adult respiratory disease is influenced by events in childhood. The impact of childhood pneumonia on chronic obstructive pulmonary disease (COPD) is not well defined. We hypothesize that childhood pneumonia is a risk factor for reduced lung function and COPD in adult smokers. COPD cases and control smokers between 45-80 years old from the United States COPDGene Study were included. Childhood pneumonia was defined by self-report of pneumonia at <16 years. Subjects with lung disease other than COPD or asthma were excluded. Smokers with and without childhood pneumonia were compared on measures of respiratory disease, lung function, and quantitative analysis of chest CT scans. Of 10,192 adult smokers, 854 (8.4%) reported pneumonia in childhood. Childhood pneumonia was associated with COPD (OR 1.40; 95% CI 1.17-1.66), chronic bronchitis, increased COPD exacerbations, and lower lung function: post-bronchodilator FEV1 (69.1 vs. 77.1% predicted), FVC (82.7 vs. 87.4% predicted), FEV1/FVC ratio (0.63 vs. 0.67; p < 0.001 for all comparisons). Childhood pneumonia was associated with increased airway wall thickness on CT, without significant difference in emphysema. Having both pneumonia and asthma in childhood further increased the risk of developing COPD (OR 1.85; 95% CI 1.10-3.18). Children with pneumonia are at increased risk for future smoking-related lung disease including COPD and decreased lung function. This association is supported by airway changes on chest CT scans. Childhood pneumonia may be an important factor in the early origins of COPD, and the combination of pneumonia and asthma in childhood may pose the greatest risk. ClinicalTrials.gov, NCT00608764 (Active since January 28, 2008).

Evaluation of respiratory parameters in finswimmers regarding gender, swimming style and distance.

PubMed

Stavrou, V; Vavougios, G; Karetsi, E; Adam, G; Daniil, Z; Gourgoulianis, K I

2018-04-13

The purpose of our study was to investigate the differences in the finswimmers' physiological characteristics, as far as gender, the swimming style and the different swimming distance are concerned. 52 finswimmers participated in our study (Age: 17.4 ± 2.1yrs, BMI: 21.8 ± 2.3, body fat: 12.2 ± 4.7%) and were allocated into groups [Gender: Female vs. Male, swimming style: Bifin vs. Surface, and swimming distance: <200 m vs. ≥200 m]. Anthropometric characteristics, handgrip, estimated strength of inspiratory muscles (PI max ) and pulmonary function parameters (FEV 1 , FVC and PEF) were measured. The Independent T-test was used for statistical comparisons between groups. Multivariate analyses were performed via binary logistic regression. The results showed differences between groups in gender in PEF (p < 0.05), PI max (p < 0.05) and handgrip (p < 0.001) in swimming style in handgrip (p < 0.05), FEV 1 (p < 0.05) and FVC (p < 0.05) and in swimming distance (p < 0.05) in hours/day spent at the gym (p < 0.05) and FVC (p < 0.05). In multivariate analyses handgrip remained an independent predictor of style (OR: 1.154; 95%CI: 1.022-1.303, p = .021), and hours/day spent at the gym was retained as an independent predictor of distance (OR: 131.607; 95%CI: 3.655-4739.441, p = .008). The data from the present study reveal that handgrip was associated with style, and hours per day spent at the gym were associated with distance. Copyright © 2018 Elsevier B.V. All rights reserved.

Total Airway Count on Computed Tomography and the Risk of Chronic Obstructive Pulmonary Disease Progression. Findings from a Population-based Study.

PubMed

Kirby, Miranda; Tanabe, Naoya; Tan, Wan C; Zhou, Guohai; Obeidat, Ma'en; Hague, Cameron J; Leipsic, Jonathon; Bourbeau, Jean; Sin, Don D; Hogg, James C; Coxson, Harvey O

2018-01-01

Studies of excised lungs show that significant airway attrition in the "quiet" zone occurs early in chronic obstructive pulmonary disease (COPD). To determine if the total number of airways quantified in vivo using computed tomography (CT) reflects early airway-related disease changes and is associated with lung function decline independent of emphysema in COPD. Participants in the multicenter, population-based, longitudinal CanCOLD (Canadian Chronic Obstructive Lung Disease) study underwent inspiratory/expiratory CT at visit 1; spirometry was performed at four visits over 6 years. Emphysema was quantified as the CT inspiratory low-attenuation areas below -950 Hounsfield units. CT total airway count (TAC) was measured as well as airway inner diameter and wall area using anatomically equivalent airways. Participants included never-smokers (n = 286), smokers with normal spirometry at risk for COPD (n = 298), Global Initiative for Chronic Obstructive Lung Disease (GOLD) I COPD (n = 361), and GOLD II COPD (n = 239). TAC was significantly reduced by 19% in both GOLD I and GOLD II compared with never-smokers (P < 0.0001) and by 17% in both GOLD I and GOLD II compared with at-risk participants (P < 0.0001) after adjusting for low-attenuation areas below -950 Hounsfield units. Further analysis revealed parent airways with missing daughter branches had reduced inner diameters (P < 0.0001) and thinner walls (P < 0.0001) compared with those without missing daughter branches. Among all CT measures, TAC had the greatest influence on FEV 1 (P < 0.0001), FEV 1 /FVC (P < 0.0001), and bronchodilator responsiveness (P < 0.0001). TAC was independently associated with lung function decline (FEV 1 , P = 0.02; FEV 1 /FVC, P = 0.01). TAC may reflect the airway-related disease changes that accumulate in the "quiet" zone in early/mild COPD, indicating that TAC acquired with commercially available software across various CT platforms may be a biomarker to predict accelerated COPD progression.

Pulmonary function in adolescents with ataxia telangiectasia.

PubMed

McGrath-Morrow, Sharon; Lefton-Greif, Maureen; Rosquist, Karen; Crawford, Thomas; Kelly, Amber; Zeitlin, Pamela; Carson, Kathryn A; Lederman, Howard M

2008-01-01

Pulmonary complications are common in adolescents with ataxia telangiectasia (A-T), however objective measurements of lung function may be difficult to obtain because of underlying bulbar weakness, tremors, and difficulty coordinating voluntary respiratory maneuvers. To increase the reliability of pulmonary testing, minor adjustments were made to stabilize the head and to minimize leaks in the system. Fifteen A-T adolescents completed lung volume measurements by helium dilution. To assess for reproducibility of spirometry testing, 10 A-T adolescents performed spirometry on three separate occasions. Total lung capacity (TLC) was normal or just mildly decreased in 12/15 adolescents tested. TLC correlated positively with functional residual capacity (FRC), a measurement independent of patient effort (R2=0.71). The majority of individuals had residual volumes (RV) greater than 120% predicted (10/15) and slow vital capacities (VC) less than 70% predicted (9/15). By spirometry, force vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) values were reproducible in the 10 individuals who underwent testing on three separate occasions (R=0.97 and 0.96 respectively). Seven of the 10 adolescents had FEV1/FVC ratios>90%. Lung volume measurements from A-T adolescents revealed near normal TLC values with increased RV and decreased VC values. These findings indicate a decreased ability to expire to residual volume rather then a restrictive defect. Spirometry was also found to be reproducible in A-T adolescents suggesting that spirometry testing may be useful for tracking changes in pulmonary function over time in this population. Copyright (c) 2007 Wiley-Liss, Inc.

A Randomized, Multicenter, Double-blind, Phase III Study to Evaluate the Efficacy on Allergic Rhinitis and Safety of a Combination Therapy of Montelukast and Levocetirizine in Patients With Asthma and Allergic Rhinitis.

PubMed

Kim, Mi-Kyeong; Lee, Sook Young; Park, Hae-Sim; Yoon, Ho Joo; Kim, Sang-Ha; Cho, Young Joo; Yoo, Kwang-Ha; Lee, Soo-Keol; Kim, Hee-Kyoo; Park, Jung-Won; Park, Heung-Woo; Chung, Jin-Hong; Choi, Byoung Whui; Lee, Byung-Jae; Chang, Yoon-Seok; Jo, Eun-Jung; Lee, Sang-Yeub; Cho, You Sook; Jee, Young-Koo; Lee, Jong-Myung; Jung, Jina; Park, Choon-Sik

2018-06-24

The aim of this study was to evaluate the efficacy and safety of a fixed-dose combination of montelukast and levocetirizine in patients with perennial allergic rhinitis with mild to moderate asthma compared with the efficacy and safety of montelukast alone. This study was a 4-week, randomized, multicenter, double-blind, Phase III trial. After a 1-week placebo run-in period, the subjects were randomized to receive montelukast (10mg/day, n = 112) or montelukast (10 mg/day)/levocetirizine (5 mg/day) (n = 116) treatment for 4 weeks. The primary efficacy end point was mean daytime nasal symptom score. Other efficacy end points included mean nighttime nasal symptom score, mean composite symptom score, overall assessment of allergic rhinitis by both subjects and physicians, forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), FEV 1 /FVC, asthma control test score, and the frequency of rescue medication used during the treatment period. Of 333 patients screened for this study, 228 eligible patients were randomized to treatment. The mean (SD) age of patients was 43.32 (15.02) years, and two thirds of subjects were female (66.67%). The demographic characteristics were similar between the treatment groups. Compared with the montelukast group, the montelukast/levocetirizine group reported significant reductions in mean daytime nasal symptom score (least squares mean [SE] of combination vs montelukast, -0.98 [0.06] vs -0.81 [0.06]; P = 0.045). For all other allergic rhinitis efficacy end points, the montelukast/levocetirizine group showed greater improvement than the montelukast group. Similar results were observed in overall assessment scores and in FEV 1 , FVC, FEV 1 /FVC, and asthma control test score changes from baseline for the 2 treatment groups. Montelukast/levocetirizine was well tolerated, and the safety profile was similar to that observed in the montelukast group. The fixed-dose combination of montelukast and levocetirizine was effective and safe in treating perennial allergic rhinitis in patients with asthma compared with montelukast alone. ClinicalTrials.gov identifier: NCT02552667. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Vital capacities in acute and chronic airway obstruction: dependence on flow and volume histories.

PubMed

Brusasco, V; Pellegrino, R; Rodarte, J R

1997-06-01

The aim of this study was to investigate whether measurements of vital capacity (VC) are affected by the direction of the manoeuvre (inspiratory vs expiratory) and by the rate of expiratory flow. The study was performed on 25 individuals with chronic airway obstruction (CAO) and a forced expiratory volume in one second (FEV1) (expressed in standardized residuals (SR)) of -2.0+/-1.4 SD (CAO group), and 10 asthmatic subjects with methacholine (MCh)-induced bronchoconstriction (FEV1 -23+/-1.02 SR) (MCh group). VCs were measured during fast inspiration following both slow (FIVCse) and forced (FIVCfe) expiration from end-tidal inspiration to residual volume (RV), and during slow (EVC) or forced (FVC) expiration from total lung capacity (TLC). In the CAO group, FVC was the smallest volume (3.75+/-1.03 L) and significantly different from the other three estimates of VC; FIVCse (4.03+/-0.91 L) was the largest volume and significantly different from FVC and FIVCfe (3.83+/-0.98 L). In the MCh group, FVC (4.16+/-0.94 L) and EVC (4.19+/-0.89 L) were the largest volumes, although only the difference between FVC and FIVCfe (3.76+/-0.81 L) reached statistical significance. These data suggest that both flow and volume histories contribute to decreased vital capacities during bronchoconstriction. However, whereas increasing expiratory flow always tends to decrease vital capacity, the volume history of full inflation has different effects in chronic and acute bronchoconstriction, probably due to different effects on airway calibre. These results stress the importance of using standardized manoeuvres in order to obtain comparable values of vital capacity.

Air pollution and childhood respiratory health: Exposure to sulfate and ozone in 10 Canadian Rural Communities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stern, B.R.; Raizenne, M.E.; Burnett, R.T.

1994-08-01

This study was designed to examine differences in the respiratory health status of preadolescent school children, aged 7-11 years, who resided in 10 rural Canadian communities in areas of moderate and low exposure to regional sulfate and ozone pollution. Five of the communities were located in central Saskatchewan, a low-exposure region, and five were located in southwestern Ontario, an area with moderately elevated exposures resulting from long-range atmospheric transport of polluted air masses. In this cross-sectional study, the child's respiratory symptoms and illness history were evaluated using a parent-completed questionnaire, administered in September 1985. Respiratory function was assessed once formore » each child in the schools between October 1985 and March 1986, by the measurement of pulmonary function for forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV[sub 1.0]), peak expiratory flow rate (PEFR), mean forced expiratory flow rate during the middle half of the FVC curve (FEF[sub 25-75]), and maximal expiratory flow at 50% of the expired vital capacity (V[sub 50]max). After controlling for the effects of age, sex, parental smoking, parental education and gas cooking, no significant regional differences were observed in rates of chronic cough or phlegm, persistent wheeze, current asthma, bronchitis in the past year, or any chest illness that kept the child at home for 3 or more consecutive days during the previous year. Children living in southwestern Ontario had statistically significant (P < 0.01) mean decrements of 1.7% in FVC and 1.3% in FEV[sub 1.0] compared with Saskatchewan children, after adjusting for age, sex, weight, standing height, parental smoking, and gas cooking. There were no statistically significant regional differences in the pulmonary flow parameters (P > 0.05). 54 refs., 1 fig., 7 tabs.« less

Occupational exposures to solvents and metals are associated with fixed airflow obstruction.

PubMed

Alif, Sheikh M; Dharmage, Shyamali C; Benke, Geza; Dennekamp, Martine; Burgess, John A; Perret, Jennifer L; Lodge, Caroline J; Morrison, Stephen; Johns, David P; Giles, Graham G; Gurrin, Lyle C; Thomas, Paul S; Hopper, John L; Wood-Baker, Richard; Thompson, Bruce R; Feather, Iain H; Vermeulen, Roel; Kromhout, Hans; Walters, E Haydn; Abramson, Michael J; Matheson, Melanie C

2017-11-01

Objectives This study investigated the associations between occupational exposures to solvents and metals and fixed airflow obstruction (AO) using post-bronchodilator spirometry. Methods We included 1335 participants from the 2002-2008 follow-up of the Tasmanian Longitudinal Health Study. Ever-exposure and cumulative exposure-unit (EU) years were calculated using the ALOHA plus job exposure matrix (JEM). Fixed AO was defined as post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) <0.7 and FEV 1 /FVC

COPD in Never Smokers

PubMed Central

McBurnie, Mary Ann; Vollmer, William M.; Gudmundsson, Gunnar; Welte, Tobias; Nizankowska-Mogilnicka, Ewa; Studnicka, Michael; Bateman, Eric; Anto, Josep M.; Burney, Peter; Mannino, David M.; Buist, Sonia A.

2011-01-01

Background: Never smokers comprise a substantial proportion of patients with COPD. Their characteristics and possible risk factors in this population are not yet well defined. Methods: We analyzed data from 14 countries that participated in the international, population-based Burden of Obstructive Lung Disease (BOLD) study. Participants were aged ≥ 40 years and completed postbronchodilator spirometry testing plus questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. A diagnosis of COPD was based on the postbronchodilator FEV1/FVC ratio, according to current GOLD (Global Initiative for Obstructive Lung Disease) guidelines. In addition to this, the lower limit of normal (LLN) was evaluated as an alternative threshold for the FEV1/FVC ratio. Results: Among 4,291 never smokers, 6.6% met criteria for mild (GOLD stage I) COPD, and 5.6% met criteria for moderate to very severe (GOLD stage II+) COPD. Although never smokers were less likely to have COPD and had less severe COPD than ever smokers, never smokers nonetheless comprised 23.3% (240/1,031) of those classified with GOLD stage II+ COPD. This proportion was similar, 20.5% (171/832), even when the LLN was used as a threshold for the FEV1/FVC ratio. Predictors of COPD in never smokers include age, education, occupational exposure, childhood respiratory diseases, and BMI alterations. Conclusion: This multicenter international study confirms previous evidence that never smokers comprise a substantial proportion of individuals with COPD. Our data suggest that, in addition to increased age, a prior diagnosis of asthma and, among women, lower education levels are associated with an increased risk for COPD among never smokers. PMID:20884729

Peripheral killer cells do not differentiate between asthma patients with or without fixed airway obstruction.

PubMed

Tubby, Carolyn; Negm, Ola H; Harrison, Timothy; Tighe, Patrick J; Todd, Ian; Fairclough, Lucy C

2017-06-01

The three main types of killer cells - CD8 + T cells, NK cells and NKT cells - have been linked to asthma and chronic obstructive pulmonary disease (COPD). However, their role in a small subset of asthma patients displaying fixed airway obstruction (FAO), similar to that seen in COPD, has not been explored. The objective of the present study was to investigate killer cell numbers, phenotype and function in peripheral blood from asthma patients with FAO, asthma patients without FAO, and healthy individuals. Peripheral CD8 + T cells (CD8 + CD3 + CD56 - ), NK cells (CD56 + CD3 - ) and NKT-like cells (CD56 + CD3 + ) of 14 asthma patients with FAO (post-bronchodilator FEV/FVC <0.7, despite clinician-optimised treatment), 7 asthma patients without FAO (post-bronchodilator FEV/FVC ≥ 0.7), and 9 healthy individuals were studied. No significant differences were seen between the number, receptor expression, MAPK signalling molecule expression, cytotoxic mediator expression, and functional cytotoxicity of peripheral killer cells from asthma patients with FAO, asthma patients without FAO and healthy individuals. Peripheral killer cell numbers or functions do not differentiate between asthma patients with or without fixed airway obstruction.

Prevalence and risk factors of COPD among never-smokers in two areas of Sweden - Occupational exposure to gas, dust or fumes is an important risk factor.

PubMed

Hagstad, Stig; Backman, Helena; Bjerg, Anders; Ekerljung, Linda; Ye, Xiong; Hedman, Linnea; Lindberg, Anne; Torén, Kjell; Lötvall, Jan; Rönmark, Eva; Lundbäck, Bo

2015-11-01

Although active tobacco smoking is the main risk factor for COPD, COPD is not uncommon also among never-smokers. Different study locations along with different spirometric definitions of COPD have historically yielded different prevalence estimates of the disease. To study current prevalence and risk factors of COPD among never-smokers in two areas of Sweden. Data collected in 2008-2012 within the West Sweden Asthma Study and Obstructive Lung Disease in Northern Sweden Studies was pooled. The study population consisted of 1839 subjects who participated in spirometry and interviews. COPD was defined as post-bronchodilator a) FEV(1)/(F)VC < 0.7, b) FEV(1)/FVC < 0.7 and c) FEV(1)/FVC < lower limit of normal. Of the 1839 subjects, 967 (52.6%) were never-smokers. Among the never-smoking subjects, the prevalence of COPD according to definitions a-c was 7.7%, 4.9% and 3.0%, respectively. The corresponding prevalence of GOLD grade ≥2 was 2.0%, 1.4% and 1.3%. No significant difference in prevalence between the two study areas was observed. In never-smokers, occupational exposure to gas, dust or fumes (GDF) was significantly associated with both COPD (OR 1.85, 95% CI 1.03-3.33), and GOLD ≥2 (OR 4.51, 1.72-11.9) according to definition a), after adjusting for age, educational level and exposure to passive smoking at work. Depending on definition, prevalence of COPD among never-smokers was 3.0-7.7%, whereas GOLD ≥2 was present in 1.3-2.0%. Occupational exposure to GDF remained independently and significantly associated with COPD regardless of spirometric definition of the disease. Copyright © 2015 Elsevier Ltd. All rights reserved.

Associations between Dietary Patterns and Post-Bronchodilation Lung Function in the SAPALDIA Cohort.

PubMed

Steinemann, Nina; Grize, Leticia; Pons, Marco; Rothe, Thomas; Stolz, Daiana; Turk, Alexander; Schindler, Christian; Brombach, Christine; Probst-Hensch, Nicole

2018-05-04

Chronic obstructive pulmonary disease (COPD) is not restricted to smokers. Dietary habits may contribute to the disease occurrence. Epidemiological studies point to a protective effect of fruit and vegetable intake against COPD. To investigate the associations between dietary patterns and parameters of lung function related to COPD in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA). Data were included from the second follow-up assessment of the SAPALDIA cohort in 2010-2011 using a food frequency questionnaire. Principal component factor analysis was used to derive dietary patterns, whose association with FEV1, FEV1/FVC, FEF2575, and COPD was investigated by applying multivariate regression analyses. After adjustment for potential confounders, the "prudent dietary pattern" characterised by the predominant food groups vegetables, fruits, water, tea and coffee, fish, and nuts was positively associated with FEV1 (increase of 40 mL per SD, p < 0.001). Also for factor 3 ("high-carbohydrate diet"), we found a significant positive association with FEV1 (with an increase per SD of 36 mL, p = 0.006). The main results are consistent with a protective effect of a diet rich in fruits, vegetables, fish, and nuts against age-related chronic respiratory disease. If confirmed in prospective cohorts, our results may guide nutritional counselling towards respiratory health promotion. © 2018 The Author(s) Published by S. Karger AG, Basel.

Effect of oral arginine supplementation on exhaled nitric oxide concentration in sickle cell anemia and acute chest syndrome.

PubMed

Sullivan, Kevin Joseph; Kissoon, Niranjan; Sandler, Eric; Gauger, Cynthia; Froyen, Melanie; Duckworth, Laurie; Brown, Martha; Murphy, Suzanne

2010-10-01

Decreased exhaled nitric oxide levels (FE(NO)) have been described in patients with sickle cell disease (SCD) and a history of acute chest syndrome (ACS) when compared with non-ACS controls. Oral arginine supplementation has been shown to increase FE(NO) in healthy participants, but its effect in SCD patients is not known. To determine the effect of oral arginine intake on FENO in sickle cell patients with and without history of ACS, and in healthy controls. No differences in the FE(NO) increase were seen in SCD patients with a history of ACS (ACS+) compared with healthy controls (HC) and SCD patients without history of ACS (ACS-). ACS+ (n=6), ACS- (n=9), and HC (n=7) patients were studied. At baseline, and after the administration of escalating doses of oral L-arginine (0.1, 0.2, and 0.4 g/kg), serial measurements were made of the following: FE(NO), plasma concentrations of arginine, ornithine, citrulline, aspartate, glutamate, arginine/ornithine ratio, nitrite, nitrate, heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturation (SpO2), forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC). At baseline, FE(NO) did not differ among the groups. ACS- and ACS+ groups were deficient in arginine, and had decreased FEV1, FVC, and SaO2 when compared with HC patients. After arginine supplementation, FE(NO), arginine, ornithine, citrulline, nitrite, and the arginine/ornithine ratio increased similarly in all groups. Changes from baseline for HR, BP, SpO2, RR, FEV1, and FVC were minimal and similar in all groups. In contrast to our earlier study, ACS+ patients had similar FE(NO) values when compared with ACS- and HC patients. All SCD patients were arginine deficient at baseline and showed impairment in respiratory physiology when compared with HC patients. After arginine supplementation, FE(NO) concentration increased in all groups to a similar degree, and lung function and physiologic parameters were minimally affected. The physiologic significance of alterations in FE(NO) in SCD patients and its relationship to ACS predilection requires further delineation.

Quantitative computed tomography of lung parenchyma in patients with emphysema: analysis of higher-density lung regions

NASA Astrophysics Data System (ADS)

Lederman, Dror; Leader, Joseph K.; Zheng, Bin; Sciurba, Frank C.; Tan, Jun; Gur, David

2011-03-01

Quantitative computed tomography (CT) has been widely used to detect and evaluate the presence (or absence) of emphysema applying the density masks at specific thresholds, e.g., -910 or -950 Hounsfield Unit (HU). However, it has also been observed that subjects with similar density-mask based emphysema scores could have varying lung function, possibly indicating differences of disease severity. To assess this possible discrepancy, we investigated whether density distribution of "viable" lung parenchyma regions with pixel values > -910 HU correlates with lung function. A dataset of 38 subjects, who underwent both pulmonary function testing and CT examinations in a COPD SCCOR study, was assembled. After the lung regions depicted on CT images were automatically segmented by a computerized scheme, we systematically divided the lung parenchyma into different density groups (bins) and computed a number of statistical features (i.e., mean, standard deviation (STD), skewness of the pixel value distributions) in these density bins. We then analyzed the correlations between each feature and lung function. The correlation between diffusion lung capacity (DLCO) and STD of pixel values in the bin of -910HU <= PV < -750HU was -0.43, as compared with a correlation of -0.49 obtained between the post-bronchodilator ratio (FEV1/FVC) measured by the forced expiratory volume in 1 second (FEV1) dividing the forced vital capacity (FVC) and the STD of pixel values in the bin of -1024HU <= PV < -910HU. The results showed an association between the distribution of pixel values in "viable" lung parenchyma and lung function, which indicates that similar to the conventional density mask method, the pixel value distribution features in "viable" lung parenchyma areas may also provide clinically useful information to improve assessments of lung disease severity as measured by lung functional tests.

Long-Term Exposure to Primary Traffic Pollutants and Lung Function in Children: Cross-Sectional Study and Meta-Analysis.

PubMed

Barone-Adesi, Francesco; Dent, Jennifer E; Dajnak, David; Beevers, Sean; Anderson, H Ross; Kelly, Frank J; Cook, Derek G; Whincup, Peter H

2015-01-01

There is widespread concern about the possible health effects of traffic-related air pollution. Nitrogen dioxide (NO2) is a convenient marker of primary pollution. We investigated the associations between lung function and current residential exposure to a range of air pollutants (particularly NO2, NO, NOx and particulate matter) in London children. Moreover, we placed the results for NO2 in context with a meta-analysis of published estimates of the association. Associations between primary traffic pollutants and lung function were investigated in 4884 children aged 9-10 years who participated in the Child Heart and Health Study in England (CHASE). A systematic literature search identified 13 studies eligible for inclusion in a meta-analysis. We combined results from the meta-analysis with the distribution of the values of FEV1 in CHASE to estimate the prevalence of children with abnormal lung function (FEV1<80% of predicted value) expected under different scenarios of NO2 exposure. In CHASE, there were non-significant inverse associations between all pollutants except ozone and both FEV1 and FVC. In the meta-analysis, a 10 μg/m3 increase in NO2 was associated with an 8 ml lower FEV1 (95% CI: -14 to -1 ml; p: 0.016). The observed effect was not modified by a reported asthma diagnosis. On the basis of these results, a 10 μg/m3 increase in NO2 level would translate into a 7% (95% CI: 4% to 12%) increase of the prevalence of children with abnormal lung function. Exposure to traffic pollution may cause a small overall reduction in lung function and increase the prevalence of children with clinically relevant declines in lung function.

Speed of onset of bronchodilator response to salbutamol inhaled via different devices in asthmatics: a bioassay based on functional antagonism

PubMed Central

Lavorini, Federico; Geri, Pietro; Mariani, Laura; Marmai, Cecilia; Maluccio, Nazzarena Maria; Pistolesi, Massimo; Fontana, Giovanni A

2006-01-01

Aims To evaluate the speed of onset of bronchodilation following salbutamol administered via a metered-dose inhaler with a spacer (pMDI + Volumatic) and a dry-powder inhaler (Diskus), as well as the relative potencies of these devices in asthmatic patients with methacholine-induced bronchoconstriction. Methods Eighteen patients inhaled methacholine (MCh) until FEV1 decreased by 35% of control. Following administration of placebo, 200 µg salbutamol or 400 µg salbutamol through the pMDI + Volumatic or the Diskus, we calculated the time elapsed from drug administration and the appearance of a 90% increase in post-MCh forced vital capacity (FVC), FEV1 and volume-adjusted mid-expiratory flow (recovery times). The salbutamol doses to be delivered by the two inhalation devices to achieve similar recovery times and the relative potencies of the devices were calculated by using the 2-by-2 Finney parallel regression method. Results For all functional variables, recovery times were significantly (P < 0.01) shorter in pMDI + Volumatic than Diskus trials. The salbutamol doses to be delivered by the Diskus to achieve recovery times for FVC, FEV1 and volume-adjusted mid-expiratory flow similar to those obtained with 200 µg salbutamol administered via the pMDI + Volumatic were 558 (95% CI 537, 579) µg, 395 (95% CI 388, 404) µg and 404 (95% CI 393, 415) µg, respectively, and corresponded to relative potencies of 2.79 (95% CI 2.68, 2.90), 1.98 (95% CI 1.94, 2.02), and 2.02 (95% CI 1.96, 2.07). Conclusions Administration of salbutamol via the pMDI + Volumatic provides faster reversal of induced bronchoconstriction than via the Diskus. The salbutamol dose targeting the lungs with the pMDI + Volumatic is approximately twice that with the Diskus. PMID:16995861

Association between arachidonate 5-lipoxygenase-activating protein (ALOX5AP) and lung function in a Korean population.

PubMed

Ro, M; Kim, S; Pyun, J-A; Shin, C; Cho, N H; Lee, J-Y; Koh, I; Kwack, K

2012-08-01

Arachidonate 5-lipoxygenase-activating protein (ALOX5AP) plays a role in the 5-lipoxygenase (LO) pathway, which includes the LTC(4), LTD(4), LTE(4) and LTB(4). These leukotrienes are known causative factors of asthma, allergy, atopy and cardiovascular diseases. ALOX5AP lacks enzyme activity and acts by helping 5-LO function. In this study, healthy and general subjects who live in rural and urban areas of Korea were tested for the association of ALOX5AP polymorphisms with lung function. Lung function was also estimated by calculating the predicted values for forced expiratory volume in one second (FEV(1) _%PRED) and the proportion of the forced vital capacity exhaled in the first second (FEV(1) /FVC_PRED). The linear regression was adjusted for residence area, gender, age, height and smoking status. The analysis revealed associations between FEV(1) and the single-nucleotide polymorphism (SNP) rs9506352 and the haplotype TCAC (permuted P-value < 0.05). The linkage disequilibrium block that included the significant SNPs overlapped with SNPs that were revealed previously to associate with myocardial infarction and asthma and to affect lung function. This study is the first to demonstrate the association between lung function and ALOX5AP polymorphisms in a healthy and general population. © 2012 The Authors. Scandinavian Journal of Immunology © 2012 Blackwell Publishing Ltd.

The validity of using ICD-9 codes and pharmacy records to identify patients with chronic obstructive pulmonary disease

PubMed Central

2011-01-01

Background Administrative data is often used to identify patients with chronic obstructive pulmonary disease (COPD), yet the validity of this approach is unclear. We sought to develop a predictive model utilizing administrative data to accurately identify patients with COPD. Methods Sequential logistic regression models were constructed using 9573 patients with postbronchodilator spirometry at two Veterans Affairs medical centers (2003-2007). COPD was defined as: 1) FEV1/FVC <0.70, and 2) FEV1/FVC < lower limits of normal. Model inputs included age, outpatient or inpatient COPD-related ICD-9 codes, and the number of metered does inhalers (MDI) prescribed over the one year prior to and one year post spirometry. Model performance was assessed using standard criteria. Results 4564 of 9573 patients (47.7%) had an FEV1/FVC < 0.70. The presence of ≥1 outpatient COPD visit had a sensitivity of 76% and specificity of 67%; the AUC was 0.75 (95% CI 0.74-0.76). Adding the use of albuterol MDI increased the AUC of this model to 0.76 (95% CI 0.75-0.77) while the addition of ipratropium bromide MDI increased the AUC to 0.77 (95% CI 0.76-0.78). The best performing model included: ≥6 albuterol MDI, ≥3 ipratropium MDI, ≥1 outpatient ICD-9 code, ≥1 inpatient ICD-9 code, and age, achieving an AUC of 0.79 (95% CI 0.78-0.80). Conclusion Commonly used definitions of COPD in observational studies misclassify the majority of patients as having COPD. Using multiple diagnostic codes in combination with pharmacy data improves the ability to accurately identify patients with COPD. PMID:21324188

Air Pollution, Airway Inflammation, and Lung Function in a Cohort Study of Mexico City Schoolchildren

PubMed Central

Barraza-Villarreal, Albino; Sunyer, Jordi; Hernandez-Cadena, Leticia; Escamilla-Nuñez, Maria Consuelo; Sienra-Monge, Juan Jose; Ramírez-Aguilar, Matiana; Cortez-Lugo, Marlene; Holguin, Fernando; Diaz-Sánchez, David; Olin, Anna Carin; Romieu, Isabelle

2008-01-01

Background The biological mechanisms involved in inflammatory response to air pollution are not clearly understood. Objective In this study we assessed the association of short-term air pollutant exposure with inflammatory markers and lung function. Methods We studied a cohort of 158 asthmatic and 50 nonasthmatic school-age children, followed an average of 22 weeks. We conducted spirometric tests, measurements of fractional exhaled nitric oxide (FeNO), interleukin-8 (IL-8) in nasal lavage, and pH of exhaled breath condensate every 15 days during follow-up. Data were analyzed using linear mixed-effects models. Results An increase of 17.5 μg/m3 in the 8-hr moving average of PM2.5 levels (interquartile range) was associated with a 1.08-ppb increase in FeNO [95% confidence interval (CI), 1.01–1.16] and a 1.07-pg/mL increase in IL-8 (95% CI 0.98–1.19) in asthmatic children and a 1.16 pg/ml increase in IL-8 (95% CI, 1.00–1.36) in nonasthmatic children. The 5-day accumulated average of exposure to particulate matter < 2.5 μm in aerodynamic diamter (PM2.5) was significantly inversely associated with forced expiratory volume in 1 sec (FEV1) (p = 0.048) and forced vital capacity (FVC) (p = 0.012) in asthmatic children and with FVC (p = 0.021) in nonasthmatic children. FeNO and FEV1 were inversely associated (p = 0.005) in asthmatic children. Conclusions Exposure to PM2.5 resulted in acute airway inflammation and decrease in lung function in both asthmatic and nonasthmatic children. PMID:18560490

Organization of metabolic pathways in vastus lateralis of patients with chronic obstructive pulmonary disease.

PubMed

Green, Howard J; Bombardier, Eric; Burnett, Margaret; Iqbal, Sobia; D'Arsigny, Christine L; O'Donnell, Dennis E; Ouyang, Jing; Webb, Katherine A

2008-09-01

The objective of this study was to determine whether patients with chronic obstructive lung disease (COPD) display differences in organization of the metabolic pathways and segments involved in energy supply compared with healthy control subjects. Metabolic pathway potential, based on the measurement of the maximal activity (V(max)) of representative enzymes, was assessed in tissue extracted from the vastus lateralis in seven patients with COPD (age 67 +/- 4 yr; FEV(1)/FVC = 44 +/- 3%, where FEV(1) is forced expiratory volume in 1 s and FVC is forced vital capacity; means +/- SE) and nine healthy age-matched controls (age 68 +/- 2 yr; FEV(1)/FVC = 75 +/- 2%). Compared with control, the COPD patients displayed lower (P < 0.05) V(max) (mol.kg protein(-1).h(-1)) for cytochrome c oxidase (COX; 21.2 +/- 2.0 vs. 28.7 +/- 2.2) and 3-hydroxyacyl-CoA dehydrogenase (HADH; 2.54 +/- 0.14 vs. 3.74 +/- 0.12) but not citrate synthase (CS; 2.20 +/- 0.16 vs. 3.19 +/- 0.5). While no differences between groups were observed in V(max) for creatine phosphokinase, phosphorylase (PHOSPH), phosphofructokinase (PFK), pyruvate kinase, and lactate dehydrogenase, hexokinase (HEX) was elevated in COPD (P < 0.05). Enzyme activity ratios were higher (P < 0.05) for HEX/CS, HEX/COX, PHOSPH/HADH and PFK/HADH in COPD compared with control. It is concluded that COPD patients exhibit a reduced potential for both the electron transport system and fat oxidation and an increased potential for glucose phosphorylation while the potential for glycogenolysis and glycolysis remains normal. A comparison of enzyme ratios indicated greater potentials for glucose phosphorylation relative to the citric acid cycle and the electron transport chain and glycogenolysis and glycolysis relative to beta-oxidation.

Prospective randomized blinded trial of pulmonary function, pain, and cosmetic results after laparoscopic vs. microlaparoscopic cholecystectomy.

PubMed

Schwenk, W; Neudecker, J; Mall, J; Böhm, B; Müller, J M

2000-04-01

The size of laparoscopic instruments has been reduced for use in abdominal video endoscopic surgery. However, it has yet to be proven that microlaparoscopic surgery will actually result in clinically relevant benefits for patients. Fifty patients were randomized in a blinded fashion to receive either elective laparoscopic (MINI), (n = 25) or microlaparoscopic (MICRO) (n = 25) cholecystectomy. Pulmonary function (FVC, FEV (1)), analgesic consumption during patient-controlled analgesia (PCA), pain perception by visual analogue score (VAS), and the cosmetic result (by the patient's self-assessment) were evaluated postoperatively as clinically relevant end points. Age, sex, body mass index (BMI), preoperative pulmonary function, pain perception, and operative time were similar for the two groups. At 8:00 PM on the day of surgery, FVC (MINI: 1.96 L [range, 1.48-2.48]; MICRO: 2.13 L) [(range, 1.61.-2.50)] and FEV (1) (MINI: 1.17 L/sec) [range, 0.87-1. 48]; MICRO: 1.34 L/sec [range, 1.05.-2.14] were also similar (each p = 0.5). From surgery to the 3rd postoperative day, cumulative PCA morphine doses were comparable (MINI: 0.15 mg/kg bw [range, 0.09-0. 23]; MICRO: 0.21 mg/kg bw [range, 0.10-0.42]; p = 0.4), but overall VAS scores for pain while coughing were higher in the laparoscopic group (406 [range, 358-514]) than in the microlaparoscopic group (365 [range, 215-427]; p = 0.02). The cosmetic result was judged to be slightly superior by the microlaparoscopic patients (10 [range, 9-10]), as compared to those in the laparoscopic (9 [range, 8-10]) group (p = 0.04). Because microlaparoscopic cholecystectomy has some minor advantages over laparoscopic surgery, it should be considered for use in selected patients.

Short-Term Particulate Air Pollution Exposure is Associated with Increased Severity of Respiratory and Quality of Life Symptoms in Patients with Fibrotic Sarcoidosis.

PubMed

Pirozzi, Cheryl S; Mendoza, Daniel L; Xu, Yizhe; Zhang, Yue; Scholand, Mary Beth; Baughman, Robert P

2018-05-26

This study aimed to determine if short-term exposure to particulate matter (PM 2.5 ) and ozone (O₃) is associated with increased symptoms or lung function decline in fibrotic sarcoidosis. Sixteen patients with fibrotic sarcoidosis complicated by frequent exacerbations completed pulmonary function testing and questionnaires every three months for one year. We compared 7-, 10-, and 14-day average levels of PM 2.5 and O₃ estimated at patient residences to spirometry (forced expiratory volume in 1 s (FEV1), to forced vital capacity (FVC), episodes of FEV1 decline > 10%) and questionnaire outcomes (Leicester cough questionnaire (LCQ), Saint George Respiratory Questionnaire (SGRQ), and King's Sarcoidosis Questionnaire (KSQ)) using generalized linear mixed effect models. PM 2.5 level averaged over 14 days was associated with lower KSQ general health status (score change -6.60 per interquartile range (IQR) PM 2.5 increase). PM 2.5 level averaged over 10 and 14 days was associated with lower KSQ lung specific health status (score change -6.93 and -6.91, respectively). PM 2.5 levels were not associated with FEV₁, FVC, episodes of FEV₁ decline > 10%, or respiratory symptoms measured by SGRQ or LCQ. Ozone exposure was not associated with any health outcomes. In this small cohort of patients with fibrotic sarcoidosis, PM 2.5 exposure was associated with increased severity of respiratory and quality of life symptoms.

Measures of body habitus are associated with lung function in adults with cystic fibrosis: A population-based study☆

PubMed Central

Forrester, Doug L.; Knox, Alan J.; Smyth, Alan R.; Fogarty, Andrew W.

2013-01-01

Background Body habitus differences may explain some of the variation in lung function between individuals with cystic fibrosis (CF). We tested the hypothesis that measures of lean muscle mass and obesity are independently associated with lung function in CF. Methods Cross-sectional study design using UK CF registry data from 2096 clinically stable adults. Results Serum creatinine and BMI were positively and independently associated with FEV1 and FVC. One standard deviation increment in serum creatinine was associated with an FEV1 increase of 171 ml (95% confidence intervals CI: + 116 to + 227 ml) in males and 90 ml (95% CI: + 46 to + 133 ml) in females. Compared to the reference group of 20–24.9 kg/m2, those with a BMI < 20 kg/m2 had lower FEV1 with values of − 642 ml (95%CI: − 784 to − 500 ml) for males and − 468 ml (95%CI: − 564 to − 372 ml) for females. Conclusions Prospective studies and controlled trials are required to ascertain if these associations have therapeutic potential in modifying disease progression. PMID:22958983

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goren, A.I.; Brenner, S.; Hellmann, S.

During the summer of 1984 a health survey was carried out among the population of six rural settlements, three in a polluted and three in a low polluted area. Residents of these settlements between 6 and 65 years of age filled out an ATS-NHLI health questionnaire and performed the following pulmonary function tests (PFT): FVC, FEV/sub 1/, FEV/sub 1//FVC, PEF, FEF/sub 50/, and FEF/sub 75/. A trend of higher prevalence of reported respiratory symptoms and diseases characterizes children growing up in a polluted rural as compared with a low polluted rural area. The relative risks (calculated from logistic models) formore » children from the polluted area to have sputum with cold is 2.13, cough accompanied by sputum 3.89, and for their siblings to have respiratory diseases 3.02, as compared with 1.00 in the low polluted area. A trend of lower PFT characterizes children from the polluted area, with significantly reduced PEF. The trends for adults in the two areas were similar to those for the children. The relative risks for adults from the polluted area to have sputum is 1.7 and cough accompanied by sputum 2.6, as compared with 1.0 in the low polluted area. PEF is significantly lower among adults from the polluted area, while FEF/sub 50/ and FEF/sub 75/ are lower (not significantly) among adults from the low polluted area.« less

Increased lung function decline in blue-collar workers exposed to welding fumes.

PubMed

Thaon, Isabelle; Demange, Valérie; Herin, Fabrice; Touranchet, Annie; Paris, Christophe

2012-07-01

There is no consensus at the present time about the effect of welding on lung function decline. This study compared lung function decline between blue-collar workers exposed and not exposed to welding fumes in a French longitudinal cohort of 21,238 subjects aged 37 to 52 years at inclusion. Medical data, occupation, sector of activity, and spirometry were recorded twice by occupational physicians in 1990 and 1995. A job-exposure matrix was used to identify 503 male blue-collar workers exposed to welding fumes and 709 control subjects and to define the weekly duration of exposure to welding fumes. Baseline lung function parameters were higher in workers exposed to welding fumes than in control subjects. After a 5-year follow-up, welding-fume exposure was associated with a nonsignificant decline in FVC (P = .06) and FEV(1) (P = .07) after adjustment for age, pack-years, BMI, and baseline value of the parameter. A significant accelerated decline in FEV(1) (P = .046) was also observed in never smokers exposed to welding fumes. An “exposure-response” relationship was observed between FEV(1) decline and weekly duration of exposure to welding fumes in nonsmokers but not in smokers. Blue-collar workers exposed to welding fumes showed accelerated decline in lung function, which, in nonsmokers, was related to weekly duration of exposure.

Adopting Clean Fuels and Technologies on School Buses. Pollution and Health Impacts in Children.

PubMed

Adar, Sara D; D'Souza, Jennifer; Sheppard, Lianne; Kaufman, Joel D; Hallstrand, Teal S; Davey, Mark E; Sullivan, James R; Jahnke, Jordan; Koenig, Jane; Larson, Timothy V; Liu, L J Sally

2015-06-15

More than 25 million American children breathe polluted air on diesel school buses. Emission reduction policies exist, but the health impacts to individual children have not been evaluated. Using a natural experiment, we characterized the exposures and health of 275 school bus riders before, during, and after the adoption of clean technologies and fuels between 2005 and 2009. Air pollution was measured during 597 trips on 188 school buses. Repeated measures of exhaled nitric oxide (FeNO), lung function (FEV1, FVC), and absenteeism were also collected monthly (1,768 visits). Mixed-effects models longitudinally related the adoption of diesel oxidation catalysts (DOCs), closed crankcase ventilation systems (CCVs), ultralow-sulfur diesel (ULSD), or biodiesel with exposures and health. Fine and ultrafine particle concentrations were 10-50% lower on buses using ULSD, DOCs, and/or CCVs. ULSD adoption was also associated with reduced FeNO (-16% [95% confidence interval (CI), -21 to -10%]), greater changes in FVC and FEV1 (0.02 [95% CI, 0.003 to 0.05] and 0.01 [95% CI, -0.006 to 0.03] L/yr, respectively), and lower absenteeism (-8% [95% CI, -16.0 to -0.7%]), with stronger associations among patients with asthma. DOCs, and to a lesser extent CCVs, also were associated with improved FeNO, FVC growth, and absenteeism, but these findings were primarily restricted to patients with persistent asthma and were often sensitive to control for ULSD. No health benefits were noted for biodiesel. Extrapolating to the U.S. population, changed fuel/technologies likely reduced absenteeism by more than 14 million/yr. National and local diesel policies appear to have reduced children's exposures and improved health.

Older women exhibit greater airway 8-isoprostane responses to strenuous exercise compared with older men and younger controls.

PubMed

Kurti, Stephanie P; Emerson, Sam R; Smith, Joshua R; Rosenkranz, Sara K; Alexander, Samantha A; Lovoy, Garrett M; Harms, Craig A

2018-05-01

Development of late-onset respiratory diseases is associated with elevated 8-isoprostane, a marker of oxidative stress, in the airways. However, sex differences exist in development of these diseases. Using an exhaustive exercise bout as a physiological stressor may elucidate whether there is a sex difference with aging in pre- to postexercise airway 8-isoprostane generation. The purpose of this study was to determine whether older women exhibit a greater airway 8-isoprostane response to exhaustive exercise compared with older men and younger controls. Thirty-six individuals completed the study (12 postmenopausal older women (OW) and 12 age-matched older men (OM), 65 ± 4 years of age; and 12 younger controls (YC), 21 ± 2 years of age). Baseline measurements included exhaled breath condensate (EBC) for assessment of airway 8-isoprostane and standard pulmonary function tests (PFTs) to assess forced expiratory volume in 1-s (FEV 1 ), forced vital capacity (FVC), FEV 1 /FVC, and forced expiratory flow at 25%-75% of FVC. Subjects then performed a peak oxygen uptake test to exhaustion on a cycle ergometer. Immediately postexercise, PFTs and EBC were performed. The generation of airway 8-isoprostane from pre- to postexercise was greater in OW compared with OM and YC (p < 0.01), increasing ∼74% ± 77% in OW, while decreasing in OM (∼12% ± 50%) and YC (∼20.9% ± 30%). The OW exhibited a greater airway 8-isoprostane response to exhaustive exercise compared with OM and YC, which may suggest that sex differences in oxidative stress generation following exhaustive exercise may provide a mechanistic rationale for sex differences in late-onset respiratory diseases.

Adopting Clean Fuels and Technologies on School Buses. Pollution and Health Impacts in Children

PubMed Central

D’Souza, Jennifer; Sheppard, Lianne; Kaufman, Joel D.; Hallstrand, Teal S.; Davey, Mark E.; Sullivan, James R.; Jahnke, Jordan; Koenig, Jane; Larson, Timothy V.; Liu, L. J. Sally

2015-01-01

Rationale: More than 25 million American children breathe polluted air on diesel school buses. Emission reduction policies exist, but the health impacts to individual children have not been evaluated. Methods: Using a natural experiment, we characterized the exposures and health of 275 school bus riders before, during, and after the adoption of clean technologies and fuels between 2005 and 2009. Air pollution was measured during 597 trips on 188 school buses. Repeated measures of exhaled nitric oxide (FeNO), lung function (FEV1, FVC), and absenteeism were also collected monthly (1,768 visits). Mixed-effects models longitudinally related the adoption of diesel oxidation catalysts (DOCs), closed crankcase ventilation systems (CCVs), ultralow-sulfur diesel (ULSD), or biodiesel with exposures and health. Measurements and Main Results: Fine and ultrafine particle concentrations were 10–50% lower on buses using ULSD, DOCs, and/or CCVs. ULSD adoption was also associated with reduced FeNO (−16% [95% confidence interval (CI), −21 to −10%]), greater changes in FVC and FEV1 (0.02 [95% CI, 0.003 to 0.05] and 0.01 [95% CI, −0.006 to 0.03] L/yr, respectively), and lower absenteeism (−8% [95% CI, −16.0 to −0.7%]), with stronger associations among patients with asthma. DOCs, and to a lesser extent CCVs, also were associated with improved FeNO, FVC growth, and absenteeism, but these findings were primarily restricted to patients with persistent asthma and were often sensitive to control for ULSD. No health benefits were noted for biodiesel. Extrapolating to the U.S. population, changed fuel/technologies likely reduced absenteeism by more than 14 million/yr. Conclusions: National and local diesel policies appear to have reduced children’s exposures and improved health. PMID:25867003

Relationship between ultrasound bone parameters, lung function, and body mass index in healthy student population.

PubMed

Cvijetić, Selma; Pipinić, Ivana Sabolić; Varnai, Veda Maria; Macan, Jelena

2017-03-01

Low bone mineral density has been reported in paediatric and adult patients with different lung diseases, but limited data are available on the association between lung function and bone density in a healthy young population. We explored the predictors of association between bone mass and pulmonary function in healthy first-year university students, focusing on body mass index (BMI). In this cross-sectional study we measured bone density with ultrasound and lung function with spirometry in 370 university students (271 girls and 99 boys). Information on lifestyle habits, such as physical activity, smoking, and alcohol consumption were obtained with a questionnaire. All lung function and bone parameters were significantly higher in boys than in girls (P<0.001). Underweight students had a significantly lower forced vital capacity (FVC%) (P=0.001 girls; P=0.012 boys), while overweight students had a significantly higher FVC% than normal weight students (P=0.024 girls; P=0.001 boys). BMI significantly correlated with FVC% (P=0.001) and forced expiratory volume in 1 second (FEV1 %) in both genders (P=0.001 girls; P=0.018 boys) and with broadband ultrasound attenuation (BUA) in boys. There were no significant associations between any of the bone and lung function parameters either in boys or girls. The most important determinant of lung function and ultrasound bone parameters in our study population was body mass index, with no direct association between bone density and lung function.

Airway Obstruction Worsens in Young Adults with Asthma Who Become Obese.

PubMed

Strunk, Robert C; Colvin, Ryan; Bacharier, Leonard B; Fuhlbrigge, Anne; Forno, Erick; Arbelaez, Ana Maria; Tantisira, Kelan G

2015-01-01

Few studies have examined how developing obesity in early adulthood affects the course of asthma. We analyzed lung function and asthma impairment and risk among nonobese children with asthma, comparing those who were obese in young adulthood with those who remained nonobese. We carried out the post hoc analysis of 771 subjects with mild to moderate asthma who were not obese (pediatric definition, body mass index [BMI] < 95th percentile) when enrolled in the Childhood Asthma Management Program at ages 5-12 years. The subjects were then followed to age 20 years or more. For visits at ages 20 years or more, spirometry values as percent predicted and recent asthma symptom scores and prednisone exposure were compared between 579 subjects who were nonobese at all visits and 151 who were obese (adult definition of BMI ≥ 30 kg/m(2)) on at least 1 visit (median number of visits when obese = 4, IQR 2-7). Compared with participants who were nonobese (BMI 23.4 ± 2.6 kg/m(2)), those who became obese (BMI 31.5 ± 3.8 kg/m(2)) had significant decreases in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (P < .0003) and FEV1 (P = .001), without differences in FVC (P = .15) during visits at ages 20 years or more. For each unit increase of BMI, FEV1 percent predicted decreased by 0.29 (P = .0009). The relationship between BMI and lung function was not confounded by sex or BMI at baseline. Asthma impairment (symptom scores) and risk (prednisone use) did not differ between the 2 groups. Becoming obese in early adulthood was associated with increased airway obstruction, without impact on asthma impairment or risk. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study.

PubMed

Sköld, Carl Magnus; Janson, Christer; Elf, Åsa Klackenberg; Fiaschi, Marie; Wiklund, Kerstin; Persson, Hans Lennart

2016-01-01

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC) >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs) were collected from medical charts. Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1) [mean (SD)], diffusion capacity (DLco) was 45.1% (13.8) of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1) to FVC was 0.78 (0.1). The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a third of the patients had ADRs, but discontinuation of the treatment because of ADRs was relatively uncommon.

Biomarkers for Pulmonary Inflammation and Fibrosis and Lung Ventilation Function in Chinese Occupational Refractory Ceramic Fibers-Exposed Workers

PubMed Central

Gu, Yishuo; Ma, Wenjun; Gao, Panjun; Liu, Mengxuan; Xiao, Pei; Wang, Hongfei; Chen, Juan; Li, Tao

2017-01-01

Refractory ceramic fibers (RCFs) can cause adverse health effects on workers’ respiratory system, yet no proper biomarkers have been used to detect early pulmonary injury of RCFs-exposed workers. This study assessed the levels of two biomarkers that are related to respiratory injury in RCFs-exposed workers, and explored their relations with lung function. The exposure levels of total dust and respirable fibers were measured simultaneously in RCFs factories. The levels of TGF-β1 and ceruloplasmin (CP) increased with the RCFs exposure level (p < 0.05), and significantly increased in workers with high exposure level (1.21 ± 0.49 ng/mL, 115.25 ± 32.44 U/L) when compared with the control group (0.99 ± 0.29 ng/mL, 97.90 ± 35.01 U/L) (p < 0.05). The levels of FVC and FEV1 were significantly decreased in RCFs exposure group (p < 0.05). Negative relations were found between the concentrations of CP and FVC (B = −0.423, p = 0.025), or FEV1 (B = −0.494, p = 0.014). The concentration of TGF-β1 (B = 0.103, p = 0.001) and CP (B = 8.027, p = 0.007) were associated with respirable fiber exposure level. Occupational exposure to RCFs can impair lung ventilation function and may have the potential to cause pulmonary inflammation and fibrosis. TGF-β1 and CP might be used as sensitive and noninvasive biomarkers to detect lung injury in occupational RCFs-exposed workers. Respirable fiber concentration can better reflect occupational RCFs exposure and related respiratory injuries. PMID:29280967

The association of exposure to hepatitis B and C viruses with lung function and respiratory disease: a population based study from the NHANES III database.

PubMed

Goh, Li Yen; Card, Tim; Fogarty, Andrew W; McKeever, Tricia M

2014-12-01

Globally, 500 million people are chronically infected with Hepatitis B virus (HBV) and Hepatitis C virus (HCV). While these viruses are notorious for their detrimental effect on the liver they are also known to affect multiple organs in the body including the lungs. To investigate if exposure to HBV and HCV is associated with lung function and respiratory diseases. Data from the Third National Health and Nutrition Examination Survey (NHANES III) was analysed using multiple linear regressions to investigate the association between exposure to HBV and HCV with the various measures of lung function, while multiple logistic regressions were used to evaluate the association with the respiratory diseases asthma and chronic obstructive pulmonary disease (COPD). Exposure to HCV was significantly associated with an increase in Forced Expiratory Volume in 1 s, FEV1 (Coef: 97.94 ml, 95% CI: 38.87 to 157.01) and Full Vital Capacity, FVC (Coef: 90 ml, 95% CI: 14.50 to 166.24). Individuals who had been exposed to both HBV and HCV also had a significantly higher FEV1 (Coef: 145.82, CI: 60.68 to 230.94) and FVC (Coef: 195.09, CI: 78.91 to 311.26). There was also a significant association between exposure to HBV and asthma (OR: 1.28, 95% CI: 1.05 to 1.58). These associations were no longer significant after additionally adjusting for cocaine and marijuana use as well as poverty income ratio. Our research implies that hepatotropic viruses may affect the respiratory system, but more work at a population level is needed to further explore these associations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Natural history and galsulfase treatment in mucopolysaccharidosis VI (MPS VI, Maroteaux-Lamy syndrome)--10-year follow-up of patients who previously participated in an MPS VI Survey Study.

PubMed

Giugliani, Roberto; Lampe, Christina; Guffon, Nathalie; Ketteridge, David; Leão-Teles, Elisa; Wraith, James E; Jones, Simon A; Piscia-Nichols, Cheri; Lin, Ping; Quartel, Adrian; Harmatz, Paul

2014-08-01

Mucopolysaccharidosis VI (MPS VI) is a clinically heterogeneous and progressive disorder with multiorgan manifestations caused by deficient N-acetylgalactosamine-4-sulfatase activity. A cross-sectional Survey Study in individuals (n = 121) affected with MPS VI was conducted between 2001 and 2002 to establish demographics, urinary glycosaminoglycan (GAG) levels, and clinical progression of disease. We conducted a Resurvey Study (ClinicalTrials.gov: NCT01387854) to obtain 10-year follow-up data, including medical histories and clinical assessments (n = 59), and survival status over 12 years (n = 117). Patients received a mean (SD) of 6.8 (2.2) years of galsulfase ERT between baseline (Survey Study) and follow-up. ERT patients increased in height by 20.4 cm in the 4-7-year-old baseline age group and by 16.8 cm in the 8-12-year-old baseline age group. ERT patients <13 years-old demonstrated improvement in forced vital capacity (FVC) by 68% and forced expiratory volume in 1 sec (FEV1) by 55%, and those ≥13 years-old increased FVC by 12.8% and maintained FEV1. Patients with >200 µg/mg baseline uGAG levels increased FVC by 48% in the <13-year-old baseline age group and by 15% in the ≥13-year-old baseline age group. ERT patients who completed the 6-min walk test demonstrated a mean (SD) increase of 65.7 (100.6) m. Cardiac outcomes did not significantly improve or worsen. Observed mortality rate among naïve patients was 50% (7/14) and 16.5% (17/103) in the ERT group (unadjusted hazard ratio, 0.24; 95% CI, 0.10-0.59). Long-term galsulfase ERT was associated with improvements in pulmonary function and endurance, stabilized cardiac function and increased survival. © 2014 Wiley Periodicals, Inc.

Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery.

PubMed

Cleva, Roberto de; Assumpção, Marianna Siqueira de; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C; Jacob Filho, Wilson

2014-07-01

Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. The mean age of the patients was 56 ± 13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6 ± 0.6 L) and FVC (2.0 ± 0.7 L) with maintenance of FEV1/FVC of 0.8 ± 0.2 in both groups. The maximum intra-abdominal pressure values were similar (p=0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goren, A.I.; Hellman, S.; Brenner, S.

During spring 1984, 2,334 second and 2,000 fifth-grade schoolchildren living in three Haifa Bay areas on the eastern Mediterranean coast with different levels of air pollution were studied. The parents of these children filled out American Thoracic Society and National Heart and Lung Institute health questionnaires, and the children performed the following pulmonary function tests (PFT): FVC, FEV{sub 1}, FEV{sub 1}/FEV, PEF, FEF{sub 50}, and FEF{sub 75}. A trend of higher prevalence of most reported respiratory symptoms was found for schoolchildren growing up in the medium and high pollution areas as compared with the low pollution area. Part of themore » reported respiratory diseases were significantly more common among children from the high pollution area. Models fitted for the respiratory conditions that differed significantly among the three areas of residence also included background variables that could be responsible for these differences. Relative risk values, which were calculated from the logistic models, were in the range of 1.38 for sputum with cold and 1.81 for sputum without cold for children from the high pollution area as compared with 1.00 for children from the low pollution area. All the measured values of PFT were within the normal range. There was no consistent trend of reduced pulmonary function that characterized any residential area.« less

Impact of geocoding methods on associations between long-term exposure to urban air pollution and lung function.

PubMed

Jacquemin, Bénédicte; Lepeule, Johanna; Boudier, Anne; Arnould, Caroline; Benmerad, Meriem; Chappaz, Claire; Ferran, Joane; Kauffmann, Francine; Morelli, Xavier; Pin, Isabelle; Pison, Christophe; Rios, Isabelle; Temam, Sofia; Künzli, Nino; Slama, Rémy; Siroux, Valérie

2013-09-01

Errors in address geocodes may affect estimates of the effects of air pollution on health. We investigated the impact of four geocoding techniques on the association between urban air pollution estimated with a fine-scale (10 m × 10 m) dispersion model and lung function in adults. We measured forced expiratory volume in 1 sec (FEV1) and forced vital capacity (FVC) in 354 adult residents of Grenoble, France, who were participants in two well-characterized studies, the Epidemiological Study on the Genetics and Environment on Asthma (EGEA) and the European Community Respiratory Health Survey (ECRHS). Home addresses were geocoded using individual building matching as the reference approach and three spatial interpolation approaches. We used a dispersion model to estimate mean PM10 and nitrogen dioxide concentrations at each participant's address during the 12 months preceding their lung function measurements. Associations between exposures and lung function parameters were adjusted for individual confounders and same-day exposure to air pollutants. The geocoding techniques were compared with regard to geographical distances between coordinates, exposure estimates, and associations between the estimated exposures and health effects. Median distances between coordinates estimated using the building matching and the three interpolation techniques were 26.4, 27.9, and 35.6 m. Compared with exposure estimates based on building matching, PM10 concentrations based on the three interpolation techniques tended to be overestimated. When building matching was used to estimate exposures, a one-interquartile range increase in PM10 (3.0 μg/m3) was associated with a 3.72-point decrease in FVC% predicted (95% CI: -0.56, -6.88) and a 3.86-point decrease in FEV1% predicted (95% CI: -0.14, -3.24). The magnitude of associations decreased when other geocoding approaches were used [e.g., for FVC% predicted -2.81 (95% CI: -0.26, -5.35) using NavTEQ, or 2.08 (95% CI -4.63, 0.47, p = 0.11) using Google Maps]. Our findings suggest that the choice of geocoding technique may influence estimated health effects when air pollution exposures are estimated using a fine-scale exposure model.

High-pitched breath sounds indicate airflow limitation in asymptomatic asthmatic children.

PubMed

Habukawa, Chizu; Nagasaka, Yukio; Murakami, Katsumi; Takemura, Tsukasa

2009-04-01

Asthmatic children may have airway dysfunction even when asymptomatic, indicating that their long-term treatment is less than optimal. Although airway dysfunction can be identified on lung function testing, performing these tests can be difficult in infants. We studied whether breath sounds reflect subtle airway dysfunction in asthmatic children. The highest frequency of inspiratory breaths sounds (HFI) and the highest frequency of expiratory breath sounds (HFE) were measured in 131 asthmatic children while asymptomatic and with no wheezes for more than 2 weeks. No child was being treated with inhaled corticosteroids (ICS). Breath sounds were recorded and analysed by sound spectrography and compared with spirometric parameters. After initial evaluation, cases with more than step 2 (mild persistent) asthma were treated using inhaled fluticasone (100-200 microg/day) for 1 month, and then breath sound analysis and pulmonary function testing were repeated. On initial evaluation, HFI correlated with the percentage of predicted FEF(50) (%FEF(50)), (r = -0.45, P < 0.001), the percentage of predicted FEF(75) (%FEF(75)) (r = -0.456, P < 0.001), and FEV(1) as a percentage of FVC (FEV(1)/FVC (%)) (r = -0.32, P < 0.001). HFI did not correlate with the percentage of predicted PEF (%PEF). The 69 children with lower than normal %FEF(50) were then treated with ICS. The %FEF(50) and %FEF(75) improved after ICS treatment, and increases in %FEF(50) (P < 0.005) correlated with decreases in HFI (P < 0.001). Higher HFI in asymptomatic asthmatic children may indicate small airway obstruction. Additional ICS treatment may improve the pulmonary function indices representing small airway function with simultaneous HFI decreases in such patients.

Influence of radiological emphysema on lung function test in idiopathic pulmonary fibrosis.

PubMed

Bodlet, Aline; Maury, Gisèle; Jamart, Jacques; Dahlqvist, Caroline

2013-11-01

Idiopathic pulmonary fibrosis (IPF) is one of the most frequent interstitial lung disease. Emphysema can be associated with IPF as described in the «Combined pulmonary fibrosis and emphysema» syndrome. The primary endpoint of this retrospective cohort study was to evaluate the impact of the association of IPF and emphysema on lung function tests parameters (FVC, TLC, FEV1, FEV1/FVC and DLCO). The secondary endpoint was to assess the impact of the associated radiological emphysema on lung function parameters used in the du Bois prognostic score recently developed by Ron du Bois et al. We retrospectively reviewed the medical files of 98 patients with lung fibrosis who were followed in our University Hospital with access to pharmacological studies and lung transplantation from 1981 to 2011. Fifty six patients were considered for analysis. The collected data included gender, age, smoking history and respiratory hospitalizations. We also analysed their pulmonary functional parameters along with radiological characteristics, in particular the presence of emphysema which was assessed on thoracic high resolution CT scan. The du Bois score was retrospectively calculated from these data. TLC and FVC at diagnosis were significantly higher in the IPF-E group compared to the IPF group (respectively 86.6 ± 17.2% pv versus 72.0 ± 15.0% pv; p: 0.004 and 86.8 ± 18.4% pv versus 72.6 ± 20.6% pv; p: 0.020). The [Formula: see text] used in the calculation of the du Bois prognostic score was significantly higher in the IPF-E group. By cons, [Formula: see text] was not statistically different between the two groups. Radiological emphysema associated with IPF had an impact on pulmonary function tests. Despite this difference, the du Bois score was not statistically different between these two groups. Nevertheless, after one year of follow up, the patients with emphysema were in a subclass with a lower mortality rate than those without emphysema. Copyright © 2013 Elsevier Ltd. All rights reserved.

Biologic lung volume reduction in advanced upper lobe emphysema: phase 2 results.

PubMed

Criner, Gerard J; Pinto-Plata, Victor; Strange, Charlie; Dransfield, Mark; Gotfried, Mark; Leeds, William; McLennan, Geoffrey; Refaely, Yael; Tewari, Sanjiv; Krasna, Mark; Celli, Bartolome

2009-05-01

Biologic lung volume reduction (BioLVR) is a new endobronchial treatment for advanced emphysema that reduces lung volume through tissue remodeling. Assess the safety and therapeutic dose of BioLVR hydrogel in upper lobe predominant emphysema. Open-labeled, multicenter phase 2 dose-ranging studies were performed with BioLVR hydrogel administered to eight subsegmental sites (four in each upper lobe) involving: (1) low-dose treatment (n = 28) with 10 ml per site (LD); and (2) high-dose treatment (n = 22) with 20 ml per site (HD). Safety was assessed by the incidence of serious medical complications. Efficacy was assessed by change from baseline in pulmonary function tests, dyspnea score, 6-minute walk distance, and health-related quality of life. After treatment there were no deaths and four serious treatment-related complications. A reduction in residual volume to TLC ratio at 12 weeks (primary efficacy outcome) was achieved with both LD (-6.4 +/- 9.3%; P = 0.002) and HD (-5.5 +/- 9.4%; P = 0.028) treatments. Improvements in pulmonary function in HD (6 mo: DeltaFEV(1) = +15.6%; P = 0.002; DeltaFVC = +9.1%; P = 0.034) were greater than in LD patients (6 mo: DeltaFEV(1) = +6.7%; P = 0.021; DeltaFVC = +5.1%; P = 0.139). LD- and HD-treated groups both demonstrated improved symptom scores and health-related quality of life. BioLVR improves physiology and functional outcomes up to 6 months with an acceptable safety profile in upper lobe predominant emphysema. Overall improvement was greater and responses more durable with 20 ml per site than 10 ml per site dosing. Clinical trial registered with www.clinicaltrials.gov (NCT 00435253 and NCT 00515164).

Epidemiological study of respiratory disease in workers exposed to polyvinylchloride dust.

PubMed Central

Soutar, C A; Copland, L H; Thornley, P E; Hurley, J F; Ottery, J; Adams, W G; Bennett, B

1980-01-01

The respiratory health of workers exposed to polyvinylchloride (PVC) dust has been investigated in 818 men sampled from the work force of a factory manufacturing PVC. In a cross-sectional survey, the lung function and prevalences of respiratory symptoms and chest radiographic abnormalities were compared with estimates of individual PVC dust exposures based on detailed occupational histories and current measurements of respirable PVC dust. Complaints of slight exertional dyspnoea were associated with PVC dust exposure, though age and smoking effects were much stronger. The forced expired volume in one second (FEV1) and forced vital capacity (FVC) were inversely related to dust exposure after age, height, and smoking effects had been taken into account. This effect was seen principally in cigarette smokers, and there was suggestive evidence that PVC dust exposure and cigarette smoking interacted in the reduction of FEV1 and FVC. Gas transfer factor was not related to dust exposure. The chest radiographs were read according to the ILO U/C classification by three experienced readers. One reader recorded a low prevalence of small rounded opacities, and these were not related to age or dust exposure. Another reader recorded a higher prevalence of small rounded opacities category 0/1 or more, and these were related to age but not to dust exposure. The third reader recorded the highest prevalence of small rounded opacities (though none greater than category 1/1), and these were independently related both to age and to PVC dust exposure, indicating an effect of PVC dust on the appearance of the chest radiography. These appearances were so slight that only the higher sensitivity of this reader in the interpretation of profusion of small rounded opacities on the ILO U/C scale enabled detection of this effect of PVC dust. In conclusion, exposure to PVC dust is associated with some deterioration of lung function, slight abnormalities of the chest radiograph, and complaints of slight dyspnoea. The mean decline in FEV1 associated with the average dust exposure experienced in the study was small, though some of the men with higher dust exposures may have suffered clinically important loss of lung function as a result of their occupation. PMID:7444838

Systemic complications of trinitrotoluene (TNT) in exposed workers.

PubMed

Naderi, Mostafa; Ghanei, Mostafa; Shohrati, Majid; Saburi, Amin; Babaei, Mahmoud; Najafian, Bita

2013-03-01

2,4,6-trinitrotoluene (TNT) has been widely used as an explosive. TNT can induce some well-recognized toxic impacts comprising toxic hepatitis, aplastic anemia and cataract. The aim of study was evaluation of TNT exposed workers for systemic complication. In a cross-sectional study, we carried out Liver Function Test (LFT), complete blood count (CBC) and slit lamp biomicroscopy to compare the prevalence and severity of these 3 complications between 47 male TNT exposed workers (with at least one year continuous experience of TNT exposure) and 43 unexposed male hospital worker who hadn't had any previous contacts with TNT. We also performed Pulmonary Function Test (PFT) to assess the probable obstructive/restrictive abnormalities, caused by TNT. Mean alkaline phosphatase (ALP) level of TNT exposed group was significantly higher than the unexposed group (p = 0.023) Forced Expiratory Volume in one second to Forced Vital Capacity (FEV1/FVC) ratios of both groups were in the range of restrictive pattern (82.03% and 81.42% for the exposed and unexposed group, respectively) with no meaningful difference. We didn't find out any specific TNT induced cataract and general cortical cataract (CC) and nuclear sclerotic cataract (NSC) prevalence was not significantly different. we haven't found TNT as a chemical, causing toxic hepatitis or aplastic anemia; neither did we find it as a compound, responsible for a meaningful increase in cataract prevalence. However, due to the increased ALP serum levels and FEV1/FVC ratios among TNT workers, safety precautions are advised.

Comparison between two thoracotomy closure techniques: postoperative pain and pulmonary function*

PubMed Central

Leandro, Juliana Duarte; Rodrigues, Olavo Ribeiro; Slaets, Annie France Frere; Schmidt, Aurelino F.; Yaekashi, Milton L.

2014-01-01

OBJECTIVE: To compare two thoracotomy closure techniques (pericostal and transcostal suture) in terms of postoperative pain and pulmonary function. METHODS: This was a prospective, randomized, double-blind study carried out in the Department of Thoracic Surgery of the Luzia de Pinho Melo Hospital das Clínicas and at the University of Mogi das Cruzes, both located in the city of Mogi das Cruzes, Brazil. We included 30 patients (18-75 years of age) undergoing posterolateral or anterolateral thoracotomy. The patients were randomized into two groups by the type of thoracotomy closure: pericostal suture (PS; n = 16) and transcostal suture (TS; n = 14). Pain intensity during the immediate and late postoperative periods was assessed by a visual analogic scale and the McGill Pain Questionnaire. Spirometry variables (FEV1, FVC, FEV1/FVC ratio, and PEF) were determined in the preoperative period and on postoperative days 21 and 60. RESULTS: Pain intensity was significantly greater in the PS group than in the TS group. Between the preoperative and postoperative periods, there were decreases in the spirometry variables studied. Those decreases were significant in the PS group but not in the TS group. CONCLUSIONS: The patients in the TS group experienced less immediate and late post-thoracotomy pain than did those in the PS group, as well as showing smaller reductions in the spirometry parameters. Therefore, transcostal suture is recommended over pericostal suture as the thoracotomy closure technique of choice. PMID:25210961

Improved health of hospitality workers after a Swiss cantonal smoking ban.

PubMed

Durham, André-Dante; Bergier, Samuel; Morisod, Xavier; Locatelli, Isabella; Zellweger, Jean-Pierre; Huynh, Cong Khanh; Cornuz, Jacques

2011-12-22

Hospitality workers are a population particularly at risk from the noxious effects of environmental tobacco smoke (ETS). The Canton of Vaud, Switzerland banned smoking in public places in September 2009. This prospective study addresses the impact of the ban on the health of hospitality workers. ETS exposure was evaluated using a passive sampling device that measures airborne nicotine; lung function was assessed by spirometry; health-related quality of life, ETS exposure symptoms and satisfaction were measured by questionnaire. 105 participants (smokers and non-smokers) were recruited initially and 66 were followed up after one year. ETS exposure was significantly lower after the ban. Hospitality workers had lower pre-ban forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values than expected. FEV1 remained stable after the ban, with a near-significant increase in the subgroup of asthmatics only. FVC increased at one year follow-up from 90.42% to 93.05% (p = 0.02) in the entire cohort; women, non-smokers and older participants gained the greatest benefit. The health survey showed an increase in physical wellbeing after the ban, the greatest benefit being observed in non-smokers. ETS exposure symptoms were less frequent after the ban, especially red and irritated eyes and sneezing. The new law was judged useful and satisfactory by the vast majority of employees, including smokers. The recent cantonal ban on smoking in public places brought about an improvement in lung function, physical well-being and ETS symptoms of hospitality workers, including smokers.

Diagnostic management of chronic obstructive pulmonary disease.

PubMed

Broekhuizen, B D L; Sachs, A P E; Hoes, A W; Verheij, T J M; Moons, K G M

2012-01-01

Detection of early chronic obstructive pulmonary disease (COPD) in patients presenting with respiratory symptoms is recommended; however, diagnosing COPD is difficult because a single gold standard is not available. The aim of this article is to review and interpret the existing evidence, theories and consensus on the individual parts of the diagnostic work-up for COPD. Relevant articles are discussed under the subheadings: history taking, physical examination, spirometry and additional lung function assessment. Wheezing, cough, phlegm and breathlessness on exertion are suggestive signs for COPD. The diagnostic value of the physical examination is limited, except for auscultated pulmonary wheezing or reduced breath sounds, increasing the probability of COPD. Spirometric airflow obstruction after bronchodilation, defined as a lowered ratio of the forced volume in one second to the forced vital capacity (FEV1/FVC ratio), is a prerequisite, but can only confirm COPD in combination with suggestive symptoms. Different thresholds are being recommended to define low FEV1/FVC, including a fixed threshold, and one varying with gender and age; however, the way physicians interpret these thresholds in their assessment is not well known. Body plethysmography allows a more complete assessment of pulmonary function, providing results on the total lung capacity and the residual volume and is indicated when conventional spirometry results are inconclusive. Chest radiography has no diagnostic value for COPD but is useful to exclude alternative diagnoses such as heart failure or lung cancer. Extensive history taking is of key importance in diagnosing COPD.

Clinical characterization of children with resistant airflow obstruction, a multicenter study.

PubMed

Krishnan, Sankaran; Dozor, Allen J; Bacharier, Leonard; Lang, Jason E; Irvin, Charles G; Kaminsky, David; Farber, Harold J; Gerald, Lynn; Brown, Mark; Holbrook, Janet T; Wise, Robert A; Ryu, Julie; Bose, Sonali; Yasin, Razan; Saams, Joy; Henderson, Robert J; Teague, William G

2018-05-17

To characterize a cohort of children with airflow limitation resistant to bronchodilator (BD) therapy. Pulmonary function tests performed in children 6-17 years of age at 15 centers in a clinical research consortium were screened for resistant airflow limitation, defined as a post-BD FEV 1 and/or an FEV 1 /FVC less than the lower limits of normal. Demographic and clinical data were analyzed for associations with pulmonary function. 582 children were identified. Median age was 13 years (IQR: 11, 16), 60% were males; 62% were Caucasian, 28% were African-American; 19% were obese; 32% were born prematurely and 21% exposed to second hand smoke. Pulmonary diagnoses included asthma (93%), prior significant pneumonia (28%), and bronchiectasis (5%). 65% reported allergic rhinitis, and 11% chronic sinusitis. Subjects without a history of asthma had significantly lower post-BD FEV 1 % predicted (p = 0.008). Subjects without allergic rhinitis had lower post-BD FEV 1 % predicted (p = 0.003). Children with allergic rhinitis, male sex, obesity and Black race had better pulmonary function post-BD. There was lower pulmonary function in children after age 11 years without a history of allergic rhinitis, as compared to those with a history of allergic rhinitis. The most prevalent diagnosis in children with BD-resistant airflow limitation is asthma. Allergic rhinitis and premature birth are common co-morbidities. Children without a history of asthma, as well as those with asthma but no allergic rhinitis, had lower pulmonary function. Children with BD-resistant airflow limitation may represent a sub-group of children with persistent obstruction and high risk for life-long airway disease.

Body Mass Index and Phenotype in Mild-to-Moderate Persistent Asthma

PubMed Central

Sutherland, E. Rand; Lehman, Erik B.; Teodorescu, Mihaela; Wechsler, Michael E.

2009-01-01

Background While obesity has been hypothesized to worsen asthma, data from studies of well-characterized asthmatics are lacking. Objective Evaluate the relationship between body mass index (BMI), asthma impairment and response to therapy. Methods BMI (kg/m2) and asthma phenotypic and treatment response data were extracted from Asthma Clinical Research Network (ACRN) studies. The cross-sectional relationship between BMI and asthma impairment was analyzed, as was the longitudinal relationship between BMI and response to asthma controller therapies. Results 1,265 subjects with mild-to-moderate persistent asthma were evaluated. Analyses of lean vs. overweight/obese asthmatics demonstrated small differences in FEV1 (3.05 vs. 2.91 L, p=0.001), FEV1/FVC (mean 83.5% vs. 82.4%, p=0.01), rescue albuterol use (1.1 vs. 1.2 puffs/day, p=0.03) and asthma-related quality of life (5.77 vs. 5.59, p=0.0004). Overweight/obese asthmatics demonstrated a smaller improvement in exhaled nitric oxide with inhaled corticosteroid (ICS) treatment than did lean asthmatics (3.6 vs. 6.5ppb, p=0.04). With ICS/long-acting beta agonist treatment, overweight/obese asthmatics demonstrated smaller improvements in lung function than lean asthmatics, with an 80mL (p=0.04) and 1.7% (p=0.02) lesser improvement in FEV1 and FEV1/FVC ratio, respectively. Significant differences in therapeutic response to leukotriene modifiers between BMI categories were not observed. Conclusions Elevated BMI is not associated with clinically-significant worsening of impairment in patients with mild-to-moderate persistent asthma. There is a modest association between elevated BMI and reduced therapeutic effect of ICS-containing regimens in this patient population. Prospective studies evaluating the impact of overweight and obesity on treatment response in asthma are warranted. Clinical Implications In individuals with mild to moderate persistent asthma, being overweight or obese does not appear to modify indices of asthma-related impairment. Elevated body mass index may reduce response to inhaled corticosteroid-containing treatment regimens. PMID:19501235

Pulmonary Function Testing After Stereotactic Body Radiotherapy to the Lung

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bishawi, Muath; Kim, Bong; Moore, William H.

2012-01-01

Purpose: Surgical resection remains the standard of care for operable early-stage non-small-cell lung cancer (NSCLC). However, some patients are not fit for surgery because of comorbidites such as chronic obstructive pulmonary disease (COPD) and other medical conditions. We aimed to evaluate pulmonary function and tumor volume before and after stereotactic body radiotherapy (SBRT) for patients with and without COPD in early-stage lung cancer. Methods and Materials: A review of prospectively collected data of Stage I and II lung cancers, all treated with SBRT, was performed. The total SBRT treatment was 60 Gy administered in three 20 Gy fractions. The patientsmore » were analyzed based on their COPD status, using their pretreatment pulmonary function test cutoffs as established by the American Thoracic Society guidelines (forced expiratory volume [FEV]% {<=}50% predicted, FEV%/forced vital capacity [FVC]% {<=}70%). Changes in tumor volume were also assessed by computed tomography. Results: Of a total of 30 patients with Stage I and II lung cancer, there were 7 patients in the COPD group (4 men, 3 women), and 23 in t he No-COPD group (9 men, 14 women). At a mean follow-up time of 4 months, for the COPD and No-COPD patients, pretreatment and posttreatment FEV% was similar: 39 {+-} 5 vs. 40 {+-} 9 (p = 0.4) and 77 {+-} 0.5 vs. 73 {+-} 24 (p = 0.9), respectively. The diffusing capacity of the lungs for carbon monoxide (DL{sub CO}) did significantly increase for the No-COPD group after SBRT treatment: 60 {+-} 24 vs. 69 {+-} 22 (p = 0.022); however, DL{sub CO} was unchanged for the COPD group: 49 {+-} 13 vs. 50 {+-} 14 (p = 0.8). Although pretreatment tumor volume was comparable for both groups, tumor volume significantly shrank in the No-COPD group from 19 {+-} 24 to 9 {+-} 16 (p < 0.001), and there was a trend in the COPD patients from 12 {+-} 9 to 6 {+-} 5 (p = 0.06). Conclusion: SBRT did not seem to have an effect on FEV{sub 1} and FVC, but it shrank tumor volume and improved DL{sub CO} for patients without COPD.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jingbo; Department of Radiation Oncology, Cancer Hospital, Chinese Academic Medical Sciences and Peking Union Medical College, Beijing; Cao, Jianzhong

Purpose: Poor pulmonary function (PF) is often considered a contraindication to definitive radiation therapy for lung cancer. This study investigated whether baseline PF was associated with radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) receiving conformal radiation therapy (CRT). Methods and Materials: NSCLC patients treated with CRT and tested for PF at baseline were eligible. Baseline predicted values of forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and diffusion capacity of lung for carbon monoxide (DLCO) were analyzed. Additional factors included age, gender, smoking status, Karnofsky performance status, coexisting chronic obstructive pulmonary diseasemore » (COPD), tumor location, histology, concurrent chemotherapy, radiation dose, and mean lung dose (MLD) were evaluated for RILT. The primary endpoint was symptomatic RILT (SRILT), including grade ≥2 radiation pneumonitis and fibrosis. Results: There was a total of 260 patients, and SRILT occurred in 58 (22.3%) of them. Mean FEV1 values for SRILT and non-SRILT patients were 71.7% and 65.9% (P=.077). Under univariate analysis, risk of SRILT increased with MLD (P=.008), the absence of COPD (P=.047), and FEV1 (P=.077). Age (65 split) and MLD were significantly associated with SRILT in multivariate analysis. The addition of FEV1 and age with the MLD-based model slightly improved the predictability of SRILT (area under curve from 0.63-0.70, P=.088). Conclusions: Poor baseline PF does not increase the risk of SRILT, and combining FEV1, age, and MLD may improve the predictive ability.« less

Occupational asthma, eosinophil and skin prick tests and serum total IgE values of the workers in a plant manufacturing rose oil.

PubMed

Akkaya, A; Ornek, Z; Kaleli, S

2004-01-01

This study was aimed to determine the rate of occupational asthma (OA) in workers at a rose extracting plant. Specific clinical tests of 52 workers, randomly chosen from four local rose extracting plants, were statistically compared with the test results of 30 local control subjects of similar age and sex as the plant workers, but who had never worked in such a plant. There were no significant differences in pulmonary function tests (FVC, FEV1, FEV1/FVC, PEFR) between the control and test groups. Significantly higher serum total IgE values (p < 0.0001) were observed for the test subjects (239.08+/-240 IU/ml) compared to the control subjects (81.33+/-61.45 IU/ml). There were also significant differences (p < 0.0001) in the number of eosinophils between the control and test groups, with corresponding mean values of 2.28+/-2.75% and 0.73+/-1.72%, respectively. A specifically prepared skin prick test using a rose allergen (Rosa domescena) was positive for 53.84% in the test subjects whereas only 5.33% positive test results were seen in the control group. We have demonstrated the involvement of Rosa domescena pollen in occupational allergy, through IgE-mediated hypersensitivity. It was concluded that the workers of a rose oil extracting plant are more susceptible to the rose pollens.

Effects of indoor air pollution on lung function of primary school children in Kuala Lumpur

DOE Office of Scientific and Technical Information (OSTI.GOV)

Azizi, B.H.; Henry, R.L.

1990-01-01

In a cross-sectional study of 7-12 year-old primary school children in Kuala Lumpur city, lung function was assessed by spirometric and peak expiratory flow measurements. Spirometric and peak expiratory flow measurements were successfully performed in 1,214 and 1,414 children, respectively. As expected, the main predictors of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and peak expiratory flow rate (PEFR) were standing height, weight, age, and sex. In addition, lung function values of Chinese and Malays were generally higher than those of Indians. In multiple regressionmore » models which included host and environmental factors, asthma was associated with significant decreases in FEV1, FEF25-75, and PEFR. However, family history of chest illness, history of allergies, low paternal education, and hospitalization during the neonatal period were not independent predictors of lung function. Children sharing rooms with adult smokers had significantly lower levels of FEF25-75. Exposures to wood or kerosene stoves were, but to mosquito repellents were not, associated with decreased lung function.« less

Respiratory Abnormalities among Occupationally Exposed, Non-Smoking Brick Kiln Workers from Punjab, India.

PubMed

Tandon, Supriya; Gupta, Sharat; Singh, Sharanjeet; Kumar, Avnish

2017-07-01

Brick manufacturing industry is one of the oldest and fast-growing industries in India that employs a large section of people. Brick kiln workers are occupationally exposed to air pollutants. Nonetheless, only a few studies have so far been conducted on their respiratory health. To investigate the extent of respiratory impairment in brick kiln workers and to correlate it with the duration of exposure. A cross-sectional study was conducted. Spirometric parameters of 110 non-smoking male brick kiln workers aged 18-35 years in Patiala district, Punjab, India, were compared with an age-matched comparison group of 90 unexposed individuals. Brick kiln workers showed a significant (p<0.05) decline in forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), forced mid-expiratory flow rate (FEF 25-75% ) and peak expiratory flow rate (PEFR) compared with those of the comparison group. The extent of deterioration in lung function of brick kiln workers was associated with the duration of exposure. In workers with >8 years of exposure, the mean values of FEV 1 (1.92 L), FVC (2.01 L), FEF 25-75% (2.19 L/s) and PEFR (4.81 L/s) were significantly (p<0.05) lower than those recorded in workers with <8 years of exposure in whom the values were 2.01 L, 2.68 L, 2.71 L/s, and 5.76 L/s, respectively. There is a significant association between exposure to workplace pollutants and lung function deterioration among brick kiln workers.

Lung function in adults following in utero and childhood exposure to arsenic in drinking water: preliminary findings.

PubMed

Dauphiné, David C; Ferreccio, Catterina; Guntur, Sandeep; Yuan, Yan; Hammond, S Katharine; Balmes, John; Smith, Allan H; Steinmaus, Craig

2011-08-01

Evidence suggests that arsenic in drinking water causes non-malignant lung disease, but nearly all data concern exposed adults. The desert city of Antofagasta (population 257,976) in northern Chile had high concentrations of arsenic in drinking water (>800 μg/l) from 1958 until 1970, when a new treatment plant was installed. This scenario, with its large population, distinct period of high exposure, and accurate data on past exposure, is virtually unprecedented in environmental epidemiology. We conducted a pilot study on early-life arsenic exposure and long-term lung function. We present these preliminary findings because of the magnitude of the effects observed. We recruited a convenience sample consisting primarily of nursing school employees in Antofagasta and Arica, a city with low drinking water arsenic. Lung function and respiratory symptoms in 32 adults exposed to >800 μg/l arsenic before age 10 were compared to 65 adults without high early-life exposure. Early-life arsenic exposure was associated with 11.5% lower forced expiratory volume in 1 s (FEV(1)) (P = 0.04), 12.2% lower forced vital capacity (FVC) (P = 0.04), and increased breathlessness (prevalence odds ratio = 5.94, 95% confidence interval 1.36-26.0). Exposure-response relationships between early-life arsenic concentration and adult FEV(1) and FVC were also identified (P trend = 0.03). Early-life exposure to arsenic in drinking water may have irreversible respiratory effects of a magnitude similar to smoking throughout adulthood. Given the small study size and non-random recruitment methods, further research is needed to confirm these findings.

Lung function measures following simulated wildland firefighter exposures.

PubMed

Ferguson, Matthew D; Semmens, Erin O; Weiler, Emily; Domitrovich, Joe; French, Mary; Migliaccio, Christopher; Palmer, Charles; Dumke, Charles; Ward, Tony

2017-09-01

Across the world, biomass smoke is a major source of air pollution and is linked with a variety of adverse health effects. This is particularly true in the western U.S. where wood smoke from wildland forest fires are a significant source of PM 2.5 . Wildland firefighters are impacted as they experience elevated PM 2.5 concentrations over extended periods of time, often occurring during physical exertion. Various epidemiological studies have investigated wood smoke impacts on human health, including occupational field exposures experienced by wildland firefighters. As there are numerous challenges in carrying out these field studies, having the ability to research the potential health impacts to this occupational cohort in a controlled setting would provide important information that could be translated to the field setting. To this end, we have carried out a simulated wildland firefighter exposure study in a wood smoke inhalation facility. Utilizing a randomized crossover trial design, we exposed 10 participants once to clean filtered-air, 250 µg/m 3 , and 500 µg/m 3 wood stove-generated wood smoke PM 2.5 . Participants exercised on a treadmill at an absolute intensity designed to simulate wildland firefighting for 1.5 hr. In addition to measured PM 2.5 smoke concentrations, mean levels of CO 2 , CO, and % relative humidity were continuously monitored and recorded and were representative of occupational "real-world" exposures. Pulmonary function was measured at three time points: before, immediately after, and 1-hr post-exposure. Although there were some reductions in FVC, FEV 1 , and FVC:FEV 1 measures, results of the spirometry testing did not show significant changes in lung function. The development of this wood smoke inhalational facility provides a platform to further address unique research questions related to wood smoke exposures and associated adverse health effects.

[Control of asthma symptoms and cellular markers of inflammation in induced sputum in children and adolescents with chronic asthma].

PubMed

Ciółkowski, Janusz; Stasiowska, Barbara; Mazurek, Henryk

2009-03-01

After the GINA 2006 publication, asthma therapy is based on control of symptoms. However there are suggestions of monitoring of airway inflammation. Aim of the study was to compare clinical criteria of asthma control with cellular markers of lower airway inflammation in induced sputum in a group of young asthmatics. To assess relationship between sputum eosinophilia, asthma severity and spirometry. A group of 154 young patients with chronic asthma (8-21 years) underwent sputum induction by inhalation of 4,5% saline solution. Sputum induction was effective in 121 patients (78%), and in this group control of clinical symptoms was assessed according to GINA 2006 criteria. Asthma was controlled in 82 subjects (67.8%) and uncontrolled in 39 (32.2%). Patients with controlled asthma had higher FEV1/FVC (79.8 +/- 7.1% vs 74.2 +/- 9.9%; p = 0.004) and MMEF (80.7 +/- 23.0% vs 65.3 +/- 21.8%; p < 0.001) than those with uncontrolled disease, but the average FEV1 (as percent predicted) did not differ between the two groups. Patients with controlled asthma had lower sputum eosinophil count than those with uncontrolled asthma (3.5 +/- 6.3% vs 7.2 +/- 8.7%; p = 0.01), but difference in neutrophil count was borderline (27.3 +/- 15.5% vs 34.5 +/- 21.0%; p = 0.05). High sputum eosinophil count (> 3%) was observed in 24.4% of patients with controlled asthma and in 61.5% with uncontrolled asthma (p < 0.001). Increased sputum neutrophil count was more frequent in a group of uncontrolled asthma (2.4 vs 15.4%; p = 0.022). Mean sputum eosinophil count was lower in patients with mild astma than in patients with moderate-severe disease (3.1 +/- 5.7% vs 7.1% +/- 8.8; p = 0.006). Patients with high sputum eosinophil count had lower FEV1 (89.4 +/- 14.9% vs 94.9 +/- 13.9%; p = 0.047), FEV1/FVC (74.5 +/- 10.1% vs 79.2 +/- 9.3%; p = 0.01) and MMEF (68.7 +/- 23.3% vs 81.7 +/- 23.1%; p = 0.004). In this study of young asthmatics, control of asthma symptoms was observed in 67.8% of patients. However, cellular markers of lower airway inflammation were present in 1/4 of patients with controlled asthma and in 3/4 with uncontrolled disease. Sputum eosinophilia was related to asthma severity. FEV1/FVC and MMEF were more important that FEV1 for estimating control of asthma. Improvement of asthma control scoring is needed as well as availability of simple methods of inflammation monitoring.

Correlation and Agreement of Handheld Spirometry with Laboratory Spirometry in Allogeneic Hematopoietic Cell Transplant Recipients

PubMed Central

Cheng, Guang-Shing; Campbell, Angela P.; Xie, Hu; Stednick, Zach; Callais, Cheryl; Leisenring, Wendy M.; Englund, Janet A.; Chien, Jason W.; Boeckh, Michael

2016-01-01

BACKGROUND Early detection of subclinical lung function decline may help identify allogeneic hematopoietic cell transplantation (HCT) recipients who are at increased risk for late non-infectious pulmonary complications including bronchiolitis obliterans syndrome (BOS). We evaluated the use of handheld spirometry in this population. METHODS Allogeneic HCT recipients enrolled in a single center observational trial performed weekly spirometry with a handheld spirometer for one year after transplantation. Participants performed pulmonary function tests in an outpatient laboratory setting at 3 time points: pre-transplant, day 80 and 1 year post-transplant. Correlation between the two methods was assessed by Pearson and Spearman correlations; agreement was assessed using Bland-Altman plots. RESULTS A total of 437 subjects had evaluable pulmonary function tests. Correlation for FEV1 was r=0.954 (p<.0001) at day 80 and r=0.931 (p<.0001) at 1 year when the handheld and laboratory tests were performed within one day of each other. Correlation for handheld FEV6 with laboratory FVC was r=0.914 (p<.0001) at day 80 and r=0.826 (p<.0001) at 1 year. The bias, or the mean difference (handheld minus laboratory) for FEV1 at day 80 and 1 year was −0.13L (−0.63, 0.37) and −0.10L (−0.77, 0.56), respectively. FEV6 showed greater bias at day 80 [−0.51L (−1.44, 0.42)] and 1 year [−0.40L (−1.81, 1.01)]. CONCLUSIONS Handheld spirometry correlated well with laboratory spirometry after allogeneic HCT and may be useful for self-monitoring of patients for early identification of airflow obstruction. PMID:26748162

Association between lung capacity and abnormal glucose metabolism: findings from China and Australia.

PubMed

Yu, Dahai; Chen, Tao; Qin, Rui; Cai, Yamei; Jiang, Zhixin; Zhao, Zhanzheng; Simmons, David

2016-07-01

Restricted pulmonary function is found among people with diabetes. This study aimed to investigate the dose-response relationship between pulmonary function measurements [forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)] and risk of metabolic syndrome (MS)/type 2 diabetes. A total of 1454 adults in rural Victoria, Australia, and 5824 adults in Nanjing, China, from randomly selected households provided clinical history, oral glucose tolerance test, lipids, anthropometric, blood pressure and spirometric measurements. MS was defined by International Diabetes Federation criteria. Adjusted odds ratios for MS and type 2 diabetes with lung capacity measurements were estimated using logistic regression. Dose-response relationships were explored using the restricted cubic spline models. There was a nonlinear relationship between FEV1 and the risk of type 2 diabetes and MS (both P < 0·0001) in both the Australian and Chinese populations. The FEV1 associated with the lowest risk of type 2 diabetes and MS was above 2·70 l (95%CI: 2·68 to 2·72 l and 2·65 to 2·76 l in Chinese and Australian populations, respectively). The discrimination of the model could be significantly improved using the FEV1 threshold in both the Australian and Chinese populations. In both the Australian and Chinese populations, the risk of type 2 diabetes and MS is lowest with a FEV1 of 2·65-2·76 l. This might be used in clinical practice in different countries as a prompt to screen for type 2 diabetes and MS in patients with obstructive lung disease and to ensure there was no abnormal glucose metabolism before the commencement of steroids if indicated. © 2015 John Wiley & Sons Ltd.

Longitudinal assessment of spirometry in the World Trade Center medical monitoring program.

PubMed

Skloot, Gwen S; Schechter, Clyde B; Herbert, Robin; Moline, Jacqueline M; Levin, Stephen M; Crowley, Laura E; Luft, Benjamin J; Udasin, Iris G; Enright, Paul L

2009-02-01

Multiple studies have demonstrated an initial high prevalence of spirometric abnormalities following World Trade Center (WTC) disaster exposure. We assessed prevalence of spirometric abnormalities and changes in spirometry between baseline and first follow-up evaluation in participants in the WTC Worker and Volunteer Medical Monitoring Program. We also determined the predictors of spirometric change between the two examinations. Prebronchodilator and postbronchodilator spirometry, demographics, occupational history, smoking status, and respiratory symptoms and exposure onset were obtained at both examinations (about 3 years apart). At the second examination, 24.1% of individuals had abnormal spirometry findings. The predominant defect was a low FVC without obstruction (16.1%). Between examinations, the majority of individuals did not have a greater-than-expected decline in lung function. The mean declines in prebronchodilator FEV(1) and FVC were 13 mL/yr and 2 mL/yr, respectively (postbronchodilator results were similar and not reported). Significant predictors of greater average decline between examinations were lack of bronchodilator responsiveness at examination 1 and weight gain [corrected]. Elevated rates of spirometric abnormalities were present at both examinations, with reduced FVC most common. Although the majority had a normal decline in lung function, lack of bronchodilator response at examination 1 and weight gain were significantly associated with greater-than-normal lung function declines [corrected]. Due to the presence of spirometric abnormalities > 5 years after the disaster in many exposed individuals, longer-term monitoring of WTC responders is essential.

Evaluation of atrial electromechanical delay and its relationship to inflammation and oxidative stress in patients with chronic obstructive pulmonary disease.

PubMed

Acar, Gurkan; Kahraman, Hasan; Akkoyun, Murat; Kilinc, Metin; Zencir, Cemil; Yusufoglu, Edagani; Dirnak, Imran; Sahin, Hatice; Olmez, Soner; Akcay, Ahmet; Ardic, Idris

2014-05-01

The aims of this study were to evaluate atrial electromechanical delay, inflammation, and oxidative stress parameters, along with to investigate clinical and laboratory characteristics affecting atrial electromechanical delay in patients with chronic obstructive pulmonary disease (COPD). Forty-three patients with COPD (60.5 ± 9.9 years) and 50 healthy controls (59.6 ± 7.1 years) were included in the study. Atrial electromechanical delay intervals were measured from lateral mitral annulus corrected PA (cPA lateral) and lateral tricuspid annulus (cPA tricuspid) using tissue Doppler imaging (TDI), and corrected for heart rate. Left and right ventricles functions were examined using conventional and TDI. Plasma levels of high-sensitive C-reactive protein (hsCRP) and oxidative stress parameters were also measured. Factors associated with atrial electromechanical delay were evaluated by stepwise multiple regression analysis. Corrected PA lateral and cPA tricuspid were significantly higher in patients with COPD (69.8 ± 10.4 vs. 62.2 ± 8.9 msec, P < 0.001 and 45.4 ± 10.2 vs. 33.5 ± 5.1 msec, P < 0.001, respectively). Plasma levels of hsCRP and malondialdehyde, an indicator of oxidative stress, were increased in patient's group (15.7 ± 31.7 vs. 4.8 ± 4.7 mg/L, P = 0.01 and 17.1 ± 10.3 vs. 11.6 ± 7.9 nmol/L, P = 0.005, respectively). cPA lateral is independently related to lateral Em /Am ratio (β = -0.29, P = 0.004) and forced expiratory volume in 1st second/forced vital capacity (FEV1 /FVC) ratio (β = -0.24, P = 0.02). cPA tricuspid is independently related to only FEV1 /FVC ratio (β = -0.51, P < 0.001). This study shows that atrial electromechanical delay intervals are prolonged in patients with COPD. Prolongation of atrial electromechanical delay measured from lateral tricuspid annulus was independently related with FEV1 /FVC ratio in these patients. © 2013, Wiley Periodicals, Inc.

Impact of air pollution on pulmonary function and respiratory symptoms in children. Longitudinal repeated-measures study.

PubMed

Linares, Benigno; Guizar, Juan M; Amador, Norma; Garcia, Alfonso; Miranda, Victor; Perez, Jose R; Chapela, Rocío

2010-11-24

Salamanca, Mexico occupied fourth place nationally in contaminating emissions. The aim of the study was to determine the impact of air pollution on the frequency of pulmonary function alterations and respiratory symptoms in school-age children in a longitudinal repeated-measures study. We recruited a cohort of 464 children from 6 to 14 years of age, from two schools differing in distance from the major stationary air pollution sources. Spirometry, respiratory symptoms and air pollutants (O3, SO2, NO, NO2, NOx, PM10,) were obtained for each season. Mixed models for continuous variables and multilevel logistic regression for respiratory symptoms were fitted taking into account seasonal variations in health effects according to air pollution levels. Abnormalities in lung function and frequency of respiratory symptoms were higher in the school closer to major stationary air pollution sources than in the distant school. However, in winter differences on health disappeared. The principal alteration in lung function was the obstructive type, which frequency was greater in those students with greater exposure (10.4% vs. 5.3%; OR = 1.95, 95% CI 1.0-3.7), followed by the mixed pattern also more frequent in the same students (4.1% vs. 0.9%; OR = 4.69, 95% CI, 1.0-21.1). PM10 levels were the most consistent factor with a negative relationship with FVC, FEV1 and PEF but with a positive relationship with FEV1/FVC coefficient according to its change per 3-month period. Students from the school closer to major stationary air pollution sources had in general more respiratory symptoms than those from the distant school. However, in winter air pollution was generalized in this city and differences in health disappeared. PM10 levels were the most consistent factor related to pulmonary function according, to its change per 3-month period.

[Effects of anxiety on cardiorespiratory function].

PubMed

Dimitriev, D A; Saperova, E V; Dimitriev, A D; Karpenko, Iu D

2014-01-01

The present study was undertaken to investigate the effect of anxiety on pulmonary function parameters and respiratory sinus arrhythmia (RSA) in healthy people under real-life conditions. This study consisted of two interrelated parts. During the first stage, eighty healthy students were examined in the following sequence: recording of heart rate variability (HRV) and respiration parameters at rest and shortly before real life stress. In a longitudinal study (the second stage), we assessed the profile of cardiorespiratory activity over 50 days in ten healthy women. Pulmonary function parameters like breath rate, tidal volume, forced expiratory volume in ones (FEV1), peak expiratory flow (PEF), forced expired flow at 25%, 50%, 75% of FVC, forced expired flow from 25-75% of FVC (FEF25-75%) and HRV measures (SDNN, RMSSD, pNN50, LF, HF, HFnorm, LF/HF ratio) of all subjects were tested. State anxiety was measured by Spielberger state anxiety inventory. Higher levels of state anxiety were associated with higher levels of breath rate, tidal volume and reduced HRV parameters, especially indicators of the RSA (HF and HFnorm) at baseline. These changes depend on the category of state anxiety: the group of students with a qualitative increase in state anxiety before examination has increased level of FEV1, PEF, forced expired flow at 25%, 50%, 75% of FVC, FEF25-75%. Less reactive students have no difference in respiratory parameters. We found a strong negative correlation between the level of HF at rest and state anxiety scores before examination. Longitudinal study found a negative correlation between RSA parameters and PEF, positive correlation between state anxiety and PEF of the majority those surveyed, except for two women with low levels of state anxiety and RSA indicators were in a narrow range. The variations of cardiorespiratory parameters during a longitudinal study depend on the changes of state anxiety. The higher level of state anxiety was associated with significant changes in RSA and the respiratory parameters. These results lend strong support to the notion that parasympathetic function is a critical physiological component of emotional processes.

The Effects of Ramadan Fasting on the Spirometric Data of Healthy Adult Males.

PubMed

Latiri, Imed; Sandid, Siwar; Fennani, Mohamed Amine; Hadrich, Mohamed; Masmoudi, Tasnim; Maatoug, Chiraz; Zammit-Chatti, Makrem; Chamari, Karim; Ben Saad, Helmi

2017-07-01

The few studies carried out on the effects of Ramadan fasting (RF) on spirometric values present contradictory conclusions. This study aimed at assessing whether RF affects healthy adults' spirometric values. Twenty-nine nonsmoking healthy males ( M ± standard error of mean [ SEM] of age: 27 ± 1 years) who fasted during Ramadan (June 29-July 28, 2014) volunteered to the study. Three periods (before-Ramadan [June 23-25], mid-Ramadan [July 14-16] and after-Ramadan [August 11-14]) were selected for spirometry measurements that were consistently performed 5.5 to 3.5 hours (between 15:00 and 17:00 hours) before fasting break. Assessment sessions comprised following: weight (kg), forced vital capacity (FVC), first second expiratory volume (FEV 1 ), FEV 1 /FVC, peak expiratory flow (PEF), maximal mid expiratory flow (MMEF), and forced expiratory flow rate at the x% of FVC to be exhaled (FEF x% ). Spirometric data were expressed in percentages of reference values. Results were analyzed by applying repeated measures analysis of variance. The M ± SEM of weight (before-R: 81.6 ± 2.8 kg, mid-R: 80.8 ± 2.9 kg, after-R: 81.2 ± 2.9 kg), FEV 1 (before-R: 99 ± 2%, mid-R: 98 ± 2%, after-R: 98 ± 2%), FVC (before-R: 103 ± 2%, mid-R: 101 ± 2%, after-R: 101 ± 2%), PEF (before-R: 112 ± 3%, mid-R: 113 ± 2%, after-R: 114 ± 3%), MMEF (before-R: 83 ± 3%, mid-R: 83 ± 3%, after-R: 82 ± 3%), FEF 25% (before-R: 90 ± 5%, mid-R: 89 ± 6%, after-R: 87 ± 6%), FEF 50% (before-R: 94 ± 4%, mid-R: 91 ± 4%, after-R: 93 ± 3%), and FEF 75% (before-R: 108 ± 3%, mid-R: 111 ± 2%, after-R:111 ± 3%) were not significantly influenced by RF. To conclude, RF did not bring about any significant changes in the spirometric values of nonsmoking healthy adult males.

Effect of Emphysema Extent on Serial Lung Function in Patients with Idiopathic Pulmonary Fibrosis.

PubMed

Cottin, Vincent; Hansell, David M; Sverzellati, Nicola; Weycker, Derek; Antoniou, Katerina M; Atwood, Mark; Oster, Gerry; Kirchgaessler, Klaus-Uwe; Collard, Harold R; Wells, Athol U

2017-11-01

Patients with idiopathic pulmonary fibrosis and emphysema may have artificially preserved lung volumes. In this post hoc analysis, we investigated the relationship between baseline emphysema and fibrosis extents, as well as pulmonary function changes, over 48 weeks. Data were pooled from two phase III, randomized, double-blind, placebo-controlled trials of IFN-γ-1b in idiopathic pulmonary fibrosis (GIPF-001 [NCT00047645] and GIPF-007 [NCT00075998]). Patients with Week 48 data, baseline high-resolution computed tomographic images, and FEV 1 /FVC ratios less than 0.8 or greater than 0.9 (<0.7 or >0.9 in GIPF-007), as well as randomly selected patients with ratios of 0.8-0.9 and 0.7-0.8, were included. Changes from baseline in pulmonary function at Week 48 were analyzed by emphysema extent. The relationship between emphysema and fibrosis extents and change in pulmonary function was assessed using multivariate linear regression. Emphysema was identified in 38% of patients. A negative correlation was observed between fibrosis and emphysema extents (r = -0.232; P < 0.001). In quartile analysis, patients with the greatest emphysema extent (28 to 65%) showed the smallest FVC decline, with a difference of 3.32% at Week 48 versus patients with no emphysema (P = 0.047). In multivariate analyses, emphysema extent greater than or equal to 15% was associated with significantly reduced FVC decline over 48 weeks versus no emphysema or emphysema less than 15%. No such association was observed for diffusing capacity of the lung for carbon monoxide or composite physiologic index. FVC measurements may not be appropriate for monitoring disease progression in patients with idiopathic pulmonary fibrosis and emphysema extent greater than or equal to 15%.

Chronic Obstructive Pulmonary Disease and Herbicide Exposure in Vietnam-Era U.S. Army Chemical Corps Veterans.

PubMed

Cypel, Yasmin; Hines, Stella E; Davey, Victoria J; Eber, Stephanie M; Schneiderman, Aaron I

2018-04-01

Past research demonstrates a possible association between herbicide exposure and respiratory health. Biologic plausibility and inhalation as a mode of exposure further support the contention that herbicides may act as adverse contributors to respiratory status, especially in military personnel who were responsible for chemical maintenance and distribution during the Vietnam War. This study examines the association between chronic obstructive pulmonary disease and herbicide exposure among Vietnam-era U.S. Army Chemical Corps veterans. A 2013 three-phase health study was conducted that included a survey (mail or telephone), in-home physical examinations, and medical record reviews/abstractions. Living, eligible veterans (n = 4,027) were identified using an existing cohort of men (n = 5,609) who either served in Vietnam (n = 2,872) or never served in Southeast Asia (n = 2,737). The health survey collected self-reported data on physician-diagnosed pulmonary conditions (chronic obstructive pulmonary disease, emphysema, and chronic bronchitis), service-related herbicide spraying history, cigarette smoking status, alcohol use, and demographics. Data from service personnel files confirmed chemical operations involvement and service status, whereas serum samples analyzed for 2,3,7,8-tetrachlorodibenzo-p-dioxin supported self-reported herbicide exposure. National Institute for Occupational Safety and Health quality-assured spirometry was performed during the physical examinations on a subset of survey respondents (n = 468 of 733 selected for participation and who provided consent) to determine mainly spirometric obstructive respiratory disease (forced expiratory volume in 1 second [FEV 1 ]/forced vital capacity [FVC] < lower limit of normal [LLN], FVC ≥ LLN, and FEV 1  < LLN; and FEV 1 /FVC < LLN and FEV 1  ≥ LLN). Associations between chronic obstructive pulmonary disease and veteran characteristics were examined (n = 403) using multivariable models. Reporting here specifically on spirometrically diagnosed disease, prevalence of obstructive disease was 8.4%. No significant differences in mean values of FEV 1 /FVC or mean percentage of predicted for FEV 1 and FVC between herbicide sprayers and nonsprayers were found. The odds of spirometric obstructive disease among sprayers were 0.65 times the odds among nonsprayers (adjusted odds ratio, 0.65; 95% confidence interval, 0.28-1.47), although elevated odds for spirometric restrictive disease were observed for sprayers versus nonsprayers (adjusted odds ratio, 1.61; 95% confidence interval, 0.85-3.06). Race/ethnicity, anthropometric measures, and cigarette smoking status accounted for differences among veterans' respiratory patterns. No significant association between herbicide exposure and spirometry-determined chronic obstructive pulmonary disease was found. Greater focus is required on confirming diagnoses of respiratory disease through spirometry in epidemiological research.

The Effect of Wood Aerosols and Bioaerosols on the Respiratory Systems of Wood Manufacturing Industry Workers in Golestan Province

PubMed Central

Badirdast, Phateme; Salehpour, Soussan; Ghadjari, Ali; Khodakarim, Soheila; Panahi, Davod; Fadaei, Moslem; Rahimi, Abolfazl

2017-01-01

Background: Occupational exposure to dust leads to acute and chronic respiratory diseases, occupational asthma, and depressed lung function. In the light of a lack of comprehensive studies on the exposure of Iranian workers to wood dusts, the objective of this study was to monitor the occupational exposure to wood dust and bioaerosol, and their correlation with the lung function parameters in chipboard manufacturing industry workers. Materials and Methods: A cross-sectional study was conducted on chipboard workers in Golestan Province; a total of 150 men (100 exposed cases and 50 controls) were assessed. Workers were monitored for inhalable wood dust and lung function parameters, i.e., FVC, FEV1, FEV1/FVC, and FEF25–75%. The workers’ exposure to bioaerosols was measured using a bacterial sampler; a total of 68 area samples were collected. The analysis was performed using the Mann-Whitney, Kruskal-Wallis, and regression statistical tests. Results: The geometric mean value and geometric standard deviation of inhalable wood dust for the exposed and control groups were 19 ± 2.00 mg/m3 and 0.008 ± 0.001 mg/m3, respectively. A statistically significant correlation was observed between the lung parameters and cumulative exposure to inhalable wood dust, whereas a statistically significant correlation was not observed between the lung parameters and bioaerosol exposure. However, the exposure of Iranian workers to bioaerosols was higher, compared to their foreign coworkers. Conclusion: Considering the high level of exposure among workers in this study along with their lung function results, long-term exposure to wood dust may be detrimental to the workers’ health and steps to limit their exposure should be considered seriously. PMID:28638425

Is the bronchodilator test an useful tool to measure asthma control?

PubMed

Ferrer Galván, Marta; Javier Alvarez Gutiérrez, Francisco; Romero Falcón, Auxiliadora; Romero Romero, Beatriz; Sáez, Antonia; Medina Gallardo, Juan Francisco

2017-05-01

Asthma control includes the control of symptoms and future risk. We sought to evaluate the usefulness of the degree of spirometric reversibility of the forced expiratory volume in one second (FEV 1 ) as the target parameter of control. Patients with bronchial asthma were followed up for one year. The clinical, functional, inflammatory and control parameters of the asthma were collected. The area under the curve (AUC) was estimated to establish the cutoff point of the post-bronchodilator FEV 1 reversibility in relation to non-control asthma. In the univariate analysis, the differences between groups were studied based on the degree of estimated reversibility. Factors with a significance <0.1 were included in the multivariate analysis by binary logistic regression. A total of 407 patients with a mean age of 38.1 ± 16.7 years were included. When the patients were grouped into controlled and non-controlled groups, compared with post-bronchodilator FEV 1 reversibility, the cutoff point obtained for the non-controlled group was ≥10% (sensitivity: 65.8%, specificity: 48.4%, positive predictive value: 69.5%, and AUC: 0.619 [0.533-0.700], p < 0.01). In the year-long follow-up of this group (post-bronchodilator FEV 1 ≥10), an increased use of relief medication was observed, along with a significantly progressive drop in post-bronchodilator FEV 1 and post-bronchodilator FEV 1 /FVC (forced expiratory volume in one second/forced vital capacity). Spirometric reversibility can be useful in assessing control in asthmatic patients and can predict future risk parameters. The cutoff point related to the non-control of asthma found in our work was ≥10%. Copyright © 2017 Elsevier Ltd. All rights reserved.

Childhood measles contributes to post-bronchodilator airflow obstruction in middle-aged adults: A cohort study.

PubMed

Perret, Jennifer L; Matheson, Melanie C; Gurrin, Lyle C; Johns, David P; Burgess, John A; Thompson, Bruce R; Lowe, Adrian J; Markos, James; Morrison, Stephen S; McDonald, Christine F; Wood-Baker, Richard; Svanes, Cecilie; Thomas, Paul S; Hopper, John L; Giles, Graham G; Abramson, Michael J; Walters, E Haydn; Dharmage, Shyamali C

2018-03-20

Chronic obstructive pulmonary disease (COPD) has potential origins in childhood but an association between childhood measles and post-bronchodilator (BD) airflow obstruction (AO) has not yet been shown. We investigated whether childhood measles contributed to post-BD AO through interactions with asthma and/or smoking in a non-immunized middle-aged population. The population-based Tasmanian Longitudinal Health Study (TAHS) cohort born in 1961 (n = 8583) underwent spirometry in 1968 before immunization was introduced. A history of childhood measles infection was obtained from school medical records. During the fifth decade follow-up (n = 5729 responses), a subgroup underwent further lung function measurements (n = 1389). Relevant main associations and interactions by asthma and/or smoking on post-BD forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC; continuous variable) and AO (FEV 1 /FVC < lower limit of normal) were estimated by multiple regression. Sixty-nine percent (n = 950) had a history of childhood measles. Childhood measles augmented the combined adverse effect of current clinical asthma and smoking at least 10 pack-years on post-BD FEV 1 /FVC ratio in middle age (z-score: -0.70 (95% CI: -1.1 to -0.3) vs -1.36 (-1.6 to -1.1), three-way interaction: P = 0.009), especially for those with childhood-onset asthma. For never- and ever-smokers of <10 pack-years who had current asthma symptoms, compared with those without childhood measles, paradoxically, the odds for post-BD AO was not significant in the presence of childhood measles (OR: 12.0 (95% CI: 3.4-42) vs 2.17 (0.9-5.3)). Childhood measles infection appears to compound the associations between smoking, current asthma and post-BD AO. Differences between asthma subgroups provide further insight into the complex aetiology of obstructive lung diseases for middle-aged adults. © 2018 Asian Pacific Society of Respirology.

Adolescent Idiopathic Scoliosis Treatment by a Korean Neurosurgeon: The Changing Role for Neurosurgeons

PubMed Central

Kim, Woong-Beom; Park, Young-Seop; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J.

2015-01-01

Objective The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. Methods Ten AIS patients were treated by a single neurosurgeon between January 2011 and September 2013 utilizing segmental instrumentation with pedicle screws. Basic demographic information, curve pattern by Lenke classification, number of levels treated, amount of correction achieved, radiographic/clinical outcomes [by Scolisis Resarch Society (SRS-22r) questionnaire] and complications were evaluated to determine the surgical results. Pulmonary function test was utilized to assess forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) before and after surgery. Results The average percentage of correction of the major structural curve was 73.6% (ranged from 64% to 81.5%). Preoperative and final postoperative absolute FVC averaged 3.03 L and 3.76 L (0.73 L increase, p=0.046), and absolute FEV1 averaged 2.63 L and 3.49 L (0.86 L increase, p=0.021). Preoperative and final postoperative average self-image and function scores of SRS-22r were, 2.6±0.5, 3.3±0.1, 4.0±0.5, and 4.6±0.0, respectively. There was a significant improvement of the self-image and function scores of SRS-22r questionnaires before and after surgery (p<0.05). There was no case of neurological deficit, infection and revision for screw malposition. One patient underwent a fusion extension surgery for shoulder asymmetry. Conclusion Radiographic/clinical outcomes of AIS patients treated by a Korean neurosurgeon were acceptable. Fundamental understanding of pediatric spinal deformity is essential for the practice of AIS surgery. PMID:26279813

Adolescent Idiopathic Scoliosis Treatment by a Korean Neurosurgeon: The Changing Role for Neurosurgeons.

PubMed

Hyun, Seung-Jae; Kim, Woong-Beom; Park, Young-Seop; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J

2015-07-01

The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. Ten AIS patients were treated by a single neurosurgeon between January 2011 and September 2013 utilizing segmental instrumentation with pedicle screws. Basic demographic information, curve pattern by Lenke classification, number of levels treated, amount of correction achieved, radiographic/clinical outcomes [by Scolisis Resarch Society (SRS-22r) questionnaire] and complications were evaluated to determine the surgical results. Pulmonary function test was utilized to assess forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) before and after surgery. The average percentage of correction of the major structural curve was 73.6% (ranged from 64% to 81.5%). Preoperative and final postoperative absolute FVC averaged 3.03 L and 3.76 L (0.73 L increase, p=0.046), and absolute FEV1 averaged 2.63 L and 3.49 L (0.86 L increase, p=0.021). Preoperative and final postoperative average self-image and function scores of SRS-22r were, 2.6±0.5, 3.3±0.1, 4.0±0.5, and 4.6±0.0, respectively. There was a significant improvement of the self-image and function scores of SRS-22r questionnaires before and after surgery (p<0.05). There was no case of neurological deficit, infection and revision for screw malposition. One patient underwent a fusion extension surgery for shoulder asymmetry. Radiographic/clinical outcomes of AIS patients treated by a Korean neurosurgeon were acceptable. Fundamental understanding of pediatric spinal deformity is essential for the practice of AIS surgery.

Cardiorespiratory functional assessment after pediatric heart transplantation.

PubMed

Pastore, E; Turchetta, A; Attias, L; Calzolari, A; Giordano, U; Squitieri, C; Parisi, F

2001-12-01

Limited data are available on the exercise capacity of young heart transplant recipients. The aim of this study was therefore to assess cardiorespiratory responses to exercise in this group of patients. Fourteen consecutive heart transplant recipients (six girls and eight boys, age-range 5-15 yr) and 14 healthy matched controls underwent a Bruce treadmill test to determine: duration of test; resting and maximum heart rates; maximum systolic blood pressure; peak oxygen consumption (VO2 peak); and cardiac output. Duration of test and heart rate increase were then compared with: time since transplantation, rejections per year, and immunosuppressive drugs received. The recipients also underwent the following lung function tests: forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). When compared with healthy controls, transplant recipients had tachycardia at rest (126 +/- 3.7 beats/min; p < 0.001); significantly reduced tolerance (9.3 +/- 0.4 min; p < 0.001), a maximum heart rate of 169 +/- 5.4 beats/min (p < 0.05); a cardiac output of 5.65 +/- 0.6 L/min (p < 0.05); and a lower heart-rate increase from rest to peak exercise (p < 0.001) but a similar VO2 peak. The heart-rate increase correlated significantly with time post-transplant (r = 0.55; p < 0.05), number of rejection episodes per year (r = - 0.63; p < 0.05), and number of immunosuppressive drugs (r = - 0.60; p < 0.05). The recipients had normal FVC and FEV1 values. After surgery, few heart transplant recipients undertake physical activity, possibly owing to over-protective parents and teachers and to a lack of suitable supervised facilities. The authors stress the importance of a cardiorespiratory functional evaluation for assessment of health status and to encourage recipients, if possible, to undertake regular physical activity.

Psychosocial stressors and lung function in youth ages 10-17: an examination by stressor, age and gender.

PubMed

Bandoli, G; Ghosh, J K; von Ehrenstein, O; Ritz, B

2017-06-01

Research on the impact of psychosocial stressors on child and adolescent lung function is uncommon, and has primarily relied either on parents' own stress measures or parent-reported stressors the child experienced, which may be a poor proxy for perceived stress in older children and adolescents. We performed multivariate linear regression of spirometry measures (FVC, FEV1 and FEF25-75) and psychosocial stressors in 584 adolescents in the Los Angeles Family and Neighborhood Survey. We examined family conflict, unsafe neighborhood or school, and the absence of a father in models stratified by gender, adjusting for PM2.5 and potential confounders. We observed reductions in lung function in males related to the absence of a father in the house (FEV1: -176.2 ml, 95% CI -322.7, -29.7) and family conflict (FEV1: -156.2 ml, 95% CI -327.8, 15.5); associations were stronger in older males ages 15-17 years for each stressor (P for interaction of age and sex was 0.009 and 0.06, respectively). This research informs a very small literature on psychosocial stressors and lung function in adolescents. Our finding of differential vulnerability by age and gender warrants further exploration of adolescent psychosocial stressor response on lung function. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pulmonary performance of elderly normal subjects and subjects with chronic obstructive pulmonary disease exposed to 0. 3 ppm nitrogen dioxide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morrow, P.E.; Utell, M.J.; Bauer, M.A.

1992-02-01

Symptoms and changes in pulmonary function of subjects with chronic obstructive pulmonary disease (COPD) and elderly normal subjects, induced by a 4-h exposure to 0.3 ppm NO2, were investigated using a double-blind, crossover design with purified air. The 5-day experimental protocol required approximately 2 wk with at least a 5-day separation between randomized 4-h exposures to either NO2 or air which included several periods of exercise. Over a 2-yr period, COPD subjects, all with a history of smoking, consisting of 13 men and 7 women (mean age of 60.0 yr) and 20 elderly normal subjects of comparable age and sexmore » were evaluated. During intermittent light exercise, COPD subjects demonstrated progressive decrements in FVC and FEV1 compared with baseline with 0.3 ppm NO2, but not with air. Differences in percent changes from baseline data (air-NO2) showed an equivocal reduction in FVC by repeated measures of analysis of variance and cross-over t tests (p less than 0.10). Subgroup analyses suggested that responsiveness to NO2 decreased with severity of COPD; in elderly normal subjects, NO2-induced reduction in FEV1 was greater among smokers than never-smokers. A comparison of COPD and elderly normal subjects also revealed distinctions in NO2-induced responsiveness.« less

Hyperinflation and intrinsic positive end-expiratory pressure: less room to breathe.

PubMed

Krieger, Bruce P

2009-01-01

Clinically, the symptoms and limited exercise capabilities of patients with chronic obstructive pulmonary disease (COPD) correlate better with changes in lung volumes than with airflow measurements. The realization of the clinical importance of hyperinflation has been overshadowed for decades by the use of forced expiratory volume during 1 s (FEV(1)) and the ratio of the FEV(1) to the forced expiratory vital capacity (FEV(1)/FVC) to categorize the severity and progression of COPD. Hyperinflation is defined as an elevation in the end-expiratory lung volume or functional residual capacity. When severe hyperinflation encroaches upon inspiratory capacity and limits vital capacity, it results in elevated intrinsic positive end-expiratory pressure (PEEPi) that places the diaphragm at a mechanical disadvantage and increases the work of breathing. Severe hyperinflation is the major physiologic cause of the resulting hypercarbic respiratory failure and patients' inability to transition (i.e. wean) from mechanical ventilatory support to spontaneous breathing. This paper reviews the basic physiologic principles of hyperinflation and its clinical manifestations as demonstrated by PEEPi. Also reviewed are the adverse effects of hyperinflation and PEEPi in critically ill patients with COPD, and methods for minimizing or counterbalancing these effects. Copyright 2009 S. Karger AG, Basel.

Comparison of fenspiride with beclomethasone as adjunctive anti-inflammatory treatment in patients with chronic obstructive pulmonary disease.

PubMed

Shmelev, E I; Kunicina, Yu L

2006-01-01

This study aimed to compare the clinical efficacy of two anti-inflammatory medications (fenspiride and inhaled beclomethasone [beclomethasone dipropionate]) in patients with stable chronic obstructive pulmonary disease (COPD) over 6 months. DESIGN, METHODS AND PATIENTS: This was a randomised comparison of 58 patients with COPD, divided into five treatment groups: fenspiride (stages 1 and 2), beclomethasone (stage 2), and two control groups (stages 1 and 2). In addition, 64 patients with exacerbations of COPD were evaluated over a 2-week treatment period during which they received either fenspiride or prednisolone. Clinical signs and symptoms of COPD were evaluated every 2 months (aggregated numerical index of signs and symptoms), as were lung function tests (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC) and a 6-minute walking test. Statistically significant reductions in all evaluated COPD signs and symptoms were achieved with fenspiride in stage 1 COPD. Fenspiride therapy significantly reduced the indices of sputum parameters (8-fold decrease), incidence of dry rales (6-fold decrease), dyspnoea (4-fold decrease) and cough (2.5-fold decrease). In comparison with beclomethasone, fenspiride was superior in stage 2 COPD. In patients with stage 2 COPD, reductions were less marked, but remained significantly superior in the fenspiride group in comparison with the beclomethasone group and the control groups. In patients with exacerbations of COPD, fenspiride had equivalent efficacy to that of systemic corticosteroids. Anti-inflammatory therapy with fenspiride in addition to bronchodilators significantly improved clinical signs and symptoms, external respiratory function tests and physical activity tests in patients with stage 1 COPD. Adjunctive fenspiride therapy was superior to inhaled beclomethasone in stage 2 COPD. Anti-inflammatory therapy in COPD may be more effective at an early stage of this disease.

29 CFR 1910.1048 - Formaldehyde.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., these tests shall consist of forced vital capacity (FVC), forced expiratory volume in one second (FEV1... of any employee within each exposure group. (ii) The initial monitoring process shall be repeated... areas where the concentration of airborne formaldehyde exceeds either the TWA or the STEL and post all...

29 CFR 1910.1048 - Formaldehyde.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., these tests shall consist of forced vital capacity (FVC), forced expiratory volume in one second (FEV1... of any employee within each exposure group. (ii) The initial monitoring process shall be repeated... areas where the concentration of airborne formaldehyde exceeds either the TWA or the STEL and post all...

29 CFR 1910.1048 - Formaldehyde.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., these tests shall consist of forced vital capacity (FVC), forced expiratory volume in one second (FEV1... of any employee within each exposure group. (ii) The initial monitoring process shall be repeated... areas where the concentration of airborne formaldehyde exceeds either the TWA or the STEL and post all...

Adverse respiratory effects associated with cadmium exposure in small-scale jewellery workshops in India.

PubMed

Moitra, Subhabrata; Blanc, Paul D; Sahu, Subhashis

2013-06-01

Cadmium (Cd) is an important metal with both common occupational and environmental sources of exposure. Although it is likely to cause adverse respiratory effects, relevant human data are relatively sparse. A cross-sectional study of 133 workers in jewellery workshops using Cd under poor hygienic conditions and 54 referent jewellery sales staffs was performed. We assessed symptoms, performed spirometry, measured urinary Cd levels in all study subjects and quantified airborne total oxidant contents for 35 job areas in which the studied workforce was employed. We tested the association of symptoms with exposure relative to the unexposed referents using logistic regression analysis, and tested the association between urinary Cd levels and lung function using multiple regression analysis, adjusting for demographics, smoking and area-level airborne oxidants. Exposed workers had 10 times higher urinary Cd values than referents (geometric mean 5.8 vs 0.41 µg/dl; p<0.01). Of the exposed subjects, 75% reported respiratory tract symptoms compared with 33% of the referents (OR=3.1, 95% CI 1.4 to 7.3). Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were also lower among the exposed workers than the referents (>600 ml decrement for each, p<0.001). For every 1 µg increase in urinary Cd there was a 34 ml decrement in FVC and a 39 ml decrement in FEV1 (p<0.01), taking into account other covariates including workplace airborne oxidant concentrations. This cohort of heavily exposed jewellery workers experienced frequent respiratory symptoms and manifested a marked deficit in lung function, demonstrating a strong response to Cd exposure.

Multicenter study of the COPD-6 screening device: feasible for early detection of chronic obstructive pulmonary disease in primary care?

PubMed

Kjeldgaard, Peter; Lykkegaard, Jesper; Spillemose, Heidi; Ulrik, Charlotte Suppli

2017-01-01

Early detection of COPD may reduce the future burden of the disease. We aimed to investigate whether prescreening with a COPD-6 screening device (measuring FEV 1 and FEV 6 ) facilitates early detection of COPD in primary care. In primary care, individuals at high risk of COPD (ie, age ≥35 years, relevant exposure, and at least one respiratory symptom) and no previous diagnosis of obstructive lung disease were examined with a COPD-6 screening device. In prioritized order, the criteria for proceeding to confirmatory spirometry were FEV 1 /FEV 6 <0.7, FEV 1 <80%pred, or clinical suspicion of COPD regardless of test result (medical doctor's [MD] decision). Based on spirometry, including bronchodilator (BD) reversibility test, individuals were classified as COPD (post-BD FEV 1 /FVC <0.70), asthma (ΔFEV 1 ≥0.50 L), or no obstructive lung disease. A total of 2,990 subjects (54% men, mean age 59 years, and mean 28 pack-years) were enrolled, of whom 949 (32%) proceeded from COPD-6 screening to confirmative spirometry based on the following criteria: 510 (54%) FEV 1 /FEV 6 <0.70, 382 (40%) FEV 1 <80%pred, and 57 (6%) MD decision. Following confirmative spirometry, the 949 individuals were diagnosed as having COPD (51%), asthma (3%), and no obstructive lung disease (45%). COPD was diagnosed in 487 (16%) of the enrolled subjects in whom confirmative spirometry was performed in 69% based on FEV 1 /FEV 6 <0.7 and in 29% based on FEV 1 ≤80%pred. Prescreening with the COPD-6 device showed acceptable specificity for the selection of subjects for diagnostic spirometry and is likely to be a useful alternative to current practice in primary care.

Longitudinal analysis of pulmonary dysfunction in the initial years of employment in the grain industry.

PubMed

Olfert, S M; Pahwa, P; Dosman, J A

2005-11-01

The negative health effects of exposure to grain dust have previously been examined, but few studies have observed the effects on newly hired employees. Young grain workers are of interest because changes in pulmonary function may occur after a short duration of employment, and because older grain workers may represent a survivor population. The New Grain Workers Study (NGWS), a longitudinal study of 299 newly hired male grain industry workers, was conducted between 1980 and 1985. The objectives were to determine the effects of employment in the grain industry on pulmonary function. Pre-employment physical examinations and pulmonary function tests were conducted on subjects at the Division of Respiratory Medicine, Department of Medicine, Royal University Hospital, University of Saskatchewan. The Grain Dust Medical Surveillance Program (GDMSP) was a Labour Canada program that began in 1978. All subjects were grain workers employed in the grain industry in Saskatchewan. All subjects completed a respiratory symptoms questionnaire and underwent pulmonary function testing. Baseline observations were recorded every three years between 1978 and 1993. Data were available on 2184 grain workers. Generalized estimating equations were used to fit marginal and transitional multivariable regression models to determine the effects of grain dust exposure on pulmonary function. Marginal and transitional models were then compared. Height, exposure weeks, and previous FVC were predictive of FVC in the NGWS, while exposure weeks and previous FEV1 were predictive of FEV1. These models, as well as a transitional regression model built using the GDMSP data, were used to compute predicted mean annual decline inpulmonary function. Non-smoking grain workers in the NGWS had the highest pulmonary function test values, but also had the greatest predicted annual decline in pulmonary function. Ever-smoking grain workers in the GDMSP had the lowest pulmonary function test values. Non-smoking grain workers in the GDMSP had the least predicted annual decline in pulmonary function.

Difficulties of attribution of effect in workers exposed to fiberglass and asbestos.

PubMed

Kilburn, K H; Warshaw, R H

1991-01-01

Man-made mineral fibers have many properties of asbestos that raise concern about their safety. We studied 175 fiberglass production workers, using chest radiographs, measurement of total lung capacity, chest examinations, and occupational and medical histories. Pulmonary volumes and flows were calculated as percent of predicted, adjusted for height, age, ethnicity, and cigarette smoking. Thirty-one men with radiographically evident small irregular opacities of profusion of 1/0 or greater and/or pleural abnormalities were observed. Eight of 38 men with such changes said they had been exposed only to fiberglass; the other 23 with radiologically detectable pleural and/or pulmonary changes were among the 137 whose histories indicated that they had been exposed to asbestos and to fiberglass. Pulmonary function measurements as group means were reduced in the 175: FVC was 94.8% predicted, FEV1 was 91.3% predicted, FEF25-75 was 80.7% predicted, FEF75-85 was 73.1% predicted and FEV1/FVC was 0.73. Total lung capacity (TLC) was elevated to 114.2% predicted (mean) and RV/TLC (mean 0.46) was also elevated. Although only 78% of fiberglass production workers gave histories of asbestos exposure, all had shared the air in a manufacturing plant where ovens insulated with asbestos were continuously cleaned, repaired, dismantled, and rebuilt. It appears that attribution of the effects of their exposure to fiberglass could not be estimated independently of the effects of asbestos exposure.

Lung function in infants with cystic fibrosis diagnosed by newborn screening.

PubMed

Linnane, Barry M; Hall, Graham L; Nolan, Gary; Brennan, Siobhan; Stick, Stephen M; Sly, Peter D; Robertson, Colin F; Robinson, Philip J; Franklin, Peter J; Turner, Stephen W; Ranganathan, Sarath C

2008-12-15

Progressive lung damage in cystic fibrosis (CF) starts in infancy, and early detection may aid preventative strategies. To measure lung function in infants with CF diagnosed by newborn screening and describe its association with pulmonary infection and inflammation. Infants with CF (n = 68, 6 weeks to 30 months of age) and healthy infants without CF (n = 49) were studied. Forced vital capacity, FEV(0.5), and forced expiratory flows at 75% of exhaled vital capacity (FEF(75)) were measured using the raised-volume rapid thoracoabdominal compression technique. Forty-eight hours later, infants with CF had bronchoalveolar lavage (BAL) for assessment of pulmonary infection and inflammation. In the CF group, the deficit in FEV(0.5) z score increased by -0.77 (95% confidence interval, -1.14 to -0.41; P < 0.001) with each year of age. The mean FEV(0.5) z score did not differ between infants with CF and healthy control subjects less than 6 months of age (-0.06 and 0.02, respectively; P = 0.87). However, the mean FEV(0.5) z score was lower by 1.15 in infants with CF who were older than 6 months of age compared with healthy infants (P < 0.001). FVC and FEF(75) followed a similar pattern. Pulmonary infection and inflammation in BAL samples did not explain the lung function results. Lung function, measured by forced expiration, is normal in infants with CF at the time of diagnosis by newborn screening but is diminished in older infants. These findings suggest that in CF the optimal timing of therapeutic interventions aimed at preserving lung function may be within the first 6 months of life.

Breathing pattern and chest wall volumes during exercise in patients with cystic fibrosis, pulmonary fibrosis and COPD before and after lung transplantation.

PubMed

Wilkens, H; Weingard, B; Lo Mauro, A; Schena, E; Pedotti, A; Sybrecht, G W; Aliverti, A

2010-09-01

Pulmonary fibrosis (PF), cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) often cause chronic respiratory failure (CRF). In order to investigate if there are different patterns of adaptation of the ventilatory pump in CRF, in three groups of lung transplant candidates with PF (n=9, forced expiratory volume in 1 s (FEV(1))=37+/-3% predicted, forced vital capacity (FVC)=32+/-2% predicted), CF (n=9, FEV(1)=22+/-3% predicted, FVC=30+/-3% predicted) and COPD (n=21, FEV(1)=21+/-1% predicted, FVC=46+/-2% predicted), 10 healthy controls and 16 transplanted patients, total and compartmental chest wall volumes were measured by opto-electronic plethysmography during rest and exercise. Three different breathing patterns were found during CRF in PF, CF and COPD. Patients with COPD were characterised by a reduced duty cycle at rest and maximal exercise (34+/-1%, p<0.001), while patients with PF and CF showed an increased breathing frequency (49+/-6 and 34+/-2/min, respectively) and decreased tidal volume (0.75+/-0.10 and 0.79+/-0.07 litres) (p<0.05). During exercise, end-expiratory chest wall and rib cage volumes increased significantly in patients with COPD and CF but not in those with PF. End-inspiratory volumes did not increase in CF and PF. The breathing pattern of transplanted patients was similar to that of healthy controls. There are three distinct patterns of CRF in patients with PF, CF and COPD adopted by the ventilatory pump to cope with the underlying lung disease that may explain why patients with PF and CF are prone to respiratory failure earlier than patients with COPD. After lung transplantation the chronic adaptations of the ventilatory pattern to advanced lung diseases are reversible and indicate that the main contributing factor is the lung itself rather than systemic effects of the disease.

Continuous quantitative measurement of the proximal airway dimensions and lung density on four-dimensional dynamic-ventilation CT in smokers

PubMed Central

Yamashiro, Tsuneo; Moriya, Hiroshi; Tsubakimoto, Maho; Matsuoka, Shin; Murayama, Sadayuki

2016-01-01

Purpose Four-dimensional dynamic-ventilation computed tomography (CT) imaging demonstrates continuous movement of the airways and lungs, which cannot be depicted with conventional CT. We aimed to investigate continuous changes in lung density and airway dimensions and to assess the correlation with spirometric values in smokers. Materials and methods This retrospective study was approved by the Institutional Review Board, and informed consent was waived. Twenty-one smokers including six patients with COPD underwent four-dimensional dynamic-ventilation CT during free breathing (160 mm in length). The mean lung density (MLD) of the scanned lung and luminal areas (Ai) of fixed points in the trachea and the right proximal bronchi (main bronchus, upper bronchus, bronchus intermedius, and lower bronchus) were continuously measured. Concordance between the time curve of the MLD and that of the airway Ai values was expressed by cross-correlation coefficients. The associations between these quantitative measurements and the forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) values were assessed by Spearman’s rank correlation analysis. Results On the time curve for the MLD, the Δ-MLD1.05 values between the peak inspiratory frame to the later third frame (1.05 seconds later) were strongly correlated with the FEV1/FVC (ρ=0.76, P<0.0001). The cross-correlation coefficients between the airway Ai and MLD values were significantly correlated with the FEV1/FVC (ρ=−0.56 to −0.66, P<0.01), except for the right upper bronchus. This suggested that the synchrony between the airway and lung movement was lost in patients with severe airflow limitation. Conclusion Respiratory changes in the MLD and synchrony between the airway Ai and the MLD measured with dynamic-ventilation CT were correlated with patient’s spirometric values. PMID:27110108

Respiratory health of workers exposed to metal dusts and foundry fumes in a copper refinery.

PubMed Central

Ostiguy, G; Vaillancourt, C; Bégin, R

1995-01-01

OBJECTIVES--To assess airflow limitation in workers exposed long term to metal dust, the prevalence of pleural plaques in those workers exposed in the past to asbestos, the influence of pleural plaques on lung function, and the possible association with airway disease caused by asbestos. METHODS--A cross sectional and longitudinal (seven year) survey of 494 long term (mean (SEM) 21(1) years) workers in a copper refinery was carried out from medical questionnaires, chest radiographs, and forced spirometry. RESULTS--The prevalence of lifetime non-smokers was 19%, current smokers 39%, and ex-smokers 42%. The prevalence of chronic obstructive pulmonary diseases (COPD) (forced expiratory volume in one second (FEV1) < 80% predicted) was 5%, small airway dysfunction (SAD) (maximal mid-expiratory flow (MMEF) < 60% predicted) was 7%, and this did not differ from the control population. The COPD and SAD were associated with cumulative smoking index but not with the cumulative work years at the plant or with any type of work at the plant. The mean (SEM) reduction of FEV1 was 20(7) ml in non-smokers, 26(4) ml in smokers, and 26(5) ml in ex-smokers (P > 0.05). In the smokers and ex-smokers with COPD, the loss of FEV1 was 53(10) (P < 0.02). The prevalence of pleural plaques was 11% (P < 0.0001); pleural plaques were found in older workers with known exposure to asbestos. The pleural plaques were circumscribed and associated with a non-significant 196 ml reduction in forced vital capacity (FVC) and non-significant reduction of FVC over time. The pleural plaques were not associated with COPD or SAD. The cumulative smoking index obtained by a technician did not differ from that by a chest physician. CONCLUSIONS--Despite exposures to asbestos that produced pleural plaques and exposures to metal dusts and foundry fumes the long term workers of this plant did not have excessive prevalence of COPD or SAD. The data suggest that low level long term exposure to metal dusts, gases, and foundry fumes do not necessarily cause respiratory dysfunction, circumscribed pleural plaques with low grades of width and extent do not reduce FVC significantly, and exposure to asbestos dust that produced pleural plaques does not necessarily produce airway dysfunction. PMID:7735395

Age-related annual decline of lung function in patients with COPD.

PubMed

Kim, Soo Jung; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Yoon, Ho Il; Lee, Sang-Min; Yim, Jae-Joon; Kim, Young Whan; Han, Sung Koo; Yoo, Chul-Gyu

2016-01-01

According to the Fletcher-Peto curve, rate of decline in forced expiratory volume in 1-second (FEV1) accelerates as age increases. However, recent studies have not demonstrated that the rate of FEV1 decline accelerates with age among COPD patients. The objective of the study is to evaluate annual rate of FEV1 decline as age increases among COPD patients. In this retrospective cohort study, we enrolled COPD patients who were followed up at two tertiary care university hospitals from January 2000 to August 2013. COPD was defined as post-bronchodilator (BD) FEV1/forced vital capacity (FVC) of <0.7. All participants had more than two spirometries, including BD response. Age groups were categorized as follows: below versus above median age or four quartiles. A total of 518 participants (94.2% male; median age, 67 years; range, 42-90 years) were included. Mean absolute and predictive values of post-BD FEV1 were 1.57±0.62 L and 52.53%±18.29%, respectively. Distribution of Global initiative for Chronic Obstructive Lung Disease groups did not show statistical differences between age groups categorized by two different criteria. After grouping the population by age quartiles, the rate of FEV1 decline was faster among older patients than younger ones whether expressed as absolute value (-10.60±5.57 mL/year, -15.84±6.01 mL/year, -18.63±5.53 mL/year, 32.94±6.01 mL/year, respectively; P=0.048) or predicted value (-0.34%±0.19%/year, -0.53%±0.21%/year, -0.62%±0.19%/year, -1.26%±0.21%/year, respectively, P=0.010). As suggested conceptually by the Fletcher-Peto curve, annual FEV1 decline among COPD patients is accelerated among older patients than younger ones.

[The repercussions of pulmonary congestion on ventilatory volumes, capacities and flows].

PubMed

Carmo, M M; Ferreira, T; Lousada, N; Bárbara, C; Neves, P R; Correia, J M; Rendas, A B

1994-10-01

To evaluate the effects of pulmonary congestion on pulmonary function. Prospective study performed in patients with left ventricular failure or mitral stenosis. Forty-eight hospitalized patients were included suffering from pulmonary congestion either from left ventricular failure or mitral stenosis. While in hospital all patients were submitted to right heart catheterization by the Swan-Ganz method and also to an echocardiographic examination. Within 48 hours after the patients were submitted to the following lung function studies: lung volumes and capacities by the multi-breath helium dilution method and airway flows by pneumotachography. Respiratory symptoms were evaluated by the Medical Research Council Questionnaire and the functional class classified according to the NYHA. Correlations were made between the functional and clinical data. Regarding the cardiac evaluation patients presented with a mean pulmonary wedge pressure of 19.9 +/- 8.6 mmHg, a cardiac index of 2.5 +/- 0.8 l/min/m2, an end diastolic dimension of the left ventricle of 65.9 +/- 10.1 mm, and end systolic dimension of 51.2 +/- 12.2 mm, with a shortening fraction of 21.8 +/- 9.5%. The pulmonary evaluation showed a restrictive syndrome with a reduction in the mean values of the following parameters: total pulmonary capacity 71 +/- 14.4% of the predicted value (pv), forced vital capacity (FVC) 69.8 +/- 20.5% pv, and forced expiratory volume (FEV1) of 64 +/- 21.8% vp. The index FEV1/FVC was within the normal value of 72.7 +/- 9.7%. These lung function results did not correlate significantly with either the clinical, the hemodynamic or echocardiographic findings. In these group of patients pulmonary congestion led to the development of a restrictive syndrome which failed to correlate in severity with the duration of the disease, the pulmonary wedge pressure and the left ventricular function.

Mouse allergen, lung function, and atopy in Puerto Rican children.

PubMed

Forno, Erick; Cloutier, Michelle M; Datta, Soma; Paul, Kathryn; Sylvia, Jody; Calvert, Deanna; Thornton-Thompson, Sherell; Wakefield, Dorothy B; Brehm, John; Hamilton, Robert G; Alvarez, María; Colón-Semidey, Angel; Acosta-Pérez, Edna; Canino, Glorisa; Celedón, Juan C

2012-01-01

To examine the relation between mouse allergen exposure and asthma in Puerto Rican children. Mus m 1, Der p 1, Bla g 2, and Fel d 1 allergens were measured in dust samples from homes of Puerto Rican children with (cases) and without (controls) asthma in Hartford, CT (n = 449) and San Juan (SJ), Puerto Rico (n = 678). Linear or logistic regression was used for the multivariate analysis of mouse allergen (Mus m 1) and lung function (FEV(1) and FEV(1)/FVC) and allergy (total IgE and skin test reactivity (STR) to ≥1 allergen) measures. Homes in SJ had lower mouse allergen levels than those in Hartford. In multivariate analyses, mouse allergen was associated with higher FEV(1) in cases in Hartford (+70.6 ml, 95% confidence interval (CI) = 8.6-132.7 ml, P = 0.03) and SJ (+45.1 ml, 95% CI =  -0.5 to 90.6 ml, P = 0.05). In multivariate analyses of controls, mouse allergen was inversely associated with STR to ≥1 allergen in non-sensitized children (odds ratio [OR] for each log-unit increment in Mus m 1 = 0.7, 95% CI = 0.5-0.9, P<0.01). In a multivariate analysis including all children at both study sites, each log-increment in mouse allergen was positively associated with FEV(1) (+28.3 ml, 95% CI = 1.4-55.2 ml, P = 0.04) and inversely associated with STR to ≥1 allergen (OR for each log-unit increment in Mus m 1 = 0.8, 95% CI = 0.6-0.9, P<0.01). Mouse allergen is associated with a higher FEV(1) and lower odds of STR to ≥1 allergen in Puerto Rican children. This may be explained by the allergen itself or correlated microbial exposures.

Mouse Allergen, Lung Function, and Atopy in Puerto Rican Children

PubMed Central

Forno, Erick; Cloutier, Michelle M.; Datta, Soma; Paul, Kathryn; Sylvia, Jody; Calvert, Deanna; Thornton-Thompson, Sherell; Wakefield, Dorothy B.; Brehm, John; Hamilton, Robert G.; Alvarez, María; Colón-Semidey, Angel; Acosta-Pérez, Edna; Canino, Glorisa; Celedón, Juan C.

2012-01-01

Objective To examine the relation between mouse allergen exposure and asthma in Puerto Rican children. Methods Mus m 1, Der p 1, Bla g 2, and Fel d 1 allergens were measured in dust samples from homes of Puerto Rican children with (cases) and without (controls) asthma in Hartford, CT (n = 449) and San Juan (SJ), Puerto Rico (n = 678). Linear or logistic regression was used for the multivariate analysis of mouse allergen (Mus m 1) and lung function (FEV1 and FEV1/FVC) and allergy (total IgE and skin test reactivity (STR) to ≥1 allergen) measures. Results Homes in SJ had lower mouse allergen levels than those in Hartford. In multivariate analyses, mouse allergen was associated with higher FEV1 in cases in Hartford (+70.6 ml, 95% confidence interval (CI) = 8.6–132.7 ml, P = 0.03) and SJ (+45.1 ml, 95% CI =  −0.5 to 90.6 ml, P = 0.05). In multivariate analyses of controls, mouse allergen was inversely associated with STR to ≥1 allergen in non-sensitized children (odds ratio [OR] for each log-unit increment in Mus m 1 = 0.7, 95% CI = 0.5–0.9, P<0.01). In a multivariate analysis including all children at both study sites, each log-increment in mouse allergen was positively associated with FEV1 (+28.3 ml, 95% CI = 1.4–55.2 ml, P = 0.04) and inversely associated with STR to ≥1 allergen (OR for each log-unit increment in Mus m 1 = 0.8, 95% CI = 0.6–0.9, P<0.01). Conclusions Mouse allergen is associated with a higher FEV1 and lower odds of STR to ≥1 allergen in Puerto Rican children. This may be explained by the allergen itself or correlated microbial exposures. PMID:22815744

COPD case finding by spirometry in high-risk customers of urban community pharmacies: a pilot study.

PubMed

Castillo, D; Guayta, R; Giner, J; Burgos, F; Capdevila, C; Soriano, J B; Barau, M; Casan, P

2009-06-01

COPD case finding is currently recommended at primary and tertiary care levels only. To evaluate the feasibility of a community pharmacy program for COPD case finding in high-risk customers by means of spirometry. Pilot cross-sectional descriptive study in 13 urban community pharmacies in Barcelona, Spain, from April to May 2007. Customers >40 years old with respiratory symptoms and/or a history of smoking were invited to participate in the study during pharmacists' routine work shifts. High-risk customers were identified by means of a 5-item COPD screening questionnaire based on criteria of the Global Initiative for Chronic Obstructive Lung Disease, and were invited to perform spirometry accordingly. Those with an FEV(1)/FVC ratio less than 0.70 were referred to the hospital for a repeat spirometry. Of the 161 pharmacy customers studied, 100 (62%) scored 3 or more items in the COPD screening questionnaire, and after spirometry, 21 (24%) had an FEV(1)/FVC ratio<0.7. When these subjects with airflow limitation were offered referral to a hospital respiratory function laboratory for further assessments, 11 (52%) attended the appointment. Over 70% of spirometries were rated as being of acceptable quality. No significant differences were observed in lung function parameters between the pharmacy and hospital measurements. COPD case finding by spirometry in high-risk customers of urban community pharmacies is feasible. Similarly to primary care practitioners, pharmacists have access to high-risk, middle-aged subjects who have never been tested for COPD. Pharmacists can help with early detection of COPD if they are correctly trained.

Comparison of intermittent positive pressure breathing and temporary positive expiratory pressure in patients with severe chronic obstructive pulmonary disease.

PubMed

Nicolini, Antonello; Mollar, Elena; Grecchi, Bruna; Landucci, Norma

2014-01-01

Results supporting the use and the effectiveness of positive expiratory, pressure devices in chronic obstructive pulmonary disease (COPD) patients are still controversial, We have tested the hypothesis that adding TPEP or IPPB to standard pharmacological therapy may provide additional clinical benefit over, pharmacological therapy only in patients with severe COPD. Fourty-five patients were randomized in three groups: a group was treated; with IPPB,a group was treated with TPEP and a group with pharmacological; therapy alone (control group). Primary outcome measures included the measurement of scale or, questionnaire concerning dyspnea (MRC scale),dyspnea,cough, and, sputum (BCSS) and quality of life (COPD assessment test) (CAT). Secondary, outcome measures were respiratory function testing,arterial blood gas,analysis,and hematological examinations. Both patients in the IPPB group and in the TPEP group showed a significant, improvement in two of three tests (MRC,CAT) compared to the control, group.However,in the group comparison analysis for, the same variables between IPPB group and TPEP group we observed a, significant improvement in the IPPB group (P≤.05 for MRC and P≤.01 for, CAT). The difference of action of the two techniques are evident in the results of, pulmonary function testing: IPPB increases FVC, FEV1, and MIP; this reflects, its capacity to increase lung volume. Also TPEP increases FVC and FEV1 (less, than IPPB), but increases MEP, while decreasing total lung capacity and, residual volume. The two techniques (IPPB and TPEP) improves significantly dyspnea; quality of; life tools and lung function in patients with severe COPD. IPPB demonstrated a greater effectiveness to improve dyspnea and quality of life tools (MRC, CAT) than TPEP. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Effect of Mindfulness Based Stress Reduction on Quality of Life (SF-36) and Spirometry Parameters, in Chemically Pulmonary Injured Veterans.

PubMed

Arefnasab, Zahra; Ghanei, Mostafa; Noorbala, Ahmad Ali; Alipour, Ahmad; Babamahmoodi, Farhang; Babamahmoodi, Abdolreza; Salehi, Maryam

2013-09-01

Studies have shown that Mindfulness Based Stress Reduction (MBSR) has positive effect on physical and psychological dimensions of chronic illnesses. In this study for the first time we examine the effect of this new technique on quality of life and pulmonary function in chemically pulmonary injured veterans who have chronic pulmonary problem, psychological problems and low quality of life. Forty male pulmonary injured veterans were randomly replaced in two groups with 20 participants (MBSR and control Wait List (WL)). Then MBSR group received 8-weekly sessions intervention. We evaluate quality of life (used SF-36 questionnaire) and Spirometry parameters two times; before and after intervention in two group. We used "mixed factorial analyses of variance" test for analyzing data in each dependent variables. Then if we have significant interactional effect, we used -paired- sample t-test" for comparing before and after intervention data of each group, and "Independent-Sample t-test" for comparing after intervention data of two groups. The MBSR compare to WL group improved SF-36 total score, (F (1, 38) =12.09, P=0.001), "Role limitations due to physical problems"(F(1,38)= 6.92, P=0.01), "Role limitations due to emotional problems"(F(1,38)= 7.75, P=0.008), "Social functioning"(F(1,38)= 9.89, P=0.003), "Mental health"(F(1,38)= 15.93, P=0), "Vitality"(F(1,38)= 40.03, P≤0.001), and "Pain"(F(1,38)= 27.60, P≤0.001). MBSR had no significant effect on "FEV1" (F (1, 38) = 0.03, P=0.85),"FVC" (F (1, 38) = 0.16, P=0.69) and "FEV1/FVC" (F (1, 38) = 2.21, P=0.14). MBSR can improve individual's quality of life but not lung function in chemically pulmonary injured veterans.

Evaluation of respiratory functions of residents around the Orhaneli thermal power plant in Turkey.

PubMed

Pala, Kayihan; Türkkan, Alpaslan; Gerçek, Harika; Osman, Erdinc; Aytekin, Hamdi

2012-01-01

The aim of this cross-sectional study was to evaluate the health and respiratory function of residents around the Orhaneli thermal power plant in Turkey. The study was conducted using face-to-face interviews, and respiratory functions were measured with a spirometer. The respiratory functions of 2350 residents, 15 years and older, living in communities near the coal-fired Orhaneli thermal power plant in Turkey were measured. The control group consisted of 469 persons from similar communities without a nearby power plant. The FEV1 (forced expiratory volume after 1 s) and FVC (forced vital capacity) values of the study participants were significantly lower than those of the control group, and residents directly downwind of the plant's smokestack showed greater impairment of respiratory functions compared with residents upwind.

Respiratory damage in children exposed to urban pollution.

PubMed

Calderón-Garcidueñas, Lilian; Mora-Tiscareño, Antonieta; Fordham, Lynn A; Valencia-Salazar, Gildardo; Chung, Charles J; Rodriguez-Alcaraz, Antonio; Paredes, Rogelio; Variakojis, Daina; Villarreal-Calderón, Anna; Flores-Camacho, Lourdes; Antunez-Solis, Angelina; Henríquez-Roldán, Carlos; Hazucha, Milan J

2003-08-01

Southwest Metropolitan Mexico City (SWMMC) children are chronically exposed to complex mixtures of air pollutants. In a cross-sectional arm of our study, we investigated the association between exposure to SWMMC atmosphere and nasal abnormalities, hyperinflation, and interstitial markings assessed by chest X-rays, lung function changes, several serum cytokines, and endothelin-1 in 174 children aged 5-17 years vs. 27 control children residents in low-polluted areas. Control children had no nasal lesions, and only one child showed an abnormal chest X-ray. SWMMC children exhibited nasal abnormalities (22%), hyperinflation (67%), interstitial markings (49%), and a mild restrictive pattern by spirometry (10%). Interstitial markings were associated with a decrease in predicted values of FEF(25-75), FEF(75), and the FEV(1)/FVC ratio. Boys had a higher probability of developing interstitial markings with age (P = 0.004). Blood smear findings included toxic granulations in neutrophils and schistocytes. SWMMC children had more serum IL10 and IL6 and less IL8 than controls. In a longitudinal arm of our study, we found a significant seasonal drop in FVC and FEV(1) associated with a 6-month period of high ozone and PM(10) levels. Our data strongly suggest that a lifelong exposure to urban air pollution causes respiratory damage in children. Moreover, a cytokine network becomes imbalanced, with a shift towards upregulation of anti-inflammatory cytokines. Consequently, these children are potentially at risk for developing chronic lung disease and other systemic effects later in life. Copyright 2003 Wiley-Liss, Inc.

Prevalence and Determinants of Chronic Obstructive Pulmonary Disease (COPD) in Bangladesh.

PubMed

Alam, Dewan S; Chowdhury, Muhammad Ah; Siddiquee, Ali T; Ahmed, Shyfuddin; Clemens, John D

2015-01-01

There is a paucity of population-based data on COPD prevalence and its determinants in Bangladesh. To measure COPD prevalence and socioeconomic and lifestyle determinants among ≥40 years Bangladeshi adults. In a cross-sectional study, we measured lung function of 3744 randomly selected adults ≥40 years from rural and urban areas in Bangladesh, using a handheld spirometer. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as post-bronchodilator ratio of Forced Expiratory Volume in 1st second (FEV1) to Forced Vital Capacity (FVC) < 0.7. In addition, COPD was also assessed by the lower limit of normal (LLN) threshold defined as lower fifth percentile for the predicted FEV1/FVC. The prevalence of COPD was 13.5% by GOLD criteria and 10.3% by LLN criteria. Prevalence of COPD was higher among rural than urban residents and in males than females. More than half of the COPD cases were stage II COPD by both criteria. Milder cases (Stages I and II) were over estimated by the GOLD fixed criteria, but more severe cases (Stages III and IV) were similarly classified. In multiple logistic regression analysis, older age, male sex, illiteracy, underweight, history of smoking (both current and former), history of asthma and solid fuel use were significant predictors of COPD. COPD is a highly prevalent and grossly underdiagnosed public health problem in Bangladeshi adults aged 40 years or older. Illiteracy, smoking and biomass fuel burning are modifiable determinants of COPD.

Pulmonary Predictors of Incident Diabetes in Smokers

PubMed Central

Kinney, Gregory L.; Baker, Emma H.; Klein, Oana L.; Black-Shinn, Jennifer L.; Wan, Emily S.; Make, Barry; Regan, Elizabeth; Bowler, Russell P.; Lutz, Sharon M.; Young, Kendra A.; Duca, Lindsey M.; Washko, George R.; Silverman, Edwin K.; Crapo, James D.; Hokanson, John E.

2016-01-01

Background: Diabetes mellitus and its complications are a large and increasing burden for health care worldwide. Reduced pulmonary function has been observed in diabetes (both type 1 and type 2), and this reduction is thought to occur prior to diagnosis. Other measures of pulmonary health are associated with diabetes, including lower exercise tolerance, greater dyspnea, lower quality of life (as measured by the St. George’s Respiratory Questionaire [SGRQ]) and susceptibility to lung infection and these measures may also predate diabetes diagnosis. Methods: We examined 7080 participants in the COPD Genetic Epidemiology (COPDGene) study who did not report diabetes at their baseline visit and who provided health status updates during 4.2 years of longitudinal follow-up (LFU). We used Cox proportional hazards modeling, censoring participants at final LFU contact, reported mortality or report of incident diabetes to model predictors of diabetes. These models were constructed using known risk factors as well as proposed markers related to pulmonary health, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, respiratory exacerbations (RE), 6-minute walk distance (6MWD), pulmonary associated quality of life (as measured by the SGRQ), corticosteroid use, chronic bronchitis and dyspnea. Results: Over 21,519 person years of follow-up, 392 of 7080 participants reported incident diabetes which was associated with expected predictors; increased body mass index (BMI), high blood pressure, high cholesterol and current smoking status. Age, gender and accumulated smoking exposure were not associated with incident diabetes. Additionally, preserved ratio with impaired spirometry (PRISm) pattern pulmonary function, reduced 6MWD and any report of serious pulmonary events were associated with incident diabetes. Conclusions: This cluster of pulmonary indicators may aid clinicians in identifying and treating patients with pre- or undiagnosed diabetes. PMID:27795984