Early Life Factors Contribute to the Decrease in Lung Function between Ages 18 and 40

Abstract

Early life factors may influence pulmonary function. We measured forced expiratory volume in 1 second (FEV(1)) in 1985-1986 and 2, 5, and 10 years later in approximately 4,000 black and white men and women initially aged 18-30 years. We estimated the age pattern of FEV(1) according to family smoking status, early diagnosis of asthma, early smoking initiation, adult asthma, and cigarette smoking. FEV(1) followed a quadratic pattern from age of peak through age 40. The pattern varied by race and sex. Early smoking initiation was associated with a faster decrease in FEV(1). Smoking by family members was related to early life asthma and may have contributed to faster FEV(1) decrease by encouraging behaviors such as heavier smoking or earlier smoking initiation. Prevalence of smoking was 28% when no family member smoked, compared with 59% when four or more members smoked. The FEV(1) decline was 8.5% in never-smokers without asthma; 10.1% in nonsmoking individuals diagnosed with asthma; and 11.1% in baseline smokers who smoked 15 or more cigarettes per day. The combination of asthma and heavier smoking was synergistic (17.8% decline). This study delineates an increased rate of decline in those with asthma or in those who smoke cigarettes and implicates early life exposures as contributing to the faster rate of FEV(1) decline.

A study of the relative bronchodilator responsiveness in smoker asthmatics

“…22 Apostol G et al found that the decline in FEV 1 was 8.5% in non smokers without asthma, 10.1% in nonsmokers with asthma and 11.1% in smokers without asthma. 23 Similar case was found INA study by James et al 24 In the present study, non-smoker asthmatics showed significant improvement in all the four parameters vis. FEV 1 , FVC, FEV 1 /FVC ratio and PEFR after giving supramaximal dose of salbutamol.…”

Severe exacerbations predict excess lung function decline in asthma

“…All subjects with .5 pack-yr smoking history were excluded. Subjects without continuous records for o5 yrs from the age of 25 yrs, at which time lung function has maximised [10], were also excluded. Overall, 93 subjects were included in the current study pertaining to the period before ICS treatment was initiated.…”

Prevalência de tabagismo ativo e passivo em uma população de asmáticos

“…One group of authors (16) reported that the mean decrease in FEV 1 among asthma patients who smoke was 58 mL/year, compared with a significantly lower decrease of 33 mL/year among asthma patients who do not smoke. In a 10-year prospective cohort study, (17) the decrease in FEV 1 was found to be 8.5% in nonsmokers without asthma, 10.1% in nonsmokers with asthma, 11.1% in smokers without asthma and 17.8% in smokers with asthma.…”