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Association of lung function with declining ambient air pollution.

Recent studies have found a declining prevalence of respiratory infections in East German children, along with a tremendous improvement of air pollution since 1990. The present study evaluates the effects of improved air quality on lung function. Three consecutive cross-sectional surveys of schoolchildren ages 11-14 years from three communities in East Germany were performed in 1992-1993, 1995-1996, and 1998-1999. Lung function tests were available from 2,493 children. The annual mean of total suspended particulates (TSP) declined from 79 to 25 micro g/m(3), whereas levels for sulfur dioxide declined from 113 to 6 micro g/m(3). Mean forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV(1)) of the children increased from 1992-1993 to 1998-1999. The adjusted percent change of the geometric mean of FVC was 4.7% for a 50 micro g/m(3) decrease of TSP (p = 0.043) and 4.9% for a decrement of 100 micro g/m(3) SO(2) (p = 0.029). Effects on FEV(1) were smaller and not statistically significant. Our study indicates that a reduction of air pollution in a short time period may improve children's lung function.

Adolescent↗

Lung function in an Australian population: 2. Spirometric performance and cigarette-smoking habits.

The FEV1, FVC and FEV1/FVC% in 12016 females and 18 359 males were related to cigarette-smoking habits. Over all, non-smokers had significantly better lung function than cigarette smokers. Ex-smokers of either sex had significantly higher FEV1 and FEV1/FVC% than cigarette smokers, but the FVC values were higher only in females. With consumption in excess of 10 cigarettes per day, deterioration in lung function was manifest in both sexes, but was greater in males than females. The mean chronological age of males who smoked from 30 to 50 cigarettes per day was 12.9 years and 9.6 years less than would have been predicted on the basis of their FEV1 and FVC values respectively. The corresponding values in women were 9.3 years and 7.9 years respectively. Additionally, the deterioration in lung function with increasing age was greater in cigarette smokers than in non-smokers.

Adolescent↗

Effects on the lung function of exposure to carbon black dusts. Results of a study carried out on 677 members of staff of the DEGUSSA factory in Kalscheuren/Germany.

Spirometry, full-bodyplethysmography, and inhalation challenge tests are the most frequently used methods for lung function testing. In all, 677 examinations were performed among exposed employees at the Degussa carbon black plant in Kalscheuren/Germany using the above mentioned methods, in order to detect whether there is a measurable impact of carbon black fine dust on pulmonary function, or a higher prevalence of obstructive air-way diseases among the study candidates, and whether fine dust exposure is related to the prevalence of bronchial hyperresposiveness. Within the smokers' group carbon black dust exposure reveals a (minimal) impact upon the lung function of the study subjects. However, the impact of fine dust exposure within that group is less significant than the influence of smoking on pulmonary function. Nevertheless, smokers are displaying significant more frequently signs of obstructive airway diseases compared with nonsmokers. In the smokers' group we found 7.3% of study subjects with signs of obstructive airway diseases compared with 3.9% in the group of nonsmokers. No significant impact of fine dust exposure on lung function could be detected within former- and nonsmokers. The overall percentage of 5.1% is not higher than that of subjects with bronchial hyperresponsiveness in other comparable studies.

Adult↗

Thalassemia: lung function with reference to iron studies and reactive oxidant status.

Pulmonary function tests were performed in 15 thalassemic patients (age 5 years 8 months to 18 years 6 months), receiving both regular transfusions and desferrioxamine, to determine the presence and nature of any abnormalities in lung function. Reactive oxidant production from neutrophils was measured simultaneously to ascertain if a causal relationship existed between free radical production and tissue damage in the lungs. Mean total lung capacity, mean residual volume, and mean forced vital capacity were significantly reduced, indicating a restrictive pattern of lung function abnormality. In addition, the carbon monoxide diffusion was low, and hypoxemia was present in 6 of 13 patients tested. These pulmonary function abnormalities did not correlate with age, cumulative volume of transfusion, or serum ferritin levels. In addition, neutrophil reactive oxidant status did not correlate with these or with pulmonary function parameters. These results indicate that neutrophil-derived oxygen free radicals do not appear to be a major cause of lung function abnormalities in thalassemics.

Adolescent↗

Acute effects of routine firefighting on lung function.

We undertook a study to determine the acute effects of routine firefighting on lung function and the relationship between these acute effects and nonspecific airway responsiveness. For 29 firefighters from a single fire station, we calculated the concentration of methacholine aerosol that caused a 100% increase in specific airway resistance (Pc100). Over an 8-week period we than measured FEV1 and FVC in each firefighter before and after each 24-hr workshift and after every fire. From 199 individual workshifts without fires, we calculated the mean +/- 2 SD across-workshift change in FEV1 and FVC for each firefighter. Eighteen of 76 measurements obtained within 2 hr after a fire (24%) showed a greater than 2 SD fall in FEV1 and/or FVC compared to two of 199 obtained after routine workshifts without fires (1%; p less than .001). On 13 of 18 occasions when spirometry decreased significantly, we obtained repeat spirometry (postshift) 3-18.5 hr after fires, and on four of these occasions FEV1 and/or FVC were still more than 2 SD below baseline. Decrements in spirometry occurred as often in firefighters with high Pc100s as in those with low Pc100s. In two firefighters in whom FEV1 and FVC fell by more than 10% after fires, we repeated measurements of methacholine sensitivity, and it was increased over the prestudy baseline. These findings suggest that routine firefighting is associated with a high incidence of acute decrements in lung function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Asthma-related symptoms and lung function in primary school children.

The aim of the present study was to determine the prevalence of asthma-related symptoms in a group of primary school children, by means of a questionnaire completed by their parents, and their lung function using spirometry and the forced oscillation technique (FOT). Also investigated were diagnostic labeling and medical prescription. We approached 535 children, from two primary schools in Maastricht, the Netherlands. Completed questionnaires were received from 482 children (90%). Valid lung function values were obtained in 470 of these children (98%). The lifetime prevalence of wheeze and attacks of shortness of breath with wheeze was 29% and 19%, respectively. The period prevalence of wheeze was 15%, 13% reported chronic cough, and 10% attacks of shortness of breath with wheeze. The doctor-diagnosed asthma and bronchitis prevalence was 6% and 19%, respectively. Of the children diagnosed as having asthma, 69% used antiasthma medication; none of the children diagnosed as having bronchitis used antiasthma medication. A symptom-based asthma prevalence of 11% was calculated. Statistically significant differences in spirometric and FOT indices were found between the children with and without complaints. In conclusion, among the 482 investigated children a relatively high prevalence of unrecognized or misclassified, and therefore undertreated, asthma-related symptoms was found. These observations were confirmed by the lung function data, in that we found significant differences in spirometric and FOT indices between children with and without complaints.

Age Distribution↗

Lung function among workers in the soft tissue paper-producing industry.

OBJECTIVES: To describe lung function in correlation with information on exposure to dust and fibers in soft tissue paper-producing factories in Germany. METHODS: Ambient monitoring was performed for inhalable, respirable dust and fibers in nine soft tissue paper-producing factories. In a study group of 1,047 workers (189 control subjects, 240 workers with moderate exposure, and 618 workers with high exposure), spirometry (FVC, FEV(1)) was performed. Information on occupational history, duration of exposure, workshop within the company, former occupational exposures, and smoking habits were collected. By employing multiple linear regression modeling, the potentially confounding effects of age, sex, body mass index, smoking habits, and factory were incorporated into the analysis of FVC, FEV(1), and FEV(1) in percent of FVC (FEV(1)%FVC). By employing a logistic regression model, odds ratios were calculated for FVC < 80% predicted in different exposure subgroups. RESULTS: The mean concentrations for inhalable, respirable, and fibrous dusts were 12.4 mg/m(3), 0.28 mg/m(3), and 420,000 fibers per cubic meter. With relation to cumulative dust and fiber exposure, a decrease of FVC from 105.4% predicted to 96.9% predicted (dust) and 97.1% predicted (fibers) in the subgroup with highest cumulative exposure was observed. For FEV(1), a decrease from 107.3% predicted to 103.0% predicted (dust) and 102.8% predicted (fibers) was found. The parameter estimates show dose-response relationships that are more pronounced for FVC compared to FEV(1). FEV(1)%FVC did not change significantly with increasing cumulative exposure, indicating a restrictive pattern of the findings. CONCLUSIONS: Due to high ambient dust concentrations and the observed adverse effects on lung function, a reduction of dust exposure and secondary preventive measures is advised.

Adult↗

Lung function in patients with collagen vascular diseases: a study of non-smokers with normal chest roentgenograms.

Lung function was assessed in 52 patients with collagen vascular diseases (CVD) who had neither a smoking history nor an abnormality in their chest x-ray films. Values of the maximum mid-expiratory flow and the maximum expiratory flow after 50% or 75% of the forced vital capacity had been exhaled were decreased and the ratio of closing capacity to total lung capacity was increased in 36-100% (varied among categories of CVD) of patients with CVD, and the carbon monoxide diffusing capacity was decreased in 27-56% of the patients. These findings indicate that small airway diseases and a decrease in diffusing capacity are not rare in CVD patients, even if they had neither a smoking history nor abnormal findings in their chest x-ray films. Regular and routine tests on lung functions are thought to be effective to detect early pulmonary involvement in patients with CVD.

Adult↗

[Effect of smoking and alcohol drinking on the moisture-excreting lung function].

A study was made on the moisture-exuding function of the lungs in healthy persons who smoke and in patients with different forms of tuberculosis, who abuse and do not abuse alcohol. It has been ascertained that the moisture-exuding function of the lungs is time-related, dynamic and changeable, and dependent upon certain environmental factors. Smoking and alcohol enhance the moisture-exuding function of the lungs, secondary to which fact they can be regarded as those factors facilitating the development of pathological processes in the lungs, tuberculosis included.

Alcohol Drinking↗

Lung function impairment as a guide to exercise limitation in work-related lung disorders.

The hypothesis that exercise limitation of respiratory origin can be predicted accurately from the lung function impairment has been tested using maximal oxygen uptake (VO2max) as the dependent variable in a multiple regression analysis. The subjects were 157 men who met objective criteria for exercise being limited by respiratory impairment. VO2max (mean value, 1.38 L min-1) was described by FEV1 and single-breath lung transfer factor (diffusing capacity) for carbon monoxide (TL') singly or in combination, but the accuracy was poor (at best, standard error of the estimate, 0.36 L min-1; r2, 29.1%). FEV1 could be replaced by FVC and FEV1/FVC. Description of VO2max was improved by also including in the equation the variables age, fat-free mass, and submaximal exercise ventilation (VE). Transfer factor did not then contribute significantly. VO2max as percent of predicted (mean value of 60%) was described by %FVC or %FEV1, but the accuracy was poor (SEE, 16.0%; r2, 14%). Prediction was improved somewhat by the alternative use of inspiratory vital capacity and FEV1/FVC. Transfer factor did not contribute additional information; however, inclusion of VE materially improved the accuracy (SEE, 12.9%; r2, 44%). Among a subgroup of 35 men whose lung disease was due to asbestos, %TL' or transfer factor measured using a multibreath estimate of residual volume (%TLCO) made a small contribution to the explained variance, e.g.: %VO2max = 0.44% FEV1 -0.78 VE + 0.16% TLCO + 52.3 SEE 7.27%. This equation also described the %VO2max of all subjects (SEE, 13%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Acute lung function responses to ambient acid aerosol exposures in children.

We examined the relationship between lung function changes and ambient acid aerosol episodes in children attending a residential summer camp. Young females (112) performed daily spirometry, and 96 were assessed on one occasion for airway hyperresponsiveness using a methacholine bronchoprovocation test. Air quality measurements were performed on site and four distinct acid aerosol episodes were observed during the 41-day study. The maximum values observed during the 41-day study were: O3 at 143 ppb; H2SO4 at 47.7 micrograms/m3; and [H+] at 550 nmole/m3. Maximum decrements of 3.5 and 7% for FEV1 and PEF, respectively, were observed to be associated with the air pollution episodes. There was some evidence of a differential lung function response to the episodes where children with a positive response to a methacholine challenge had larger decrements compared to their nonresponsive counterparts.

Acid Rain↗

State of health and its association with death among old people at three-years follow-up. I. Lung function, circulation, sensory and motor apparatus.

A general medical examination was performed of 569 Copenhagen inhabitants aged 75, 80, and 85 years in the participants' own homes as part of an epidemiological, sociomedical intervention study. The present report contains the results of this examination regarding lung function, circulation, sensory, and motor apparatus. Curves are presented expressing the normal peak expiratory flow rate (PEFR) for men and women 75-85 years old. More men than women had a compromised lung function. Regarding circulation and motor apparatus, more women and 85-year-olds showed impairments. Functional vision and hearing declined with age, but no significant differences could be demonstrated between men and women, although a preponderance of women tended to show hearing disability. Institutionalised participants were more inclined to have impairment of lung function and sight and to walk with difficult. Gait disturbances and impairment of vision were the objective health measurements most strongly related to death at follow-up after three years.

Aged↗

Is a two-week trial of oral prednisolone predictive of target lung function in pediatric asthma?

We used a 2-week trial of prednisolone to determine "target" lung function for subsequent asthma therapy. The aim of this study was to evaluate whether some children exceed their "target" forced expired volume in 1 sec (FEV1) on subsequent visits in the following year, and whether this is associated with particular clinical or pathological features. Children (aged 6-16 years) with difficult asthma underwent spirometry and exhaled nitric oxide (FE(NO)) measurements before and after 2 weeks of prednisolone 40 mg/day. At the end of the course, subepithelial eosinophils and reticular basement membrane thickness were assessed. The highest FEV1 obtained in a 1-year follow-up was compared with the poststeroid postbronchodilator ("target") FEV1. Four of 22 children (18%) demonstrated an increase of > 9% above their "target" FEV1 during follow-up. None of these children had been prescribed additional asthma medications. Three of 7 children with persistent airflow limitation (PAL; poststeroid postbronchodilator FEV1 < 80% predicted) recorded an FEV1 > 80% predicted during follow-up. The median (interquartile range) number of subepithelial eosinophils was significantly higher in children who exceeded their target FEV1 than in children who did not (12.4 (8.5-39.9) vs. 1.4 (0.0-4.8) cells/mm2, P = 0.018). In conclusion, a 2-week course of prednisolone is not necessarily predictive of "target" lung function. Definitions such as PAL should be regularly reviewed on individual basis.

Adolescent↗

Influence of lung function and postnatal age on the response to nebulized ipratropium bromide in children born prematurely.

Nebulized ipratropium bromide reduces airways resistance in young children born prematurely, but that response is not invariable. We have assessed whether postnatal age or baseline lung function influences the effect of ipratropium bromide. Forty-five children, median gestational age 28 weeks (range 23-34) were studied at a postnatal age of 10 months (range 6-18). Twenty-four were symptomatic at follow-up. Airways resistance (Raw) was measured using a whole body plethysmograph before (baseline) and 20 min after nebulized ipratropium bromide. Sixteen patients had a significant improvement in Raw (a reduction in Raw greater than twice the coefficient of variation of the measurement). The baseline Raw of those 16 infants was significantly higher than the baseline Raw of the other 29 infants (P < 0.01). Multiple regression analysis, after taking into account baseline lung function and symptom status, demonstrated there was a significant relationship between the change in Raw following ipratropium bromide and postnatal age (P < 0.01). We conclude that both baseline lung function and postnatal age influence the response to nebulized ipratropium bromide in young children born prematurely.

Age Factors↗

Pilot study to assess the effect of inhaled corticosteroids on lung function in patients with cystic fibrosis.

OBJECTIVE: To determine the effect of inhaled corticosteroids on lung function in patients with cystic fibrosis. STUDY DESIGN: We report a pilot study of 49 patients with cystic fibrosis and moderate to severe bronchial obstruction (forced expiratory volume in 1 second < or = 55% of the predicted value); 25 patients were given inhaled corticosteroids for 30 days (1500 micrograms of beclomethasone via spacer), and 24 patients had the same standard treatment but no inhaled corticosteroids. RESULTS: Forced vital capacity, forced expiratory volume in 1 second, and airway resistance showed significant improvement in both study groups, but thoracic gas volume and the diffusion capacity of the lung for carbon monoxide improved significantly only in the group given inhaled corticosteroids. When concomitant medications were taken into account, analysis of variance confirmed a significant effect of inhaled corticosteroids on the improvement of thoracic gas volume. CONCLUSION: Inhaled corticosteroids in combination with standard treatment can contribute to the improvement of lung function in patients with cystic fibrosis and moderate to severe bronchial obstruction. Our preliminary data seem encouraging enough to warrant a multicenter, long-term, blind control study.

Administration, Inhalation↗

Effects of ozone exposure on lung function in man: a review.

Ozone, an important component of photochemical smog, has a decided impact on lung function in man. In this review, the effects of zone on human lung function are discussed with particular attention to levels which are near the threshold of producing no effect. Attempts to define dose-response relationships and effects on sensitive subject populations are described. The relationship between exercise and ozone toxicity is presented in addition to the potential impact of ambient ozone exposure on athletic performance. Effects of ozone on respiratory symptoms and the interaction of ozone with other pollutants are briefly examined. Considerable attention has been directed at the phenomenon of adaptation to repeated ozone exposure and to possible mechanism of action of ozone.

Adaptation, Physiological↗

Preoperative and postoperative abnormalities in chest x-ray indices and in lung function in pectus deformities.

In 88 patients with pectus deformities radiologic chest indices and routine pulmonary function tests were measured before and 1 to 20 years after corrective surgery. A combination of anteroposterior indices at the upper and lower level of the chest were investigated to quantitate and to discriminate the different pectus deformities. The study comprised four groups: pectus excavatum, pectus carinatum, pectus deformatum and pectus excavatum with scoliosis. These indices were also assessed in 250 healthy males and females. Generally, several indices showed significant and discriminative changes in the different patient groups and improved again after surgery. Preoperative lung function was decreased in pectus excavatum only. In all groups lung function worsened after surgery. A stepwise discriminant analysis performed on the large group with pectus excavatum indicated that postoperative lung function was decreased if the preoperative value of FEV1 or VC was more than about 75 percent predicted and vice versa, but that it was not related to other factors such as radiologic indices, age at operation or time since operation.

Adolescent↗

Lung function and bronchial response to methacholine in young adults who had asthma in childhood.

Lung function and bronchial response to methacholine were studied in 47 young adults who had had childhood asthma, and after a period of 14-21 years, showed a different clinical evolution. At present, these subjects have been classified in four clinical groups: asymptomatic, rhinitic, asthmatic only due to exercise, and asthmatic. The same study was performed in 23 healthy individuals without personal histories of respiratory or allergic pathology. We found low spirometric basal values in both the asthmatic group (FEV1 and FEF25-75) and in the group with asthmatic responses to exercise (FEF25-75). No significant differences were found among asymptomatic, rhinitic, and control groups. While airway hyperreactivity was observed in patients who still had asthma, the bronchial response to methacholine in asymptomatic and rhinitic groups was not different from the control group. We conclude that both lung function and bronchial response to methacholine in most of the adults who had asthma in infancy and had been without asthmatic symptoms for many years are similar to those observed in the general population.

Adolescent↗