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PubMed1983

Comparison of lung function in young nonsmokers and smokers before and after initiation of the smoking habit. A prospective study.

It has been suggested that young persons who smoke have better lung function initially than those who remain nonsmokers. To examine this possibility prospectively, we analyzed respiratory questionnaire responses and lung function results in residents of Burbank and Lancaster, California, who had completed field screening studies of respiratory status at 2 times 5 yr apart. At Time 1 and Time 2, we calculated the age- and height-adjusted values for forced vital capacity (FVC) and forced expiratory volume in one second (FEV) of all white residents who at Time 1 were 13 to 23 yr of age and did not smoke tobacco. Dividing these into 2 groups, "starters" and "nonsmokers," we used analysis of covariance for males and females with height and age as covariates and compared lung function values at Times 1 and 2 and changes in lung function between these times. Among males at Time 1, FVC, FEV, peak expiratory flow, and maximal flow after exhalation of 25% of FVC were significantly larger for starters than for nonsmokers. At Time 2, values for these same indexes (except for FVC) were no longer significantly different between starters and nonsmokers. Our findings suggest that (1) relatively poor lung function may discourage young males (but not young females) from becoming regular tobacco smokers; (2) prediction equations based on so-called normal populations of nonsmokers might underestimate normal lung function, and (3) the adverse effect of smoking on lung function may be even greater than that estimated from cross-sectional studies.

Adolescent↗

PubMed1992

Lung function abnormalities in repaired oesophageal atresia and tracheo-oesophageal fistula.

BACKGROUND: Respiratory complications are common after neonatal repair of oesophageal atresia and tracheo-oesophageal fistula. The prevalence of lung function abnormalities and the relation between gastrointestinal complications and lung function has not been studied in a large number of patients. METHODS: Lung volumes and flow-volume loops were measured in 155 patients without spinal curvature aged 6-37 years who had undergone surgery for oesophageal atresia and tracheo-oesophageal fistula. RESULTS: Sixty four of the 155 patients had evidence of mild lower airways disease, with values for FEV1 more than two standardised scores below the predicted value in 39 (25%) and above 2 standardised scores for the residual volume (RV)/total lung capacity (TLC) ratio in 64 (41%). Restrictive lung disease (TLC more than 2 standardised scores below predicted) was present in 28 (18%). Severe lung function abnormalities were present in under 10% of the 155. Half the subjects had some evidence of extra-thoracic tracheal obstruction, with a high ratio of expiratory to inspiratory flow for peak flow in 76 (50%) and at 50% of vital capacity in 59 (38%). Patients with radiological gastro-oesophageal reflux in early childhood had more airways obstruction and smaller lung volumes. Patients with current gastrointestinal symptoms were similar in their lung function to symptom free patients. CONCLUSIONS: Minor lung function abnormalities are common in patients after repair of oesophageal atresia. Early diagnosis and management of gastro-oesophageal reflux may help to minimise these lung function abnormalities.

Adolescent↗

PubMed1988

Lung function in infants with cystic fibrosis.

Lung function was measured in 28 infants with cystic fibrosis and repeated in 17 of the infants during the first year of life. Thoracic gas volume (TGV) and specific airway conductance (sGaw) were measured plethysmographically and maximum forced expiratory flow at functional residual capacity (VmaxFRC) was derived from the partial expiratory flow-volume curve. At the time of the initial evaluation respiratory function was correlated with the clinical condition of the infants but not with age. There was a good correlation between sGaw and VmaxFRC when both were expressed as percentages of the predicted normal values. On the basis of the normal range for sGaw the infants were divided into two groups. Group A (n = 9), who had normal sGaw, were younger and had a lower clinical score and normal VmaxFRC and TGV values. Group B (n = 19), who had low sGaw, had increased TGV and decreased VmaxFRC. There was no correlation with age for any measure of lung function for the population as a whole. Repeat testing was undertaken at intervals in 17 representative infants. In most of these infants the relation between sGaw and VmaxFRC was maintained; there was no evidence that VmaxFRC was affected before sGaw. There was no functional evidence that the earliest changes in cystic fibrosis occur in small airways, as reflected by changes in VmaxFRC in infancy.

Airway Resistance↗

PubMed1994

Cotton dust exposure, across-shift drop in FEV1, and five-year change in lung function.

To evaluate chronic loss of lung function in cotton dust-exposed workers, a 5-yr follow-up study was performed in Shanghai, China from 1981 to 1986. Workers at a nearby silk thread manufacturing mill were used as a control population. There were 384 cotton textile workers restudied from an original group of 446, and 403 silk workers restudied from the original 468. The presence of byssinosis among retested cotton workers at the time of first survey was 7.3%. The prevalence of byssinosis was 9.7% at the initial survey among those lost to follow-up. No byssinosis was found among control subjects. The mean annual decline in FEV1 was 39.5 ml among cotton workers and 30.6 ml for silk workers (p < 0.05). The greatest annual decrements were found among smoking cotton workers, but nonsmoking cotton workers also lost lung function at a faster rate than silk nonsmokers (annual loss = 33.3 ml versus 24.4 ml, respectively). Autoregressive modeling revealed that after adjustments for age, sex, height, and smoking, cotton dust exposure was significantly associated with decline in FEV1. Moreover, across-shift drop of 5% or more at the time of first survey was predictive of 5-yr decline in FEV1. Cotton workers who had an acute response (5% or greater drop in FEV1 at the time of first survey) suffered a 57.0 ml/yr FEV1 drop compared with a 35.1-ml drop among cotton workers with less acute response at baseline (p < 0.01). Silk workers with or without 5% across-shift drops had similar annual rates of decline (-33.8 ml and -36.1 ml, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1976

Effect of modification of the smoking habit on lung function.

The effect of smoking cessation or modification on lung function was determined during a 48-week period. In a large number of the cigarette smokers, a disturbance of lung function was not revealed by conventional tests, such as the 1-sec forced expiratory volume; however, an abnormality was often demonstrable in tests that may reflect alterations in small airways, such as closing volume and Phase III of the single-breath expired N2 curve. There was no relation between the degree of abnormality of lung function and the presence of respiratory symptoms, but there appeared to be a relationship to lifetime smoking history, the heaviest smokers having the poorest function. Cessation, or more than 25 per cent decrease in the number of cigarettes smoked, was attened by improvement in the slope of Phase III of the N2 washout curve, closing volume, and closing capacity, as well as forced vital capacity, 1-sec forced expiratory volume, and peak flow. Resumption of smoking after cessation was attended by a deterioration in the slope of Phase III and closing capacity. The data suggest that the functional abnormalities in smokers are related to smoking and are at least partially reversible by cessation or significant modification of the smoking habit.

Adolescent↗

PubMed1991

Relationship of airborne endotoxin and bacteria levels in pig farms with the lung function and respiratory symptoms of farmers.

Previous studies have demonstrated a high prevalence of respiratory and other symptoms and a decrement in lung function among pig farm workers, although the relationships with specific agents present in the work environment remain obscure. This study was therefore undertaken to investigate the relationship between symptoms, lung function and airborne endotoxin, ammonia and dust levels in piggeries. Information on symptoms, lung function, endotoxin, ammonia and dust levels was available for 183 pig farmers who worked in 136 farms. For 62 farms information was present on the levels of bacteria and gram-negative bacteria. For these 62 farms, endotoxin exposure measurements were taken in more than one stable. In general, no significant correlations were found between lung function and chronic respiratory symptoms, or dust and ammonia levels. The endotoxin concentration in stables was negatively related to most lung function variables, but only for the subgroup of 62 farmers was a statistically significant relationship found between endoxtoxin exposure and FEV1. A borderline statistically significant and negative relationship was found between the endotoxin concentration and the FVC. Symptoms experienced during or shortly after work showed odds ratios larger than one with the levels of bacteria, gram-negative bacteria and endotoxin, indicating a positive relationship. No consistency in the relationship between symptoms and dust levels was found. The results suggest that endotoxins and (gram-negative) bacteria probably play an important role in the development of symptoms and lung function changes among pig farmers.

Adolescent↗

PubMed1995

Effect of a microaerosol barrier filter on the measurement of lung function.

STUDY OBJECTIVE: A disposable barrier filter (Pall Biomedical, United Kingdom) was developed to prevent the contamination of lung function equipment in clinical use. The aims of this study were to examine its resistance characteristics and to determine the effect of the filter on clinical measurements of lung function. MEASUREMENTS: Twenty-one randomly selected patients and four normal subjects had lung function measured with and without the filter between the mouth and measuring equipment. Measurements of ventilatory function were made with a pneumotachograph (Lilly; Hoechberg, Germany), total lung capacity and airway resistance by constant volume plethysmography, and diffusing capacity for carbon monoxide by the single breath method. Resistance was determined in five unused filters over the flow range 1 to 12 L/s and at a single flow rate (12 L/s) just after a normal subject expired 20 forced vital capacity (FVC) breaths through each of them. RESULTS: The resistance (mean +/- SD) of unused filters was 0.19 +/- 0.02 cm H2O/L/s at 1 L/s and increased linearly to 0.56 +/- 0.02 cm H2O/L/s at 12 L/s. There was no significant increase in resistance after use. The addition of the filter to the breathing circuit caused statistically significant decreases in forced expiratory volume in 1 s (FEV1) (0.044 +/- 0.08 L, p = 0.014) and peak expiratory flow rate (PEFR) (0.47 +/- 0.073 L/s, p = 0.004). The filter did not affect other indices of lung function. CONCLUSION: The filter caused a statistically significant reduction in FEV1 and PEFR; however, this difference was believed not to affect the clinical utility of routine lung function testing.

Adult↗

PubMed1982

Lung function in adults with mycoplasmal pneumonia.

We prospectively studied on lung function of 17 patients (7 men and 10 women) of acute Mycoplasma pneumoniae pneumonia. Lung function tests including %VC, FEV1.0%, Peak flow, V75/HT, V25/HT, V50/V25 and MMF were measured during the acute and convalescent stage. The results showed dysfunction of peripheral airway because of reduction in V50/HT, V25/HT and MMF. It was suggested that lung function in patients with Mycoplasma pneumoniae pneumonia was impaired at the high lung volume as well as low lung volume.

Adolescent↗

PubMed1979

[Presurgical determination of lung function in patients with bronchogenic carcinoma].

90 out of 202 lung cancer patients hospitalized for preoperative investigations were scheduled for radical surgery. 15 patients were not operated on because of insufficient lung function data. The operation was performed in 75 patients. The complication rate was 11% and mortality 8%. 7 out of 8 patients who subsequently developed severe complications had fulfilled the criteria for lung resection only after intensive antibronchitic treatment. Nearly all the survivors showed the predicted preoperative minimal lung function values after the operation. The limit of 1000 ml for postoperative FEV1 is justified, since patients with these or larger functional reserves nearly all had a favourable early and late postoperative course, and also because lung function values continuously deteriorate in chronic obstructive lung disease.

Aged↗

PubMed1984

The UCLA population studies of chronic obstructive respiratory disease. VIII. Effects of smoking cessation on lung function: a prospective study of a free-living population.

We evaluated effects of smoking cessation on lung function and respiratory symptoms of residents 25 to 64 yr of age from 3 communities in the Los Angeles area who completed a detailed respiratory questionnaire and measurements of forced expired volumes and flow rates, closing volume, and closing capacity at 2 times (T1 and T2) 5 yr apart. Results were analyzed in 2,401 participants who fit into 4 smoking categories: never smokers (414 males, 737 females); former smokers (294 males; 172 females); quitters between T1 and T2 (106 males, 62 females); and continuing smokers (278 males, 338 females). Covariance analysis was used to determine differences in lung function across smoking categories at T1 and T2 (adjusted for T1 values) and differences in decline in lung function between T1 and T2. Chi-square analysis was used to compare continuing smokers and quitters with respect to changes in respiratory symptoms. In this population, smoking at T1 was associated with impairment in all indexes of lung function evaluated. Smoking cessation led to significant improvement in symptoms of cough, wheeze, and phlegm production, and to significantly less decline in indexes of small airway function during 5 yr compared with measurements in continuing smokers. However, at T2, lung function still was lower among quitters compared with former and never smokers. Forced expiratory volume in one second (FEV1) was marginally improved in women who quit compared with those who continued to smoke.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1981

Smoking and lung function.

In a cross-sectional survey of 3 separate communities, we studied the white residents 7 year of age and older in order to determine the relation between cigarette smoking and lung function. We identified 2,817 nonsmokers, 664 ex-smokers, and 1,209 smokers who were further classified as light smokers (1 to 20 cigarettes per day) and heavy smokers (greater than 20 cigarettes per day). Residual lung function (observed-predicted) was examined in these groups for forced expiratory volume in one second (rFEV1) and for maximal expiratory flow rates at 50% and 25% of the vital capacity (rVmax50% and rVmax 25%). Mean residuals by sex, age, and smoking category were compared and revealed an increasing progression of lung function loss with advancing age in males and females in all smoking categories. These age-related trends were due primarily to the amount smoked by persons in each group. The age of onset of these abnormalities was found to be as early as the age group 15 to 24 yr. Abnormalities were greater in smokers than ex-smokers, even when the amount smoked was taken into account. This is suggested improvement in lung function after cessation of smoking. Men and women were found to experience the same relative degree of gain. Also, the contribution of the various smoking habits to lung function loss was assessed using regression analyses and accounted for no more than 15% of the variation of the residual lung function. Combinations of variables were found to explain only slightly more variation than a single variable. The two most important variables were duration of smoking and pack-years. Inhalation and use of filters were not significant. Although the same amount of variation explained by the smoking variables after accounting for age, height, weight, and sex was small, this variation accounted for almost all of the decrease, over age, in residual lung function for smokers and ex-smokers.

Adolescent↗

PubMed1987

Longitudinal changes in lung function and respiratory symptoms in progressive systemic sclerosis. Prospective study.

Most patients with progressive systemic sclerosis (PSS) exhibit lung involvement. However, the natural history of lung disease in PSS remains poorly defined. To evaluate lung function over time in PSS, a battery of lung function tests were prospectively performed serially between 1973 and 1982 in 61 patients with PSS. Functional indexes of restriction (vital capacity and total lung capacity) and diffusion impairment (diffusing capacity) showed greater-than-expected annual rates of change. Male subjects showed a trend toward faster declines in forced vital capacity, forced expired volume in one second, total lung capacity, and functional residual capacity and a more rapid increase in static recoil pressure at 90 percent of total lung capacity than did female subjects. Nonsmokers had greater rates of decline in total lung capacity and static lung compliance (but not in forced vital capacity or diffusing capacity) and a greater rate of increase in static recoil pressure than did current and former smokers. Level of lung function at initial study visit, age, race, and chlorambucil therapy had no significant effect on the annual rates of change in lung function, whereas longer duration of disease prior to study entry was associated with a slower annual decrease in lung volumes. Between the first and last visits (mean interval 3.1 years, maximum nine years), the frequency of abnormality in pulmonary function test results showed significant change only in the diffusing capacity (60 percent increasing to 82 percent) and static lung compliance (40 percent increasing to 54 percent), whereas the frequency of respiratory symptoms showed little change. These findings indicate an overall indolent progression of PSS-related lung disease, with substantial individual variability.

Adult↗

PubMed1994

Effect of moderate NO2 air pollution on the lung function of children with asthmatic symptoms.

In the course of a 2 1/2-year longitudinal study, the influence of outdoor NO2 and of the heating device at home on lung function was investigated in 467 children of school age in the urban area of Freiburg. Data were gathered in three surveys using standardized interviews, lung function measurements, skin prick tests with inhalant allergens, and NO2 measurements from October to April near the child's home. Regarding the lung function of a subpopulation with asthmatic symptoms (n = 106) in the three consecutive surveys, multivariate regression analyses adjusted for confounders indicate negative associations between five dependent variables, FEV1%FVC (P = 0.004), FEV1% (P = 0.02), MEF75% (P = 0.038), MEF50% (P = 0.052), and MEF25% (P = 0.002), on the one hand, and outdoor NO2 for average NO2 concentrations exceeding 40 micrograms/m3 on the other. The use of individual room heaters is associated with decreased lung function and is significant only for FEV1%FVC (P = 0.033). Neither NO2 nor individual room heating is significantly associated with one of the lung function parameters in the subpopulation without asthmatic symptoms (n = 361). In conclusion, children with asthmatic symptoms are identified as being susceptible to having reduced lung function under outdoor air pollution where average NO2 concentrations exceed 40 micrograms/m3.

Air Pollutants↗

PubMed1992

Longitudinal lung function decline in subjects with respiratory symptoms.

The relation of respiratory symptoms and lung function has not been extensively investigated. To determine better the rate of FEV1 decline in subjects reporting persistent wheeze, chronic cough, chronic phlegm, and/or dyspnea, longitudinal data from an adult population sample of 3,948 subjects (1,757 men; 2,191 women) followed for 12 yr were analyzed. At the initial and subsequent follow-up visits, subjects completed a standardized respiratory questionnaire and performed spirometry using the same methods and spirometers. Subjects were categorized based on the presence or absence of self-reported respiratory symptoms (persistent wheeze, chronic cough, chronic phlegm, or shortness of breath) at the initial visit. Six-specific linear regression models were fitted to determine the effect of these respiratory symptoms on lung function. In both men and women, reporting of any respiratory symptoms was associated with both a reduction in initial lung function and more rapid decline in height-adjusted FEV1. Furthermore, after adjustment for height, age, and cigarette smoking, men with cough or phlegm and women with cough alone showed accelerated loss in FEV1. Clinicians should be aware of the predictive value of these respiratory symptoms, because therapeutic intervention may modify the associated decline in lung function.

Cough↗

PubMed1989

Lung function in children of low birth weight.

Lung function was recorded in a cohort of 130 age specific children of low birth weight (under 2000 g) and a reference population of 120 unselected local schoolchildren at 7 years of age. Children of the cohort were similar in height and forced vital capacity to the reference group, but had significantly reduced forced expiratory volume in 0.75 second and expiratory flow indices. Although neonatal respiratory illness was associated with reduced airway function, we were unable to confirm that this was a consequence of oxygen treatment or mechanical ventilation. Low birth weight, however, was closely associated with poor airway function independent of neonatal respiratory illness. Other factors of importance included the male gender and maternal smoking. The reduction in airway function observed in the low birthweight children was associated with cough but not wheeze. The disparity between the relatively well preserved vital capacity and reduced airway function suggests that very low birth weight, and hence prematurity, has its greatest effect on the subsequent growth of airway function. The absence of an association between neonatal oxygen score or mechanical ventilation and childhood lung function suggests that the long term effect of neonatal respiratory treatment is small compared with that of birth weight, maternal smoking, and male sex.

Birth Weight↗

PubMed1989

Lung function and bronchial reactivity in farmers.

The purpose of this study was to evaluate the prevalence and type of lung function disorders in Danish farmers. Three samples of farmers were drawn from a group of unselected farmers who had participated in an epidemiological study. Group I (47 persons) was a sample of the 8% of all farmers who had reported that they had asthma; group II (63 persons) was a sample of the 28% of farmers who had had wheezing, shortness of breath, or cough without phlegm; and group III (34 persons) a sample of the farmers (64% of the total) who had no asthma and no respiratory symptoms. The farmers with symptoms (groups I and II) had low mean levels of FEV1 and high values for residual volume, whereas the symptomless farmers had normal lung function and no airways obstruction. The proportion of farmers with an FEV1 below the 95% confidence limit for predicted values was 43% in group I and 23% in group II; there were none in group III. Bronchial hyperreactivity to histamine occurred in 96% of asthmatic farmers, 67% of farmers with wheezing or shortness of breath, and 59% of symptomless farmers. A low level of FEV1 was associated with the number of years in pig farming and bronchial hyperreactivity in group II but not group I or III. Most of the bronchial hyperreactivity was explained in the multiple regression analysis by a low FEV1, though this was significant only for farmers in group II. Thus farmers who reported asthma, wheezing, shortness of breath, or a dry cough in general had airways obstruction with an increased residual volume, whereas symptomless farmers had normal lung function. Severe bronchial hyperreactivity was mostly explained by a diagnosis of asthma and poor lung function, though some farmers with normal lung function and no respiratory symptoms had increased bronchial reactivity.

Adult↗

PubMed1982

[Examination of the correlation between lung function and voice quality after glottoplasty or Blom-Singer-puncture (author's transl)].

The correlation between lung function and the quality of oesophageal speech was investigated in 36 patients who had undergone laryngectomy with glottoplasty. It was found that this correlation did not depend on any important lung function parameters. Lung tests were carried out on 10 patients before and after laryngectomy. No changes in lung function could be found that may have been directly attributed to a laryngectomy. This means that restrictive or obstructive lung disturbances do not contra-indicate glottoplasty or a Blom-Singer-puncture.

Aged↗

PubMed1991

Lung function abnormalities and decline of spirometry in scleroderma: an overrated danger?

To document the prevalence and progression of pulmonary involvement in scleroderma (systemic sclerosis including the CREST syndrome), the clinical notes and lung function records of 113 cases were reviewed. Lung function was normal in 39 cases, isolated impairment of DLCO was found in 38 patients, a restrictive defect was present in 27 cases and there was evidence of airflow obstruction in 9 cases. The median duration of symptoms was 10 years. Dyspnoea and an interstitial pattern on chest X-ray were associated with impaired lung function. Death during the period of review was significantly related to initial impairment of the DLCO. Sixty-six patients (53 women and 13 men) underwent repeat spirometry at least 1 year after initial testing. The rates of change in VC and FEV1 were no more rapid than would be expected for normal subjects. There was no significant difference in rates of change between men and women or between dyspnoeic patients and those who were asymptomatic. The extent of skin involvement and the presence of interstitial fibrosis on chest X-ray were unrelated to the rate of loss of lung function. It is concluded that most scleroderma patients in this study had abnormal lung function when first tested, but overall significant worsening of spirometry was not found.

Adolescent↗