Density dependence variables (helium-to-air difference in forced expiratory flows at 50 and 25% vital capacity and volume of isoflow) were compared with spirographic performance (vital capacity, FEV1.0) in 76 men aged 33–56 years. The group included nonsmokers, asymptomatic smokers, subjects with chronic expectoration, but normal ventilatory function and subjects with chronic expectoration and minimal obstructive ventilatory impairment. Low-level correlations were found (coefficients of less than 0.3) between ΔHe25% or volume of isoflow on one side and FEV1.0 or FEV1.0/VC. Some possibly confounding factors for these correlations are discussed. We conclude that density dependence variables are not consistently related to the FEV1.0 in subjects 'at risk' or with minimal airflow limitation.
The variability (coefficient of variation of five consecutive measurements), reproducibility (difference of results at 1 h and 24 h), and interobserver difference (independent reading of the tracings by two observers) of airways resistance (Raw) and static lung volumes (residual volume, functional residual capacity, total lung capacity) using a body plethysmograph were assessed in 14 healthy subjects and in 25 patients with various respiratory disorders. The variability was low for TLC (4-5%), moderate for FRC (7-8%) and high for Raw (28%). No significant changes of Raw or lung volumes were found for the groups at 1 h and 24 h. Between observers, a slight difference existed for FRC and Raw in normal subjects; the difference was higher (4.5% for FRC and 11% for Raw) and became significant in patients. The overestimation of Raw by observer 2 as compared to observer 1 was more important at larger values. The present findings call for caution when pooling results obtained by several observers in large-scale studies, or when comparing figures obtained by different technicians in the pulmonary function laboratory.
A first survey has been conducted on 1179 iron-ore mine workers, 35-55 years old, who were randomly selected from 5900 at work with normal chest roentgenograms. Five years later, 871 of them were re-examined. Both surveys included a standard respiratory symptoms questionnaire (British MRC), a physical examination of the chest, and measurement of pulmonary function (vital capacity - VC; forced expiratory volume during 1 s - FEV1.0; residual volume - R.V. by helium dilution: carbon monoxide uptake - FuCO by the steady-state method). Both surveys were done by the same research team under identical conditions, using the same equipment. The mine technical services determined the dust and noxious gas concentrations at work places. No evidence of worsening of respiratory health status was observed overall. Symptoms of chronic bronchitis and asthma were recorded with a similar prevalence in both surveys; the decline in lung function was minimal for the total sample. However, our aim was to compare changes that were observed in groups differing by work place (surface or underground) or by activity (active or retired). Analysis showed that development of respiratory symptoms was more frequent and decline in lung function accelerated in the 5-year interval among underground workers who were still active as compared to those retired. In all subgroups (surface or underground workers, active or retired), decline of lung function values was more marked in smokers compared to non-smokers.
The alveolar nitrogen slope (PIII), closing volume (CV), and closing capacity (CC) were measured by the single-breath nitrogen washout method (SBN2) in a group of 187 healthy children and adolescents (92 boys, 95 girls), 10 to 16 yr old, from the general population of Lorraine, France. The test was performed using a computerized system, which also made the calculations. About one out of five healthy subjects in this population were unable to satisfactorily perform the test; the failure rate was the same for the two sexes (20% in boys, 21.5% in girls) and significantly higher in younger children (26.6 and 14.5% for children under and over the age of 13, respectively; p = 0.03). The distribution of results was skewed for PIII and practically normal for log PIII, CV, VC, and CV/VC or CC/TLC ratios. PIII was highly significantly, inversely related to anthropometric variables; the highest coefficient was that for the age-weight interaction term in boys (= r −0.57 for PIII, −0.62 for log PIII) and for weight in girls (r = −0.57 for both PIII and log PIII). Because the anthropometric variables were strongly interrelated (r between 0.45 and 0.79), multiple regressions did not materially improve the prediction of PIII. In simple regression, weight alone explained 36% of the variability of log PIII in boys and 32% in girls. The mean PIII was significantly higher in girls as compared to boys (1.14 ± 0.38 versus 0.98 ± 0.17% N2/L, p = 0.02); CV and CC in milliliters were related to body build as other lung volumes; the CV/VC in girls and CC/TLC ratio in both sexes were not related to anthropometric variables. In boys, CV/VC decreased significantly with height (p = 0.035 for CV/VC versus height3). Our results also suggest less homogeneous intrapulmonary distribution (i.e., higher PIII) in boys with smoking fathers, in boys with less-educated fathers, and in girls with a history of atopy (excluding asthma), but these aspects need further study in larger groups of subjects.
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