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PubMed2002

A longitudinal study of the effects of tobacco and cannabis exposure on lung function in young adults.

AIM: To assess the possible effects of tobacco and cannabis smoking on lung function in young adults between the ages of 18 and 26. SETTING AND PARTICIPANTS: A group of over 900 young adults derived from a birth cohort of 1037 subjects born in Dunedin, New Zealand in 1972/73 were studied at age 18, 21 and 26 years. MEASUREMENTS: Cannabis and tobacco smoking were documented at each age using a standardized interview. Lung function, as measured by the forced expiratory volume in one second/vital capacity (FEV1/VC) ratio, was obtained by simple spirometry. A fixed effects regression model was used to analyse the data to take account of confounding factors. FINDINGS: When the sample was stratified for cumulative use, there was evidence of a linear relationship between cannabis use and FEV1/VC (P < 0.05). In the absence of adjusting for other variables, increasing cannabis use over time was associated with a decline in FEV1/VC with time; the mean FEV1/VC among subjects using cannabis on 900 or more occasions was 7.2%, 2.6% and 5.0% less than non-users at ages 18, 21 and 26, respectively. After controlling for potential confounding factors (age, tobacco smoking and weight) the negative effect of cumulative cannabis use on mean FEV1/VC was only marginally significant (P < 0.09). Age (P < 0.001), cigarette smoking (P < 0.05) and weight (P < 0.001) were all significant predictors of FEV1/VC. Cannabis use and daily cigarette smoking acted additively to influence FEV1/VC. CONCLUSIONS: Longitudinal observations over 8 years in young adults revealed a dose-dependent relationship between cumulative cannabis consumption and decline in FEV1/VC. However, when confounders were accounted for the effect was reduced and was only marginally significant, but given the limited time frame over which observations were made, the trend suggests that continued cannabis smoking has the potential to result in clinically important impairment of lung function.

Adult↗

PubMed2004

Association between Stenotrophomonas maltophilia and lung function in cystic fibrosis.

BACKGROUND: Stenotrophomonas maltophilia (SM) is a Gram-negative non-fermenting bacteria cultured from the sputum of patients with cystic fibrosis (CF). To date, no information is available regarding the effect of this organism on lung function in CF. METHODS: A cohort study was conducted to assess the effect of SM on lung function among CF patients aged > or =6 years in the CF Foundation National Patient Registry from 1994 to 1999. Repeated measures regression was used to assess the association between SM and lung function. RESULTS: The cohort consisted of 20 755 patients with median age at entry of 13.8 years and median follow up time of 3.8 years; 2739 patients (13%) were positive at least once for SM and 18 016 (87%) were never positive. After adjusting for sex, height and age, patients with SM had a mean forced expiratory volume in 1 second which was 0.09 l less (95% CI 0.05 to 0.14) than those without SM. The mean rate of decline associated with SM positivity was 0.025 l/year (95% CI 0.012 to 0.037) but, after adjusting for confounders (sex, height, weight, intravenous antibiotic courses, hospital admissions, pancreatic insufficiency, and Pseudomonas aeruginosa and Burkholderia cepacia status), the mean rate of decline decreased to 0.008 l/year (-0.008, 95% CI -0.019 to 0.003). CONCLUSIONS: Although CF patients with SM have worse lung function at the time of positivity, no association was found between SM and increased rate of decline after controlling for confounders.

Adolescent↗

PubMed1997

Mortality of Dutch coal miners in relation to pneumoconiosis, chronic obstructive pulmonary disease, and lung function.

OBJECTIVES: To analyse the mortality patterns of former Dutch coal miners, focusing on coal workers' pneumoconiosis (CWP) and chronic obstructive pulmonary diseases (COPD) in relation to pre-existing impairment of lung function. METHODS: 3790 selected miners, medically examined between 1952 and 1963, were followed up to the end of 1991 with the municipal population registries and the causes of death from the death certificates were ascertained and converted to the codes from the ninth revision of the international classification of diseases (ICD-9). Mortality comparisons were made with the male population in The Netherlands, resulting in standardised mortality ratios (SMRs). 3367 miners had radiological manifestation of CWP at medical examinations. RESULTS: 80% of the miners died during the follow up period. Excess mortalities from CWP (SMR 4523) and COPD (SMR 179) were found. Coal miners without CWP also showed an increased mortality from COPD (SMR 2913). A diminished lung function (forced expiratory volume in one second (FEV1), or FEV1/FVC (forced vital capacity) ratio) at medical examination resulted in a significantly increased SMR for COPD (322 and 212 respectively) whereas normal lung function yielded expected mortalities from COPD. A positive correlation also emerged between diminished lung function and the SMR due to CWP. The body mass index (BMI) at the moment of medical examination was correlated with the risk of dying of COPD and CWP: a decreasing BMI resulting in an increased SMR. CONCLUSIONS: Not only infectious diseases and CWP but also COPD is an important cause of occupational mortality in miners with extensive exposure to coal mine dust. No obvious connection between pre-existing CWP and the COPD mortality exists. Impaired FEV1 and FEV1/FVC ratios are predictors of an increased risk of COPD death. The BMI seems to indicate the severity of the COPD, resulting in premature death.

Adult↗

PubMed1983

Acute effects of volcanic ash from Mount Saint Helens on lung function in children.

To evaluate the acute effects of volcanic ash from Mt. St. Helens on the lung function of children, we studied 101 children 8 to 13 yr of age who were attending a 2-wk summer camp for children with diabetes mellitus in an area where about 1.2 cm of ash had fallen after the June 12, 1980, eruption. The outcome variables used were forced vital capacity, forced expiratory volume in one second, their ratio and mean transit time. Total and respirable dust levels were measured using personal sampling pumps. The children were tested on arrival and twice (early morning [A.M.] and late afternoon [P.M.]) every second or third day during the session. A within-day effect was measured by the P.M./A.M. ratio for the lung function variables; a between-day effect was measured by the change in the P.M. measurements over the 2 wk of camp. We found no strong evidence of either a within-day or a between-day effect on lung function, even in a subgroup of children who had preexisting lung disease or symptoms, despite daytime dust/ash levels that usually exceeded the Environmental Protection Agency's significant harm level for particulate matter.

Adolescent↗

PubMed1989

Immediate effect of various treatments on lung function in infants with cystic fibrosis.

The immediate effect of four different modes of treatment was assessed by lung function tests on 19 infants with cystic fibrosis (CF) during the first year of life. The regimens were applied in a randomized fashion and consisted of aerosol inhalation of salbutamol (n = 8; SAL), aerosol inhalation of N-acetyl cysteine (n = 5; AC), chest physiotherapy (n = 6; CPT), and combined treatment with aerosol inhalation of SAL and AC followed by CPT (n = 6; COMB). Pulmonary function was measured before and shortly after therapy with each mode of treatment. Thoracic gas volume (Vtg) and specific airway conductance (SGaw) were measured by an infant whole body plethysmograph, and forced expiratory flow at resting lung volume (VmaxFRC) was determined with a thoraco-abdominal squeeze jacket. There was no correlation between baseline lung function and changes in any parameter due to treatment. Overall group comparison showed that the combined therapy resulted in a significant improvement in lung function when compared to any of the three treatments applied separately. There was no significant change in lung volumes in any individual group, but SGaw and VmaxFRC showed a small but significant improvement following the COMB treatment when compared with AC or CPT.

Acetylcysteine↗

PubMed1981

Respiratory infections and their influence on lung function in children: a multiple regression analysis.

The relationship between a history of respiratory infections (and associated variables) in children and lung function in later life was examined in a study among 228 children aged 7 to 11 years. In a multiple regression analysis only a few variables showed marked and consistent effects on lung function. Respiratory tract infections showed increasing impairment of lung function with repeated infections, but the impairment was smaller than that caused by current asthma.

Asthma↗

PubMedDate not supplied

Modelling the lung function of Caucasians during adolescence as a basis for reference values.

BACKGROUND: In childhood the relationship between lung size and stature changes during the adolescent growth spurt. This is not allowed for in models of lung function based on stature alone. For spirometric indices inclusion of an age x stature interaction (A x St) can overcome the difficulty. AIM: The study tested the hypothesis that this simple, interactive model might also be effective for total lung capacity and its subdivisions and the single breath transfer factor for carbon monoxide. SUBJECTS AND METHODS: Data were available for 695 asymptomatic non-smokers (Caucasians) aged 7-20 years (440 boys, 255 girls). Each lung function index was described using the above model and the fit was compared with that from a linear, power or polynomial model based on stature alone. RESULTS: After allowing for stature, the A x St interaction term was significant for almost all indices. The improved fit was most apparent for the lung function of older adolescent boys. Reference values using the model are reported. CONCLUSIONS: A simple model based on stature and an interaction between stature and age can account for the changing relationship between body habitus during the growth spurt and lung size and transfer factor in a single equation encompassing children and adolescents. Its use is recommended for deriving reference values when the explanatory variables are limited to stature and age.

Adolescent↗

PubMed2006

[Relationship between the composition of fine dust particles in the air and lung function in school children].

OBJECTIVE: To determine whether or not there is a relationship between the lung function of school children and the ability of fine dust particles in the air to generate radicals. DESIGN: Descriptive. METHOD: Six primary schools in locations with different traffic volumes were selected in Maastricht, the Netherlands. Air samples were taken in these schools over a period of 4 days; the concentration of fine dust was measured in the 6 pooled samples. Lung function tests were performed in children in the age of 8-13 and their parents filled out a questionnaire on the state of their children's health. RESULTS: An average of 66% of the children (184 girls and 158 boys, with an average age of 10 years (range: 8-13 years)) participated. The average FEV1 for the children from the 6 schools was not related with the total amount of fine dust particles in the air. However, a lower average FEV1 was associated with a higher radical-generating capacity in the air samples. No direct association was observed between the radical-generating capacity of the dust and the traffic intensity. CONCLUSION: There was a clear relationship between lung function and the radical-generating capacity of fine dust in the air. On the basis of these findings future guidelines could be based on chemical properties of the fine dust particles and not exclusively on the quantity of fine dust.

English Abstract↗

PubMed1998

Effect on lung function of methotrexate and non-steroid anti-inflammatory drugs in children with juvenile rheumatoid arthritis.

We evaluated lung function in a group of patients affected by juvenile rheumatoid arthritis (JRA), without clinical and/or radiological signs of respiratory involvement. We compared the effects on pulmonary function of methotrexate (MTX) therapy combined with non-steroid anti-inflammatory drugs (NSAIDs) to those of NSAIDs alone and correlated lung function to subtype onset, disease duration and disease activity. Our patients were 27 JRA children, subdivided into two groups according to the therapy (group A = 14 patients, treated with a low dose of MTX and NSAIDs; group B = 13 patients, treated with NSAIDs alone). Clinical evaluation, haematological data and pulmonary function tests (PFTs) were obtained in each group at baseline (time 0) and at 1 year (time 1). At time 0 and time 1 PFTs were altered in 51.8% of JRA patients. The restrictive pattern (reduced forced vital capacity, FVC) was the most frequent feature, observed in 22.2% of patients. In group A the mean values of FVC, FEV1 (forced expiratory flow in 1 s), FRC (functional residual capacity), TLC (total lung capacity) and DLCO (diffusing lung capacity of carbon monoxide) were significantly lower compared to those of group B, at time 0 and at time 1. No functional parameter was correlated to subtype, duration or activity of the disease. Our study confirms that abnormalities in PFTs may be detected in JRA patients, even in the absence of clinical and/or radiological signs of lung disease; MTX in combination with NSAIDs does not seem to affect lung function at 1 year more than NSAIDs alone.

Adolescent↗

PubMed1994

Longitudinal changes in lung function among asbestos-exposed workers.

To prospectively identify the determinants of persistent or accelerated loss of lung function among workers occupationally exposed to asbestos and assess the relative contribution of cigarette smoking, asbestos-induced pleural fibrosis, and specific findings from bronchoalveolar lavage and high resolution CT scans, we examined the determinants of lung function changes in 117 subjects occupationally exposed to asbestos for at least 1 yr in a high exposure setting. A minimum of 20 yr was required between the first exposure to asbestos and entry into the study. Baseline studies included an independent assessment of dyspnea, lung volumes, diffusing capacity of carbon monoxide (DLCO), a chest radiograph, a high resolution CT (HRCT) scan, and bronchoalveolar lavage (BAL). Subjects were observed for an average of 2 yr (range, 0.5 to 4.0 yr), and lung function was measured on at least two separate occasions (mean, 4.1 separate tests). During the period of observation, there was an average 1.5% decrease in the TLC and a 2.5% decrease in the DLCO. In this longitudinal data set, after controlling for age, height, pack-years of cigarette smoking, and follow-up time, persistently lower measures of TLC were independently related to moderate to severe dyspnea (p = 0.005), diffuse pleural thickening (p = 0.007), and higher concentrations of fibronectin in BAL fluid (p = 0.01). Interstitial lung disease either on the chest radiograph or HRCT scan was not independently associated with persistently lower measures of TLC during the period of observation. However, none of the clinical variables we examined were associated with an accelerated decline in TLC.(ABSTRACT TRUNCATED AT 250 WORDS)

Asbestos↗

PubMed1997

Perinatal lung function and invasive antenatal procedures.

BACKGROUND: Second trimester amniocentesis has been associated with an excess of perinatal lung function abnormalities. Early amniocentesis might have a similar adverse effect, as could other invasive investigations carried out in the first trimester. METHODS: Plethysmographic measurements of thoracic gas volume (TGV) and airway resistance (Raw), from which specific conductance (sGaw) was calculated, were made in the perinatal period in non-sedated infants. In addition, functional residual capacity (FRC) was measured using a helium gas dilution technique. Measurements were made in 47 infants whose mothers had undergone early amniocentesis, 19 whose mothers had undergone chorion villus sampling, and 25 controls whose mothers had undergone no invasive antenatal procedures. RESULTS: The infants of mothers who had undergone early amniocentesis had higher TGV (95% CI -6.3 to 1.1 ml/kg) and Raw values (95% CI -10.68 to -5.23 cm H2O/l/s) and lower sGaw (0.11 to 0.84 l/cm H2O.s) and FRC (-5.17 to - 0.87 ml/kg) values than the controls. Infants whose mothers had undergone chorion villus sampling also differed significantly from the controls with higher Raw (-7.59 to -1.99 cm H2O/l/s) and lower sGaw values (0.11 to 0.24 l/cm H2O.s), and had lower Raw values than those in the early amniocentesis group (not significant). Logistic regression analysis, taking into account possible risk factors for abnormal lung function, showed that the procedures performed in the first trimester were independently associated with a high airways resistance. CONCLUSION: These results suggest that invasive procedures performed in the first trimester of pregnancy have an adverse effect on perinatal lung function.

Adult↗

PubMed1993

Lung functions and chest radiographs in shipyard workers exposed to asbestos.

Lung functions and diffusing capacity for carbon monoxide were examined in 299 shipyard workers occupationally exposed to asbestos, among whom there was an equal number of smokers and non-smokers. The workers were classified into groups according to the lung fibrosis profusion and the length and width of the pleural plaques in accordance with the 1980 ILO International Classifications of Pneumoconioses. With regard to the profusion of the parenchyma, workers classified in category 2 (subcategories 2/1 and 2/2) had significantly lower FVC and FEV1 values than the workers in categories 0 (P < 0.01) and 1 (P < 0.05). With an increase in the category of profusion there was a trend towards a fall in mean MEF25, MEF50 and MEF75 values, but it was not significant. Diffusing capacity for carbon monoxide was identical for all categories. There were no significant differences between the workers without pleural plaques and those with visible plaques in respect to lung function values. With an increase in the length and width of the plaques FVC, FEV1, MEF25 and MEF75 values tended to become lower. The results demonstrate that the changes detected on the radiographs of the lungs and pleura are the early indicators of possible asbestos disease in shipyard workers.

Adult↗

PubMedDate not supplied

Reference values for lung function tests in females. Regression equations with smoking variables.

Prediction formulas for static and dynamic spirometry, gas distribution, static lung mechanics and transfer test were derived from measurements in healthy females. The measurements included total lung capacity, residual volume, airway resistance, static elastic recoil pressure of the lung, static compliance, closing volume, slope of the alveolar plateau (phase III), flow-volume variables (including mean transit time) during breathing of air or a helium/oxygen mixture, and conventional spirometric indices. The results from 86 smokers and 100 never-smokers were evaluated separately and combined. For all lung function tests, a single regression equation including time-related smoking variables, valid for both smokers and never-smokers, was obtained. For many lung function tests, a nonlinear age coefficient resulted in a significant reduction in variance compared with simple linear models. Heavy tobacco smoking influenced most lung function tests less than ageing from 20 to 70 years, but for airway resistance, volumic airway conductance, closing volume, phase III, FEV1/VC, volume of isoflow and mean transit time the opposite was found.

Adult↗

PubMed1989

Ventilatory lung function and chronic chest symptoms among the inhabitants of urban areas with various levels of acid aerosols: prospective study in Cracow.

The analysis carried out earlier in Cracow showed that the high level of SO2 and particulate matter (PM) alone cannot be responsible for an excess of chronic chest symptoms and faster lung function deterioration in the population at large. To check the hypothesis that acid aerosols present in the urban air may cause substantial damage of the lungs, data from a 13-year follow-up survey of chronic chest diseases in Cracow (1968-1981) have been reanalyzed. In the plan of the analysis, three areas of the city with various levels of sulfate and sulfur transformation ratio (STR) in the urban air have been defined. In each of the defined areas, the prevalence of chronic chest symptoms, as well as lung function decline, have been studied. In total, the lung function study group consisted of 1414 persons (584 males and 830 females). Those men who lived in the area with the higher sulfate and STR had lower FEV1 levels by about 151 mL than did the residents of the other areas, and this was equivalent to the effect of smoking. In females, the pattern was generally the same. In men, the FEV1 decline rate (mL/year) over the 13-year period was significantly faster by about 11 mL/year in the areas with higher and intermediate STR, which was again equivalent to the effect of smoking. It was found that the level of SO2 and PM in the urban air correlated with the symptom prevalence in women; however, it had no clear impact on lung function deterioration.

Acid Rain↗

PubMed1991

Combined effect of grain farming and smoking on lung function and the prevalence of chronic bronchitis.

The combined effect of grain farming and smoking on lung function and the prevalence of chronic bronchitis was examined in 1633 residents 20 to 65 years of age from the town of Humboldt, Saskatchewan. Multiple multivariate analysis indicated that in women grain farming and smoking had a significant synergistic effect on the values of forced expired volume in one second/forced vital capacity (FEV1/FVC), mid-expiratory flow rate (MMFR), flow rate at 50% and 25% of total volume (Vmax50 and Vmax25) after adjustment for covariates including age and height. No other factors were found to change the results. The combined effect of grain farming and smoking on lung function was not statistically significant in men. The data also show that female non-smoking grain farmers had an identical prevalence of chronic bronchitis compared with non-smoking female non-farmers, 2.0% versus 2.1%. But in women with a positive smoking history, the prevalence was 13.2% and 5.9% respectively, giving an adjusted odds ratio in grain farmers compared to non-farmers of 3.55 (95% confidence interval (Cl): 1.06-11.30). It was found that the prevalence of chronic bronchitis increased more rapidly with increasing cigarette consumption in grain farmers than in non-farmers in women. It was estimated that 85%, 72% and 66% of the prevalence of chronic bronchitis was attributed to the joint effects of grain farming and ex-smoking, light smoking (1-19 cigarettes/day) or heavy smoking (20+ cigarettes/day) status, respectively. In contrast to women, the effect of grain farming on the prevalence of chronic bronchitis was similar in men with and without a positive smoking history. Our data suggest that there is a positive interactive effect of grain farming exposure and smoking on lung function and the prevalence of chronic bronchitis in women. The difference in the interaction between men and women requires further study.

Adult↗

PubMed2004

Lung function, bronchial responsiveness, and asthma in a community cohort of 6-year-old children.

KEYWORDS: Children as young as 6 years old can perform spirometry, yet the relationship between current asthma, lung function, and bronchial responsiveness has not been described at this age; 2,537 children from a community-based birth cohort were assessed at 6 years of age, with history (n = 2,141), physical examination (n = 1,995), standard spirometry (n = 1,735), and a random sample (n = 711) offered methacholine challenge. Males had greater values of FVC and FEV(1) but not of mean forced expiratory flow during the middle half of the FVC or FEV(1)/FVC than females. The greatest influences on lung function at 6 years were height, sex, birth weight, and wheezing in the first year of life. Children with current asthma had small but significant deficits in lung function and were more sensitive to methacholine. The optimal cutpoint for determining heightened bronchial responsiveness was found to be a 15% fall in FEV(1) at a dose of 1.8 mg/ml. A negative test could be useful in excluding a diagnosis of asthma (negative predictive value of 92%). Lung function testing, including methacholine challenge, is feasible in 5- to 7-year-old children and has the potential to contribute to the clinical management of children with asthma.

Age Factors↗

PubMed2004

Baseline lung function, exercise-induced bronchoconstriction, and asthma-like symptoms in elite women ice hockey players.

PURPOSE: Exercise-induced bronchoconstriction (EIB) is high among ice rink athletes and may be related to exercise ventilation of rink air pollutants. Impaired postchallenge expiratory flows are common for this population; however, baseline lung function and symptoms have not been fully evaluated. METHODS: We examined resting lung function and asthma-like symptoms in relation to airway hyperresponsiveness in National Team female ice hockey players (N = 43). Subjects were grouped according to observed symptoms and medical history as symptomatic ('S') or asymptomatic ('A'). Baseline and postexercise lung function was determined. RESULTS: Seventeen (39.5%) presented symptoms and 9 (21%) had EIB. Baseline FEV1, FEV1/FVC, and FEF25-75 were different between 'S' and 'A' (102 +/- 14% vs 116 +/- 12%, 77.7 +/- 7.5 vs 88.2 +/- 4.5, and 74 +/- 22% vs 118 +/- 24%, respectively; P < 0.05); FVC and PEF were not different. Ten 'S' athletes had <80% FEV1/FVC; 9 had <70% predicted FEF25-75. Six of 9 EIB+ subjects had symptoms; cough occurred in all six and was related to EIB (chi 2 = 4.23, OR = 6.5, CI = 1.1-44.1; P = 0.039). CONCLUSION: Baseline lung function is related to symptoms and precludes EIB in some rink athletes, suggesting that EIB and its development is a heterogeneous and may involve fibrotic as well as inflammatory processes. Small airway dysfunction in ice arena athletes is likely related to internal combustion pollutants emitted from ice resurfacing machines.

Adult↗

PubMed1999

Decline in lung function and mortality: the Busselton Health Study.

BACKGROUND: There is a direct association between level of lung function, measured by forced expiratory volume in 1 second (FEV1) and mortality rates. A low FEV may result from an increased decline in FEV1 with age, which may be an independent predictor of mortality. OBJECTIVE: To examine the association between decline in FEV1 and mortality in a cohort from a community health study. SETTING AND METHODS: From five cross sectional studies in Busselton between 1969 and 1981 a cohort of 751 men and 940 women was identified who had three assessments of lung function over a six year period and had other health related data collected. Each subject's average FEV1 and decline in FEV1 (litre/year) were calculated from these three measurements. Mortality follow up to December 1995 was obtained. Cause of death was taken as the certified cause of death from the death certificate using ICD9 categories. RESULTS: The average decline in FEV1 was 0.04 litre per year (SD = 0.07) for men and 0.03 litre per year (SD = 0.06) for women. Average FEV1 was significantly associated with all cause and cardiovascular disease mortality in both sexes. In women there was a significant association between decline in FEV1 and death from all causes, after adjusting for average FEV1, age, smoking, coronary heart disease, and cardiovascular disease risk factors; a 0.05 litre per year increase in the rate of decline of FEV1 increased the risk of death for all causes by 1.23 (95% confidence interval 1.06, 1.44). In men the effect of decline in FEV1 on death rate was less; for all men the hazard ratio for a 0.05 litre/year greater decline in FEV1 was 1.19 (0.99, 1.21). CONCLUSION: Decline in lung function, measured by FEV1 is a predictor of death, independent of average FEV1 and risk factors for cardiovascular disease.

Alcohol Drinking↗