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PubMed1999

[Follow-up study of lung function changes for 10 years in healthy elder of ex-smokers].

OBJECTIVE: To observe changes of lung function for 10 years in healthy elderly ex-smokers who have quitted smoking for more than 10 years. METHODS: 51 healthy elderly ex-smokers were selected and routine lung function tests were performed, 12 subjects, who have never smoked and all other criteria were similar, were chosen as controls. Their routine lung function tests have also been followed up for 10 years. RESULTS: The decrease of VC, FVC, FEV1 and PEF of ex-smokers were significantly lower than non-smokers, the increase of RV and RV/TLC were significantly higher than non-smokers. FEV1/FVC, MVV, MMEF, FRC and TLC were also different, however, the difference has not reached statistically significant. CONCLUSIONS: The influence of smoking could be prolonged, even the subject has stopped smoking for years, so we suggested to stop smoking the early the better.

Aged↗
PubMed2005

Airway remodeling contributes to the progressive loss of lung function in asthma: an overview.

Airway inflammation, airflow obstruction, and bronchial hyperresponsiveness are characteristic phenotypic features of asthma. Clinically, airflow obstruction in asthma often is not fully reversible, and many asthmatic subjects experience an accelerated and progressive loss of lung function over time. Histopathologic studies of the asthmatic airway have demonstrated stereotypic changes that might explain the loss of lung function that many patients with asthma experience. The notion of airway remodeling in asthma postulates that the alteration of the structure and function of key airway constituents, including airway smooth muscle, epithelium, blood vessels, and mucus glands, might explain, at least in part, the progressive loss of lung function that is observed clinically. Inflammation driven by CD4(+) lymphocytes and mediated by effector cells, particularly the eosinophil, appears to modulate the function of mesenchymal cells, including fibroblasts and myofibroblasts, changing the composition of the airway wall matrix. Changes in the airway epithelium might alter the function of the underlying smooth muscle and the composition of the matrix and could drive inflammation. Alterations in the structure and function of airway smooth muscle change the mechanical properties of the airway wall and might also affect the function of other airway constituents. A variety of experimental models have identified candidate mechanisms and mediators for these observed changes, which are thus potential therapeutic targets. However, clinical studies to date have been disappointing, and it remains to be seen whether targeted therapies will prevent the progressive loss of lung function seen in asthma.

Animals↗
PubMed2003

Infection control of lung function equipment: a practical approach.

The degree of risk of cross-infection of patients via lung function testing equipment has yet to be quantified. Based on current evidence, elaborate precautions are not justified for the majority of patients attending the laboratory, but attention to appropriate routine cleaning and disinfection protocols is important. Disinfection and sterilization can be achieved by a variety of methods, although chemical methods should be used with caution. Identification of factors increasing the susceptibility or infectivity of particular patients is important in determining appropriate precautions. Where patients are known to be infectious or are immunocompromized, additional precautions such as using a barrier filter may be appropriate. However, because of cost constraints, the routine use of barrier filters is difficult to justify based on current evidence of minimal cross-infection associated with lung function equipment. Until further studies have been conducted to quantify the degree of risk of cross-infection that lung function test equipment poses, the recommendations given in this review provide a practical approach to dealing with this problem.

Bacterial Infections↗
PubMed1998

Effects of cigarette smoking on lung function of Saudi students.

This study was carried out to investigate the association between cigarette smoking and state of lung function among Saudi male students. A cross sectional study was conducted on a group of 680 male Saudi students. Detailed personal questionnaire, British Medical Research Council questionnaire on respiratory symptoms and smoking habit, were administered and forced spirometry and anthropometric measurements were conducted on them. Multiple regression models were used to study the cumulative effect of smoking on the function of the lung of smoking students. The percentage of cigarette smoking among the studied group was 20.29%. Smoking students had significantly lower values for lung function tests (FEV1%, FEF200-1200, FEF25-75, FEF75-85, and PEFR) compared to non-smokers. After controlling for other confounding variables, increased duration of smoking and number of cigarette smoked per day were significantly associated with more limitation of airflow in airways of the smoking young students. Recommendations were discussed accordingly.

Adolescent↗
PubMed2004

Imaging lung function using rapid dynamic acquisition of T1-maps during oxygen enhancement.

This paper describes imaging of lung function with oxygen-enhanced MRI using dynamically acquired T1 parameter maps, which allows an accurate, quantitative assessment of time constants of T1-enhancement and therefore lung function. Eight healthy volunteers were examined on a 1.5-T whole-body scanner. Lung T1-maps based on an IR Snapshot FLASH technique (TE = 1.4 ms, TR = 3.5 ms, FA = 7 (composite function )) were dynamically acquired from each subject. Without waiting for full relaxation between subsequent acquisition of T1-maps, one T1-map was acquired every 6.7 s. For comparison, all subjects underwent a standard pulmonary function test (PFT). Oxygen wash-in and wash-out time course curves of T1 relaxation rate (R1)-enhancement were obtained and time constants of oxygen wash-in (w(in)) and wash-out (w(out)) were calculated. Averaged over the whole right lung, the mean w(out) was 43.90 +/- 10.47 s and the mean (w(in)) was 51.20 +/- 15.53 s, thus about 17% higher in magnitude. Wash-in time constants correlated strongly with forced expired volume in one second in percentage of the vital capacity (FEV1 % VC) and with maximum expiratory flow at 25% vital capacity (MEF25), whereas wash-out time constants showed only weak correlation. Using oxygen-enhanced rapid dynamic acquisition of T1-maps, time course curves of R1-enhancement can be obtained. With w(in) and w(out) two new parameters for assessing lung function are available. Therefore, the proposed method has the potential to provide regional information of pulmonary function in various lung diseases.

Administration, Inhalation↗
PubMed1986

Changes in lung function determined longitudinally compared with decline assessed cross-sectionally. The Cracow Study.

Longitudinal annual changes in lung function (FEV1) with cross-sectional estimates have been compared in the sample of Cracow inhabitants who underwent epidemiological follow-up on chronic nonspecific chest diseases. The annual rate of FEV1 decline was faster in men than in women. Among male smokers the FEV1 decline rate was 30% greater, while in women smokers 9% faster than in non-smokers. The cross-sectional estimates for annual changes differed in both surveys carried out in the interval of 13 years and were not very much consistent with the average longitudinal annual decline observed in the sample. However, the prediction of annual decline across the age groups showed large inconsistencies. They resulted from the curvilinear pattern in lung function decline over the age groups. It was found that the lung function in the elderly appeared to be more homogeneous and the acceleration of decline rates slowed down. There is some evidence that the flattening of the decline curve among elderly might have been influenced by the selection bias.

Adult↗
PubMed2002

Sensitization to sunflower pollen and lung functions in sunflower processing workers.

BACKGROUND: This study aimed to investigate whether exposure to sunflower pollen (Helianthus annuus) increases both sensitization and respiratory symptoms, and whether or not it affects lung functions in sunflower processing workers. METHODS: The largest sunflower processing factories in the Thrace region of Turkey participated in this study. Workers from the units directly exposed to sunflower seed enrolled as the study group (n = 102) and workers who were not directly exposed to Helianthus annuus pollen (n = 102) were the control group. Detailed questionnaires covering respiratory and allergic symptoms were completed, and skin prick tests and lung function tests were performed. RESULTS: We found a very high rate (23.5%) of sensitization to Helianthus annuus in the study group compared to the controls (P<0.001). Logistic regression analysis showed that the risk of sensitization to H. annuus was increased 4.7-fold (odds ratio = 4.17, 95%) confidence interval = 1.3-16.7) if subjects were exposed to sunflower pollen in the workplace. While asthmatic symptoms and allergic skin diseases were not different between the two groups, workers in the study group had a higher rate of allergic rhinitis and conjunctivitis (P<0.05). We found that pulmonary function was significantly impaired in the study group (P<0.01). Using a multivariate analysis model, inclusion in the study group was found to be a predictive factor for impairment of lung function (P=0.002). CONCLUSIONS: We conclude that sunflower pollen has high allergenic potential, especially when there is close contact, and exposure to sunflower pollen in the workplace can result in impairment in lung function.

Agricultural Workers' Diseases↗
PubMed2004

Decline in lung function in the Busselton Health Study: the effects of asthma and cigarette smoking.

Asthma in adults may be associated with chronic airflow obstruction, possibly resulting from airway disease in early life and/or a greater rate of decline in lung function in adult life compared with those with asthma. Treatment and cigarette smoking may also influence the rate of decline of lung function. The aim of this analysis was to examine the level and rate of decline in lung function in relationship to asthma and cigarette smoking in adults. Subjects (n = 9,317) had participated as adults (> 18 years) in one or more of the cross-sectional Busselton Health Surveys between 1966 and 1981 or in the follow-up study of 1994/1995. The effects of sex, doctor-diagnosed asthma, smoking status, and anthropometric data on the level and rate of decline in FEV1 were examined in a linear mixed effects model. At the age of 19 years, FEV1 was reduced in subjects with asthma but was similar in smokers and nonsmokers. Males, taller subjects, smokers, and subjects with asthma had greater declines in FEV1 with age. Smoking and asthma had additive but not multiplicative effects on decline. Thus, asthma is associated with reduced lung function at the beginning of adult life as well as an increased rate of decline during adult life.

Adult↗
PubMed2005

A disintegrin and metalloprotease 33 polymorphisms and lung function decline in the general population.

RATIONALE: A disintegrin and metalloprotease 33 (ADAM33) has been identified as a susceptibility gene for asthma and single nucleotide polymorphisms (SNPs) in this gene have been associated with excessive decline of lung function in individuals with asthma. OBJECTIVES: To assess whether SNPs in ADAM33 are associated with accelerated lung function loss in the general population and with chronic obstructive pulmonary disease (COPD). METHODS: DNA was collected from subjects of the Vlagtwedde-Vlaardingen cohort participating in the last survey in 1989-1990 after a follow-up of 25 years. Information was collected every 3 years, including lung function measurements. We defined COPD as GOLD stage 2 or higher at the last survey. A total of 1,390 subjects from the cohort was genotyped for the following SNPs in ADAM33: F+1, Q-1, S_1, S_2, T_1, T_2, V_4, and ST+5. Differences in prevalence of SNPs were analyzed with chi(2) tests. Linear mixed effects models were used to analyze FEV(1) decline according to genotype. MEASUREMENTS AND MAIN RESULTS: In the whole population, mean adjusted decline was 18.7 and 12.7 ml/year in females and males, respectively. Individuals homozygous for minor alleles of SNPs S_2 and Q-1 and heterozygous for SNP S_1 had a significantly accelerated decline in FEV(1) of, respectively, 4.9, 9.6, and 3.6 ml/year compared with wild type. We found a significantly higher prevalence of SNPs F+1, S_1, S_2, and T_2 in subjects with COPD. CONCLUSIONS: We demonstrated that SNPs in ADAM33 are associated with accelerated lung function decline in the general population. These SNPs are also risk factors for COPD.

ADAM Proteins↗
PubMed2003

Effects of bracing on lung function in idiopathic juvenile kyphosis.

Although considerable information is available on the effects of bracing on lung function in kyphoscoliosis, there is a paucity of data on idiopathic juvenile kyphosis (IJK). The present study was designed to investigate the immediate effect of bracing on lung function in children and adolescents with mild-to-moderate IJK. Spirometry, measurement of lung volumes, and arterial oxyhemoglobin saturation (SaO(2)) were performed in 24 patients, 9-17 years of age, who were treated with a corrective brace for mild-to-moderate IJK (Cobb angle, 46-75 degrees ). Children were studied when braced and unbraced. When children were unbraced, mean percent predicted values (+/-standard deviation) for total lung capacity (TLC), vital capacity (VC), functional residual capacity (FRC), and forced expiratory volume in 1 sec (FEV(1)) were 100.0% (+/-13.0%), 92.7% (+/-14.2%), 108.2% (+/-20.4%), and 95.0% (+/-16.3%), respectively. With the brace on, significant reductions occurred in all lung function measurements: TLC decreased by 9.5% (P < 0.001), VC by 9.3% (P = 0.001), FRC by 14.2% (P = 0.005), and FEV(1) by 8.9% (P = 0.009). SaO(2) decreased from 96.2% (+/-1.6%) to 95.2% (+/-1.4%) (P = 0.027). An inverse relationship was observed between pre- and postbracing change in TLC and Cobb angle children (P = 0.021). Our findings indicate that corrective bracing in mild-to-moderate IJK results in mild lung restriction and a clinically insignificant drop in SaO(2). The effect of bracing on TLC decreases as the severity of kyphosis increases in these patients.

Adolescent↗
PubMed2003

Lung function, airway reactivity, and atopy in newly hired female cotton textile workers.

To assess changes in lung function and airway reactivity resulting from exposure to cotton dust, and the role of atopic status in these changes, the authors observed a group of 225 newly hired Chinese textile workers for 1 yr. All workers were female, lifelong nonsmokers, and none of them had been exposed previously to cotton or other occupational dust. Atopic status was determined at baseline. Spirometry, response to methacholine challenge, and total serum immunoglobulin E level were examined at baseline and again after subjects began work in the cotton mills. Obvious cross-shift drops in forced expiratory volume in 1 sec (FEV1.0), and declines in forced vital capacity and FEV1.0 over 1 yr, were observed. Atopic workers had a significantly greater acute drop in FEV1.0 than did nonatopic workers. Both atopic and nonatopic workers had slightly increased airway reactivity at 1 yr, compared with baseline values. The results suggest that exposure to cotton dust is responsible for acute and longitudinal declines in lung function, as well as for slightly increased airway reactivity. Atopy may interact with cotton dust to accentuate the acute lung function response.

Adolescent↗
PubMed1997

Birth weight, education, environment, and lung function at school age: a community study in an alpine area.

Our aim was to assess the effect of birth weight, gestational age, predispositions, education, housing and environmental factors on indices of lung function and to evaluate selective interactions among the main predictors. We studied schoolchildren (aged 7.5-12 yrs) in a cross-sectional survey of 13 small alpine communities in Tyrol (Austria). Data were collected retrospectively from self-administered questionnaires (n=796, 85% response), public records and lung function testing (n=752, 80% response). In the multivariate analysis it was found that a low birth weight (LBW), a low length of maternal education, a smaller gestational age, and a larger family size were all negatively associated with most lung function measures. Additionally, three significant interactions (birth weight with maternal education, birth weight with gestational age; and birth weight with family size) were observed. This implies that children of an LBW with mothers having a low level of education have a forced expiratory volume in one second (FEV1) value 148 mL lower than average values. Children born at term with an LBW have a 140 mL lower mean FEV1 value, and children of LBW from larger families display a 123 mL lower mean estimate of FEV1. However, subgroups were small (n=26, 17 and 27, respectively). The results support low birth weight as a significant predictor of decreased lung function at school age. However, the size and the direction of the association may differ depending on the levels of the interacting variables.

Altitude↗
PubMed1998

Lung function following thermal injury in children--an 8-year follow up.

INTRODUCTION: despite the frequency of pulmonary complications and the reports of abnormal lung function as a sequela of severe thermal injury, most of the lung function studies following thermal injury have been directed at the immediate post-burn period. This investigation is designed to evaluate late residual respiratory impairment in patients with severe thermal injury. METHODS: spirometry and lung volumes were completed on 17 children with severe thermal injury 8 years post-injury. None of the patients had pre-existing lung disease prior to injury. RESULTS: the patient demographic data was as follows: nine male, eight female patients; mean TBSB=67+/-29%; mean third degree=62+/-32%; 13 patients had inhalation injury diagnosed by bronchoscopy. Spirometry and lung volumes at examination as a percentage of predicted values were: [see table in text]. Spirometry and lung volumes show: two patients had an obstructive disease process; nine patients had an obstructive and restrictive disease process; five patients had a purely restrictive process; and one patient had a diffusion defect. CONCLUSION: the data indicate that children who survive severe thermal injury may not regain normal lung function.

Adolescent↗
PubMed1984

Lung function in Canadian Inuit: a follow-up study.

To assess the impact of acculturation on lung function, the forced vital capacity (FVC) and the 1-second forced expiratory volume (FEV1) of 341 Inuit at Igloolik, NWT were measured. The same observers had used the same equipment to test 196 subjects in 1970-71. Cross-sectional analysis suggested that, relative to the previous decade, younger subjects had larger lung volumes (with gains of about 10% in FVC and 5% in FEV1), while the elderly had smaller volumes (with losses of about 22% in FVC and 25% in FEV1). Longitudinal analysis confirmed an accelerating loss of lung function in the older subjects: from age 25 to 35 years men and women had a loss in FVC of 13 and 11 mL/yr respectively, whereas from age 45 to 55 years the corresponding figures were 70 and 38 mL/yr. Cigarette smoking had increased substantially among the Inuit over the decade: the proportion of males and females smoking rose from 64% to 81% and from 85% to 93% respectively. Daily cigarette consumption per smoker increased from 11.8 to 20.2 and from 7.4 to 12.0 among men and women respectively. Nevertheless, the main explanation for the shape of the ageing curve is the survival of a small cohort of elderly Inuit with advanced tuberculosis. With control of this disease future cohorts of the elderly will have better lung function.

Adolescent↗
PubMedDate not supplied

Activity levels and the relationship to lung function and nutritional status in children with cystic fibrosis.

Cystic fibrosis is characterized by chronic obstructive lung disease and malnutrition. Previous studies have shown that nutritional status and lung function are limiting factors for exercise capacity. A reduced exercise capacity may in turn diminish activity levels. We evaluated whether the total time spent somewhat active (e.g., walking) or active (e.g., biking), as reported by the Habitual Activity Estimation Scale, was related to lung function, as evaluated by forced expiratory volume in one second (%predicted FEV1), and nutritional status, measured as body mass percentile, in 36 children with cystic fibrosis, aged 6 to 16 years. The Habitual Activity Estimation Scale questionnaires were completed by the parents for children younger than 12 years of age and by both the parent and the child, independently, for those 12 years and older. Patients had a body mass percentile of 99 +/- 15.2% and % predicted FEV1 of 85.7 +/- 20, with no differences between boys (15/36) and girls (21/36). Boys spent 8.1 hours and girls spent 7.5 hours (P > 0.1) being at least somewhat active. These values are similar to those reported for healthy boys and girls. In patients with significant lung disease (%predicted FEV1, < or = 75; n = 11), activity level (the time spent somewhat active or active) was related to nutritional status (r = 0.675; P = 0.02) but not to lung function (r = 0.21; P > 0.1). Activity level reported by patients 12 years of age and older was on average 24.1% higher (P < 0.05) than that reported by their parents, but the two reportings were related (r = 0.758; P = 0.004). These results suggest that activity level may be restricted by nutritional status in those patients with significant air flow limitation. We suggest that improving the nutritional status of cystic fibrosis patients may prevent decreases in activity levels and quality of life of these affected children.

Adolescent↗
PubMed2004

Effect of backpack fit on lung function.

Carrying loads close to the trunk with a backpack causes a restrictive type of change in lung function in which Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 s (FEV1) are reduced without a corresponding decrement in the FEV1.FVC( - 1) %. It is not known whether this is due to the weight of the load acting on the chest or to the tightness of fit of the shoulder and chest straps and waist belt of the pack harness. This study examined FVC, FEV1, FEV1.FVC( - 1) %, peak expiratory flow (PEF), forced expiratory flow between 0.2 and 1.2 s (FEF0.2 - 1.2) after the start of expiration and between 25 and 75% of each FVC (FEF25 - 75%) in 12 healthy males wearing a 15 kg backpack in which the shoulder and chest straps and hip belt were loosened by 3 cm from a 'comfort fit' to achieve a 'loose pack' fit (LPF) and tightened by 3 cm from CF to achieve a 'tight pack' fit (TPF). In comparison with the control condition of no pack, a loose pack fit significantly reduced FVC (by 3.6%, p < 0.01), FEV1 (by 4.3%, p < 0.01) and FEF25 - 75% (by 8.4%, p < 0.01). A tight pack fit significantly reduced FVC (by 8.1%, p < 0.01) and FEV1 (by 9.1%, p < 0.001). It also significantly reduced FEF0.2 - 1.2 (by 7.3%, p < 0.05) and FEF25 - 75% (by 21%, p < 0.01). In comparison with a loose pack fit, the tight pack fit was associated with a significantly lower FVC (by 4.6%, p < 0.01), FEV1 (by 5.0%, p < 0.01), FEF25 - 75% (by 13.8%, p < 0.01) and a fall in FEF0.2 - 1.2 (by 5.5%). The latter was approaching significance (p = 0.077). There were no significant changes in FEV1.FVC( - 1)% and PEF. It is concluded that tightening the fit of a backpack significantly affects lung function in a manner that is typical of a restrictive change in lung function and is very similar in pattern to that of wearing a loosely fitted loaded backpack. The effect of tightness of fit is additional to that due to the weight of the load alone and may also reduce expiratory flow at low lung volumes.

Adult↗