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PubMed2004

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

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.

Adult↗
PubMed1994

Early changes in lung function and response to surfactant replacement therapy.

Dynamic respiratory system compliance (Cdyn) was measured in 44 preterm babies before, immediately after, and for 96 h following administration of artificial surfactant (Exosurf). There was no significant change in Cdyn for the whole group over the entire study period. Subdivision into three groups on the basis of Cdyn prior to surfactant revealed a significant and sustained deterioration in lung function in those babies with the highest starting compliance and a significant and sustained improvement in those with the lowest compliance. Inspired oxygen and alveolar/arterial oxygen gradient also exhibited significant differences with least improvement in the babies with the best initial lung function and most improvement in the babies with worst initial lung function and most improvement in the babies with worst initial lung function. Despite clear initial differences in clinical status, neither long-term oxygen requirements nor the incidence of chronic lung disease differed significantly between the three groups. We conclude that the response of an individual baby to the administration of surfactant is, in part, determined by the lung function before surfactant is administered. Babies with higher initial lung compliance are more likely to deteriorate after administration and caution should be used before selection of such babies for surfactant treatment.

Humans↗
PubMed1979

A new lung function index: the area under the maximum expiratory flow-volume curve.

A new lung function index, the area under the maximum expiratory flow-volume curve (AFVx) is described. A predicted AFVx based on age, sex and height is determined, and the measured to predicted AFVx ratio is assessed by comparison with other established lung function parameters. This ratio appears to be a very sensitive indicator of the degree of lung function impariment.

Age Factors↗
PubMedDate not supplied

Does screening for loss of lung function help smokers give up?

One-fifth of smokers show accelerated decline in lung function. These are the patients that go on to develop chronic obstructive pulmonary disease (COPD), an illness characterized by cough, production of sputum, shortness of breath and premature death (Sethi and Rochester, 2000). If this group of smokers stopped smoking, their decline would slow and they might avoid developing COPD. This pilot study aimed to discover whether those with accelerated decline in lung function would quit if presented with the facts about their situation. Known smokers in their 50s were screened for signs of accelerated respiratory decline. Those with an accelerated decline in lung function were identified and given tailored smoking cessation advice. Of 141 eligible patients, 22 responded and six gave up smoking and remained non-smokers 1 year later. The results of this pilot suggest that screening smokers for accelerated respiratory decline by practice nurses is feasible and acceptable to those patients that respond. Further research is needed to discover whether such an intervention would be cost-effective.

Health Behavior↗
PubMed1977

Regional lung function in asbestos workers.

Regional lung function was measured using radioactive xenon-133 in a group of normal subjects and in two groups of asbestos workers. When compared with the normal group, patients with pulmonary asbestosis showed impaired ventilation of the lower zones. Subjects with calcified pleural plaques without radiological evidence of lung parenchymal fibrosis did not show this abnormality.

Aged↗
PubMed1992

A 10 year follow up of 180 adults with bronchial asthma: factors important for the decline in lung function.

BACKGROUND: Little is known about the factors that determine outcome in asthma. The purpose of this study was to describe the relation of various factors of potential importance to the rate of decline in lung function in adults with intrinsic and extrinsic asthma. METHODS: Of 180 asthmatic patients, 143 (79%) participated in a 10 year follow up examination. At the time of enrollment all patients underwent certain tests for asthma (case history, total IgE, skinprick tests, the radioallergosorbent test (RAST), histamine release from basophil leucocytes, and specific bronchial provocations). On the basis of these tests 94 patients had intrinsic asthma and 49 extrinsic asthma. RESULTS: Patients with intrinsic asthma had an annual decline in FEV1 of 50 ml, whereas those with extrinsic asthma had a decline of 22.5 ml; the rate of decline of lung function increased with increasing age in both groups. An inverse relation between initial FEV1 and decline in FEV1 (the "horse racing effect") was found for the patients with extrinsic asthma but not for the patients with intrinsic asthma. There was no relation between rate of decline in lung function and number of cigarettes smoked. A high degree of airway variability--that is, reversibility in FEV1--at the time of enrollment was found to be associated with a steeper decline in lung function in patients with intrinsic asthma, whereas increasing degrees of obstruction (decreasing FEV1/VC ratio at enrollment) and need for treatment with corticosteroids were associated with a more pronounced decline in FEV1 in patients with extrinsic asthma. CONCLUSIONS: The rate of decline in lung function is greater in patients with intrinsic asthma than in patients with extrinsic asthma; the prognosis for intrinsic and extrinsic asthma is to some extent influenced by different factors, which suggests that the pathogenetic mechanisms underlying intrinsic and extrinsic asthma may differ.

Adult↗
PubMed2004

Long-term changes in dyspnea, lung function, and exercise capacity in COPD patients.

OBJECTIVE: To examine longitudinal changes in dyspnea, lung function, and exercise capacity in COPD patients and to compare baseline data of frequent and infrequent exacerbators at trial entry. METHODS: Nineteen stable COPD patients without significant co-morbidity (age, 58.4 +/- 8.4 years; FEV1% = 33 +/- 12%; mean +/- SD) participated in the study. After a mean period of 36 months (range = 24 - 49) the patients were retested using an identical protocol. RESULTS: Repeated measures analysis showed that there was significant deterioration of FEV1 L (from 1.028 +/- 0.349 to 0.928 +/- 0.307; p = 0.007), PImax cm H2O (from 61.9 +/- 24.2 to 42.0 +/- 22.1; p = 0.007), PaO2 mm Hg (from 69.0 +/- 8.6 to 60.1 +/- 6.8; p = 0.003), PaCO2 mm Hg (from 43.1 +/- 4.9 to 47.3 +/- 4.5; p = 0.001), ATS (from 2.4 +/- 1.0 to 2.8 +/- 0.8; p = 0.031), and 6MWD m (from 389 +/- 130 to 341 +/- 135; p = 0.014). There were also changes in IC, T(L,CO)/V(A), PAP and Borg, but they were not statistically significant. Differentiation of patients by frequency of exacerbations per year of observation (> 2 < or =) discriminated them with respect to functional parameters (FEV1, FVC, IC), dyspneic indices (ATS, VAS and Borg) and exercise capacity (6MWD) at the time of enrollment. CONCLUSIONS: 1) Lung function parameters, blood-gas and dyspneic indices, and exercise capacity decline over a mean period of 36 month in patients with COPD; 2) Patients with frequent exacerbations experience more dyspnea and have lower levels of lung function and exercise capacity at trial entry.

Disease Progression↗
PubMed1991

Abnormal lung function associated with asbestos disease of the pleura, the lung, and both: a comparative analysis.

The impairment of lung function associated with different types of asbestos related disease was examined in 1298 men. The 310 men with circumscribed pleural lesions (plaques) or diffuse pleural thickening without asbestosis were compared with 596 men with asbestosis only and with 322 men with pleural abnormalities and asbestosis, as classified from chest radiographs by ILO pneumoconiosis criteria. Spirometric indices and total lung capacity (TLC; determined by planimetry) were measured and expressed as percentages of predicted values. Non-smoking men with pleural disease only had reduced values of mid and terminal expiratory flows (80.6 and 69.9% predicted) and a reduced FEV1 (89% predicted) with a forced vital capacity (FVC) of 94% predicted. TLC was 104% predicted. Thus they had airways obstruction with-out restriction. Non-smoking men with pulmonary asbestosis (ILO profusion of opacities mostly 1/0 and 1/1) had pulmonary function similar to that of men with pleural disease. FEV1 and FVC and flow rates at other lung volumes were lower in smokers with asbestosis (after adjustment for duration of smoking) than in the non-smokers with asbestosis. Airflow limitation was worse in the men with both pleural abnormalities and pulmonary asbestosis with lower values for mid expiratory flow, FEV1 and FVC (but not TLC) than those with either abnormality alone, in both non-smokers and current smokers. Men with diffuse pleural thickening that included the costophrenic angles had more airways obstruction and air trapping and lower FVC values than those with circumscribed pleural disease.

Aged↗
PubMed2000

Lung function reference values in Chinese children and adolescents in Hong Kong. I. Spirometric values and comparison with other populations.

As part of a comprehensive evaluation of lung function in Hong Kong-born Chinese children and adolescents, this study was conducted to determine updated prediction equations for spirometry, to evaluate the secular changes of lung function during the past decade, and to compare these results with other data sets. The results are based on 852 (392 male, 460 female) healthy students, age 7 to 19 yr, recruited from seven schools in Hong Kong. All were born and lived in Hong Kong, nonsmokers, free from past or present symptoms or diseases affecting the respiratory tract. A body plethysmograph was used to record lung function measurements. Natural logarithmic values of lung volumes and body height were used in the final regression model. Prediction equations for FVC, FEV(1), and maximal expiratory flow at 50% of the FVC (MEF(50)) for both sexes are presented, with standing height as the dependent variable. Compared with Hong Kong data from 1985, the results show a significant increase in height-corrected FVC and FEV(1) in both boys and girls, over the whole height range. Compared with recent data of whites, FVC in boys were 8 to 10% lower in the study population, and the difference increased to 12% above the 165 cm height ranges, while FVC in Chinese girls had similar or only slightly lower predicted values. FEV(1) values showed a similar pattern with lesser difference between the two ethnic groups. Compared with recent data from Chinese children in Singapore, a similar pattern with overall lesser difference of the two populations was present in boys, whereas there was no significant difference between girls in the two places. Our findings support the conclusion that exogenous factors may contribute significantly to the differences in lung function values among ethnic groups and that it is important to examine normative values of various populations for secular trends.

Adolescent↗
PubMedDate not supplied

Ventilatory lung function tests in school children of 6-13 years.

Spirometry was performed in 186 healthy school children, 6-13 years of age, selected from urban population of Rohtak city (India), to derive the regression equation for prediction of normal value of ventilatory lung function in this age group. Values of lung functions in the present study are well comparable to other North Indian studies and Western reports, but higher than the South Indian children. Lung functions have shown better linear correlation with age and height as compared to weight. Comparison of ventilatory function tests in boys and girls showed statistically higher FVC, FEV1, PEFR, FEF25% and MVV in boys, while FEF50% FEF75% and FEF75-85% were statistically higher in girls in different age groups. No specific pattern of variation in lung function tests was observed with sex. Regression equations for different ventilatory functions have been derived for either sex with the best possible combination of physical parameters.

Adolescent↗
PubMed2002

A novel approach to defining the relationship between lung function and symptom status in asthma.

We present a novel approach to estimating functional relationships between forced expiratory volume in 1 second (FEV(1)) and asthma-related symptoms on a population-wide basis. We used asthma-related clinical trials that reported estimates of mean lung function (measured as FEV(1) percent predicted) and symptoms (symptom score or percentage of symptom days or nighttime awakenings). Using average baseline values from each study in weighted linear regression analyses, we found a negative association between lung function and symptom score (P < 0.001) and the percentage of nighttime awakenings (P = 0.18), but no association between lung function and symptom days. We also found consistent relationships between the mean changes in lung function and symptoms at follow-up within the studies. Functional relationships between FEV(1) percent predicted and asthma-related symptoms can be useful for inferring the effect on the symptoms of a population associated with overall improvements in lung function.

Adult↗
PubMed2006

Does reduction mammaplasty improve lung function test in women with macromastia? Results of a randomized controlled trial.

BACKGROUND: To determine the effects of reduction mammaplasty on lung function in women with mammary hypertrophy (macromastia), a prospective, randomized, controlled trial was conducted at the Academic Surgery and Plastic Surgery Units, Castle Hill Hospital, Cottingham, United Kingdom. METHODS: Seventy-three women who were referred for consideration of bilateral breast reduction surgery were randomized into either an early intervention group (surgery within 6 weeks) or a control group (surgery 6 months after recruitment). Each group had two sets of lung function tests: the intervention group had one before and one 3 months after surgery and the control arm had one test initially and a second test 4 months after randomization and before surgery. The main outcome measure was the lung function test. RESULTS: Sixty-five patients completed the study. The mean age was 39 years (SD, 12 years); both groups were equally matched for age, smoking status, social class, and educational status. By independent t test, there was no significant difference in lung function in the two groups. Subgroup analysis of the intervention group demonstrated a positive correlation between specimen weight and forced expiratory volume/vital capacity, forced expiratory volume/forced vital capacity, peak expiratory flow rate, and forced vital capacity. A paired sample t test revealed a significant improvement in the percentage of forced vital capacity performed/forced vital capacity predicted. CONCLUSION: The improvement in pulmonary function following reduction mammaplasty correlates with specimen weight resected.

Adolescent↗
PubMed2001

A prospective study of lung function among boilermaker construction workers exposed to combustion particulates.

BACKGROUND: Given the evidence of both acute cross-shift and short-term decrements in lung function in boilermaker construction workers following occupational exposure to combustion particulates, we sought to determine whether exposure is associated with an annual loss in lung function. METHODS: As part of an ongoing investigation, we conducted a 2-year longitudinal study of lung function among 118 boilermakers. Exposure was assessed with a work history questionnaire. Spirometry measurements were performed annually. RESULTS: We found an association between annual FEV(1) and hours worked at a gas-fired plant during the previous year, beta = - 9.8 mls/100 hours worked (95% CI: - 16.0, - 3.5) after adjustment for age, baseline FEV(1) and cigarette smoking status. The adjusted association between FEV(1) and "ever" worked at a gas-fired plant was - 99.7 mls (95% CI: - 154.8, - 44.5). There was also evidence of a negative association between FEV(1) and "ever" worked and hours worked at oil and coal-fired plants. CONCLUSIONS: These data suggest an association between annual lung function loss and working at gas, coal and oil-fired plants. Further follow-up of this cohort of boilermakers is in progress.

Adult↗
PubMed2003

Elastase-induced changes in lung function: relationship to morphometry and effect of drugs.

Intratracheal administration of porcine pancreatic elastase (PPE) produced a dose related decline in lung function, as assessed by changes in dynamic lung compliance (C(dyn)) in New Zealand White rabbits. This occurred within 24 h of administration and persisted for 56 days (n=6). These lung function changes were accompanied by histological evidence of emphysema in the lungs and were not mimicked by intratracheal administration of the proteolytic enzyme trypsin. Neither the lung function nor the histological changes induced by elastase could be prevented or reversed by either the glucocorticosteroid, dexamethasone, or all trans retinoic acid (ATRA).Our data suggest that local administration of elastase to the lungs of rabbits may provide a convenient way to assess the effects of drugs on the changes induced by elastase in airways.

Animals↗
PubMed1983

Terbutaline serum concentrations related to different lung function parameters and beta-receptor function.

In eight asthmatic and six normal subjects serum terbutaline concentrations were correlated with changes in FEV1, MEF50%, Gaw, sGaw, and plasma cAMP concentrations after administration of 0.5 mg terbutaline subcutaneously, 5 mg orally, and an oral placebo. In asthmatics and normals the changes in serum terbutaline levels and plasma cAMP levels were closely correlated and in the same range. No change in lung function parameters was registered in normals, whereas in asthmatics a significant improvement was shown. In asthmatics all lung function parameters closely parallelled the changes in serum terbutaline concentrations and cAMP plasma concentrations, the FEV1 being the least variable lung function parameter. The maximal effect in FEV1 occurred 30-60 min after the subcutaneous dose and 2-4 h after the oral dose. The FEV1 improvement showed a linear relationship with the serum terbutaline concentration between 1.6 and 6 ng/ml. In contrast with theophyllines and anticholinergics, serum terbutaline concentrations showed a very low interindividual variance. Nevertheless it appeared that prediction of a certain improvement in lung function was not possible on the basis of the serum concentration. Since changes in plasma cAMP values after terbutaline therapy were similar in normals and asthmatics, the lung function improvement in the asthmatics suggests that if a beta-adrenergic defect exists, this must be mainly situated in the lung tissue.

Adult↗
PubMed2002

Antioxidant gene polymorphisms and susceptibility to a rapid decline in lung function in smokers.

Oxidative stress is believed to play an important role in the pathogenesis of smoking-induced chronic obstructive pulmonary disease. We hypothesized that polymorphisms of antioxidant genes glutathione S-transferase M1 (GSTM1), GSTT1, GSTP1, and heme oxygenase-1 (HMOX1) would be associated with susceptibility to accelerated decline of lung function in smokers. We genotyped 621 subjects (299 rapid decliners [change in forced expiratory volume in 1 second (DeltaFEV(1)) = -152 +/- 2.5 ml/year] and 322 nondecliners [DeltaFEV(1) = +15 +/- 1.5 ml/year]) selected from among smokers followed for 5 years in the National Heart, Lung, and Blood Institute Lung Health Study. Because genotype frequencies were different between ethnic groups, we limited the association study to 594 whites (286 rapid decliners and 308 nondecliners). None of the genotypes studied had a statistically significant effect on decline of lung function when analyzed separately. There was an association between rapid decline of lung function and presence of all three GST polymorphisms (odds ratio [OR] = 2.83; p = 0.03). A combination of a family history of chronic obstructive pulmonary disease with GSTP1 105Ile/Ile genotype was also associated with rapid decline of lung function (OR = 2.20; p = 0.01). However, due to the multiple comparisons that were made, these associations may represent type 1 error. There was no association between HMOX1 (GT)n alleles and the rate of decline in lung function in smokers.

Adult↗
PubMed1984

Regional lung function in patients with a complete radiographic regression of small cell bronchogenic carcinoma.

Regional lung function was studied in 21 patients with small cell bronchogenic carcinoma who demonstrated a complete radiographic regression of intrathoracic tumour after 3 months of combination chemotherapy. Spirometry was performed in 20 patients. VC and FEV1 were, on average, 89 and 88% of predicted normal values. Impairment of ventilation and/or perfusion at the site of previous tumour was documented in 13 patients, while no such abnormalities were observed in 8 cases. Reduction of blood flow was generally more severe than impairment of ventilation. Neither median survival nor disease-free 2-yr survival was improved in patients with normal regional lung function compared to patients with functional impairment. This lack of survival advantage suggests that factors other than persistent tumour, such as scar formation, may contribute to reduction of regional lung function after chemotherapy for small cell bronchogenic carcinoma.

Aged↗