Reference values for respiratory function tests in males: prediction formulas with tobacco smoking parameters
Corresponding Author
Hrafn V. Fridriksson
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
National Institute of Environmental Health, Heilbrig-diseftirlit Rikisins, Post Box 505, Reykjavik, Iceland.Search for more papers by this authorPer Malmberg
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
Search for more papers by this authorHans Hedenström
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
Search for more papers by this authorGunnar Hillerdal
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
Search for more papers by this authorCorresponding Author
Hrafn V. Fridriksson
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
National Institute of Environmental Health, Heilbrig-diseftirlit Rikisins, Post Box 505, Reykjavik, Iceland.Search for more papers by this authorPer Malmberg
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
Search for more papers by this authorHans Hedenström
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
Search for more papers by this authorGunnar Hillerdal
Department of Clinical Physiology, University Hospital, S-750 14 Uppsala
Department of Lung Medicine, University Hospital, S-750 14 Uppsala
Institute of Hygiene, Uppsala University, S-751 23 Uppsala, Sweden
Search for more papers by this authorAbstract
Summary. Prediction equations for respiratory function tests were obtained by multiple regression of data from 263 healthy males. The material was evenly distributed in the ages 20–70 years, about one third each of non-smokers, smokers and ex-smokers. Measurements were done of lung volumes (with body plethysmograph), airways resistance, ventilatory capacity including flow-volume registration, gas distribution and closing volume, transfer factor and static elastic recoil pressures of the lung with calculation of static compliance. The parameters age, height, weight, years of tobacco smoking and grams of tobacco smoked each day showed significant correlation with the outcome of the test in most of the respiratory function tests. Therefore a set of basic regression equations including these parameters were calculated. In addition an ‘extended’ set of equations was calculated for prediction of some tests with inclusion of nonlinear terms and the parameter ‘years of abstinence from smoking.’ The reduction in variance which followed inclusion of tested parameters was moderate (20–69%). There were significant differences between results of the present study and several previously published regression formulas.
References
- Anthonisen N. R., Danson J., Robertson P. C. & Ross W. R. D. (1969) Airway closure as a function of age. Resp Physiol, 8, 58–65.
- Bass H. (1973) The flow volume loop: normal standards and abnormalities in chronic obstructive pulmonary disease. Chest, 63, 171–176.
- Begin R., Renzetti A. D. Jr., Bigler A. H. & Watanabe S. (1975) Flow and age dependence of airway closure and dynamic compliance. J ApplPhysiol, 38, 199–207.
- Berglund E., Birath G., Bjure J., Grimby G., Kjellmer I., Sandqvist L. & Söderholm B. (1963) Spirometric studies in normal subjects. I. Forced expirograms in subjects between 7 and 70 years of age. Acta med scand, 173, 185–192.
- Birath G., Kjellmer I. & Sanqvist L. (1963) Spirometric studies in normal subjects. II. Ventilatory capacity tests in adults. Acta med scand, 173, 193–198.
- Black L. F., Offord K. & Hyatt R. E. (1974) Variability in the maximal expiratory flow volume curve in asymptomatic smokers and in non-smokers. Amer Rev resp Dis, 110, 282–292.
- Buist A. S., Van Fleet D. L. & Ross B. B. A. (1973) A comparison of conventional spirometric tests and the test of closing volume in an emphysema screening center. Amer Rev resp Dis, 107, 735–743.
- Buist A. S. & Ross B. B. (1975) Predicted values for closing volumes using a modified single breath nitrogen test. Amer Rev resp Dis, 107, 744–752.
- Buist A. S. & Ross B. B. (1973) Quantitative analysis of the alveolar plateau in the diagnosis of early airway obstruction. Am Rev resp Dis, 108, 1078–1087.
- Buist A. S. & Nagy J. M. (1976) Relationship between smoking and the single breath nitrogen washout. Scand J resp Dis, Suppl. 95, 108–116.
- Bureau OF Central Statistics (1970) FoB, Örebro .
- Carilli A. D., Denson L. J., Rock F. & Malabanan S. (1974) The flow-volume loop in normal subjects and in diffuse lung disease. Chest, 66, 472–477.
- Cherniack R. M. & Raber M. B. (1972) Normal standards for ventilatory function using an automated vedge spirometer. Amer Rev resp Dis, 106, 38–46.
- Collins J. V., Clark T. J. H., McHardy-Young S., Cochrane G. M. & Crawley J. (1973) Closing volume in healthy non-smokers. Brit J Dis Chest, 67, 19–27.
- Cotes J. V., Rossiter C. E.; Higgings I. T. T. & Gilson J. C. (1966) Average normal values for the forced expiratory volume in white Caucasian males. Brit Med J, 1, 1016–1966.
- Ferris B. G. Jr., Anderson D. O. & Zickmantel R. (1965) Prediction values for screening tests of pulmonary function. Amer Rev resp Dis, 91, 252–261.
- Ganse W. F., Ferris B. G. Jr., Cotes J. E. (1972) Cigarette smoking and pulmonary diffusing capacity (transfer factor). Amer Rev resp Dis, 105, 30–41.
- Georges R., Saumon G. & Loiseau A. (1978) The relationship of age to pulmonary membrane conductance and capillary blood volume. Amer Rev resp Dis, 117, 1069–1078.
- Goldman H. I. & Becklake M. R. (1959) Respiratory function tests. Normal values at median altitudes and the prediction of normal results. Amer Rev Tuherc, 79, 457–467.
- Grimby G. & Soderholm B. (1963) Spirometric studies in normal subjects. III. Static lung volumes and maximum voluntary ventilation in adults with a note on physical fitness. Acta med scand, 173, 199–206.
- Grimes C. A. & Hanes B. (1973) Influence of cigarette smoking in the spirometric evaluation of employees of a large insurance company. Amer Rev resp Dis, 108, 273–282.
- Hoeppner V. H., Cooper D. M., Zamel N.. Bryan A. C. & Levison H. (1974) Relationship between elastic recoil and closing volume in smokers and non-smokers. Amer Rev resp Dis, 109, 81–86.
- Holtz B., Bake B. & Sixt R. (1979) Effects of preinspiratory volume on the nitrogen closing volume test. In: University of Göteborg.
- Hyatt R. E., Schilder D. P. & Fry D. L. (1958) Relationship between maximum expiratory flow and degree of lung inflation. J Appl Physiol, 13, 331.
- Knudson R. J., Slatin R. C., Lebowitz M. D. & Burrows B. (1976) The maximal expiratory flow-volume curve. Normal standards, variability and effects of age. Amer Rev resp Dis, 113, 587–600.
- Knudson R. J., Burrows B. & Lebowitz M. D. (1976) The maximal expiratory flow-volume curve: its use in the detection of ventilatory abnormalities in a population study. Amer Rev resp Dis, 114, 871–879.
- Knudson R. J., Lebowitz M. D., Burton A. P. & Knudson D. E. (1977) The closing volume test: evaluation of nitrogen and bolus methods in a random population. Amer Rev resp Dis, 115, 423–434.
- Knudson R. J. & Lebowitz M. D. (1977) Comparison of flow-volume and closing volume variables in a random population. Amer Rev resp Dis, 116, 1039–1045.
-
Kory P. C.,
Callahan R.,
Boren H. G. &
Syner M. J. (1961) The Veterans Administration-Army Cooperative study of pulmonary function. I. Clinical spirometry in norma) men.
Am J Med, 30, 243–258.
10.1016/0002-9343(61)90096-1 Google Scholar
- Krumholz R. A. & Hedrick E. C. (1973) Pulmonary function differences in normal smoking and non-smoking, middle-aged white-collar workers. Amer Rev resp Dis, 107, 225–230.
- Lebowitz M. D. (1977) Smoking habits and changes in smoking habits as they relate to chronic conditions and respiratory symptoms. Amer J Epidem, 105, 534–543.
- Manfreda J., Nelson N. & Cherniack R. M. (1978) Prevalence of respiratory abnormalities in a rural and an urban community. Amer Rev resp Dis, 117, 215–226.
- Marco M. & Minette A. (1976) Conventional spirometry. Amer Rev resp Dis, 114, 723–738.
- McCarthy D. S., Spencer R., Greene R. & Milic-Emili J. (1972) Measurement of ‘closing volume’ as a simple and sensitive test for early detection of small airway disease. Amer J Med, 52, 747–753.
-
Medical Research Council Committee ON THE Aetiology OF Chronic Bronchitis (1960) Standardized questionnaire on respiratory symptoms.
Brit Med J, 2, 1165.
10.1136/bmj.2.5206.1165-d Google Scholar
- Mead J., Wittenberger J. L. & Radford E. P. (1957) Surface tension as a factor in pulmonary volume-pressure hysteresis. J appl Physiol, 10, 191.
- Meneely G. R., Renzetti Jr. A. D., Steel J. D., Wyatt J. P. & Harris H. W. (1962) Chronic bronchitis, asthma and pulmonary emphysema. Am Rev res Dis, 85, 762–769.
- Melic-Emili J., Mead J., Turner M. & Glanser E. M. (1964) Improved technique for estimating pleural pressure from oesophageal ballons. J appl Physiol, 19, 207.
- Morgan W. K. C., Lapp N. L. & Morgan E. J. (1974) The early detection of occupational lung disease. Brit J Dis Chest, 68, 75–85.
- Morris J. F., Koski A. & Johnson L. C. (1974) Spirometric standards for healthy non-smoking adults. Amer Rev resp Dis, 105, 57–67.
- Mostardi R. A. & Leonard D. (1974) Air pollution and cardiopulmonary function. Arch Environ Health, 29, 325–328.
- Nie N. H., Hull C. H., Jenkins J. G., Steinbrenner K. & Bent D. H. (1975) SPSS, Statistical Package for the Social Sciences. 2nd edn. McGraw-Hill, New York .
- Ogilvie C. M., Forster R. E., Blakemore W. S. & Morton J. W. (1957) A standardized breath holding technique for the clinical measurement of the diffusion capacity of the lung for carbon monoxide. J Clin Invest, 36, 1–17.
- Oxhøj H., Bake B. & Wilhelmsen L. (1977) Ability of spirometry, flow-volume curves and the nitrogen closing volume test to detect smokers. A population study. Scand J Resp Dis, 58, 80–96.
- Reichel G. & Islam M. S. (1972) Measurement of static lung and thorax compliance in health and pulmonary diseases. Respiration, 29, 507–515.
- Rossiter C. E. & Weill H. (1974) Synergism between dust exposure and smoking. An artefact in the statistical analysis of lung function Bull Physiol-Path Resp, 10, 717–725.
- Sobol B. J. (1974) Setting the limits of normal for pulmonary function: a problem and a paradox. Editorial. Chest, 65, 240–241.
- Sobol B. J. (1976). The early detection of airway obstruction: another perspective. Amer J Med, 60, 619–624.
- Solomon D. A. (1978) Clinical significance of pulmonary function tests. Are small airways tests helpful in the detection of early airflow obstruction Chest, 74, 567–569.
- Schlesinger Z. V. I., Goldbourt U., Medalie J. H., Oron D., Neufeld H. N. & Riss E. (1973) Pulmonary ventilatory function values for healthy men aged 45 years and over. Chest, 63, 520–524.
- Worrowrrz H.-J., Buchheim F. W. & Worrowrrz R. (1967) Zur Theorie und Praxis der Ganzkör- perplethysmographie in der Lungenfunktionsanalyse. Prax Pneitmol, 21, 449–471.
