Forced oscillation technique (FOT): a new tool for epidemiology of occupational lung diseases?

Qt, Pham; Bourgkard, Ève; Chau, Nearkasèn; Willim, G; Megherbi, S. E.; Teculescu, D; Bohadana, Abraham; Bertrand, JP

doi:10.1183/09031936.95.08081307

Cited by 31 publications

(40 citation statements)

References 15 publications

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“…The information offered by FOT on respiratory impairment is in every way as significant as spirometry and FOT does not require active cooperation. Feasibility in various epidemiological surveys and field studies has been excellent [78]. Both the standard and head generator methods exhibit comparable potential to classify a variety of respiratory status measures amongst agricultural workers (smoking status, cough, expectoration and airway obstruction assessed by maximum expiratory flow/volume curve) [79].…”

Section: Follow-up and Field Studiesmentioning

confidence: 99%

The forced oscillation technique in clinical practice: methodology, recommendations and future developments

Oostveen¹,

MacLeod²,

Lorino³

et al. 2003

European Respiratory Journal

1,080

1,120

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The forced oscillation technique (FOT) is a noninvasive method with which to measure respiratory mechanics. FOT employs small-amplitude pressure oscillations superimposed on the normal breathing and therefore has the advantage over conventional lung function techniques that it does not require the performance of respiratory manoeuvres.The present European Respiratory Society Task Force Report describes the basic principle of the technique and gives guidelines for the application and interpretation of FOT as a routine lung function test in the clinical setting, for both adult and paediatric populations.FOT data, especially those measured at the lower frequencies, are sensitive to airway obstruction, but do not discriminate between obstructive and restrictive lung disorders. There is no consensus regarding the sensitivity of FOT for bronchodilation testing in adults. Values of respiratory resistance have proved sensitive to bronchodilation in children, although the reported cutoff levels remain to be confirmed in future studies.Forced oscillation technique is a reliable method in the assessment of bronchial hyperresponsiveness in adults and children. Moreover, in contrast with spirometry where a deep inspiration is needed, forced oscillation technique does not modify the airway smooth muscle tone. Forced oscillation technique has been shown to be as sensitive as spirometry in detecting impairments of lung function due to smoking or exposure to occupational hazards. Together with the minimal requirement for the subject9s cooperation, this makes forced oscillation technique an ideal lung function test for epidemiological and field studies. Novel applications of forced oscillation technique in the clinical setting include the monitoring of respiratory mechanics during mechanical ventilation and sleep.

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Section: Follow-up and Field Studiesmentioning

confidence: 99%

The forced oscillation technique in clinical practice: methodology, recommendations and future developments

Oostveen¹,

MacLeod²,

Lorino³

et al. 2003

European Respiratory Journal

1,080

1,120

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“…Respiratory impedance has been studied in adults [1][2][3][4], as well as in children [5][6][7][8][9][10][11][12][13], in various clinical and epidemiological settings. Recent reports have suggested that the technique may be a suitable tool for epidemiological studies [14,15].…”

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confidence: 99%

Low diagnostic value of respiratory impedance measurements in children

Cuijpers

Wesseling²,

Kessels³

et al. 1997

Eur Respir J

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The aim of this study was to determine whether impedance values in children with various chronic respiratory complaints differed from those observed in symptom-free children.Respiratory impedance was measured using the forced oscillation technique in 1,776 Dutch children aged 6-12 yrs. In addition to the commonly used parameters of resistance and reactance, further impedance parameters were obtained by using linear and quadratic regression to describe individual resistance and reactance curves as a function of frequency. Furthermore, the diagnostic value of the individual impedance parameters was evaluated by means of receiver operator characteristic (ROC) curves. Statistically significant differences in impedance values were found in girls with symptoms suggesting asthma compared to symptom-free girls, but not in boys. In children with chronic cough, impedance was not significantly different from the values of symptom-free children. The results obtained by the additional impedance parameters were comparable to those of the commonly used measures.We conclude that the diagnostic value of the impedance parameters appeared to be low, as no cut-off points were found to discriminate clearly between symptomatic and symptom-free children. These findings may reflect absence of functional abnormalities in symptomatic children at this age. Eur Respir J., 1997; 10: 88-93 Using the technique of forced oscillations (FOT), the mechanical properties and the frequency-dependent behaviour of the respiratory system can be determined. The FOT yields values for the total resistance (Rrs) and reactance (Xrs) of the respiratory system. The measurements are noninvasive, independent of effort, and require little or no co-operation from the subject. Therefore, they can be performed easily, especially in young children. Respiratory impedance has been studied in adults [1][2][3][4], as well as in children [5][6][7][8][9][10][11][12][13], in various clinical and epidemiological settings. Recent reports have suggested that the technique may be a suitable tool for epidemiological studies [14,15].Recently, we have reported resistance and reactance values at 8 and 28 Hz, in 371 normal children aged 6-12 yrs [16]. All impedance parameters were significantly related to height and varied between sexes. Negative frequency dependence of resistance between 8-28 Hz was a common finding, most pronounced in (young) boys. Furthermore, we have reported differences in impedance values between children with (n=110) and without (n=360) asthma-like symptoms [17]. The analysis of these was restricted to mean values at single frequencies in the frequency range 8-28 Hz. At present, more information on the impedance versus frequency curves (4-48 Hz) can be obtained, due to further computerization of the impedance data.The aims of the present study were to analyse the relationship between various respiratory symptoms, such as chronic cough or asthma, and the frequency dependence of the respiratory impedance compared with those of symptom-free children i...

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“…However, the pattern of impedance measurements and in particular its comparison with flow-volume parameters is highly dependent both on type and extent of exposure [2]. Although we and others have proposed the FOT as a tool for epidemiology of occupational lung diseases [2,8,10], few longitudinal data on impedance measurements are available. Therefore, we performed a follow-up study of lung function among workers of a large chemical plant, mainly exposed to low levels of respiratory irritants, using flowvolume and impedance measurements.…”

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confidence: 99%

“…Firstly, it was demonstrated that impedance measurements are sensitive in detecting airflow limitation induced by specific or nonspecific challenge tests [3,4] and in patients with asthma [5] and chronic obstructive pulmonary disease (COPD) [6]. Secondly, in the past decade, several crosssectional investigations [2,7,8] have shown that impedance measurements also offer a simple noninvasive method to detect airflow limitation in different occupational settings. Some of these studies showed that the FOT provided better sensitivity to distinguish between subjects with respect to exposure to irritant gases [7], organic dust and endotoxin [9], or to detect mild obstructive patterns in underground coal workers without apparent radiographic abnormalities [8].…”

mentioning

confidence: 99%

“…Secondly, in the past decade, several crosssectional investigations [2,7,8] have shown that impedance measurements also offer a simple noninvasive method to detect airflow limitation in different occupational settings. Some of these studies showed that the FOT provided better sensitivity to distinguish between subjects with respect to exposure to irritant gases [7], organic dust and endotoxin [9], or to detect mild obstructive patterns in underground coal workers without apparent radiographic abnormalities [8]. However, the pattern of impedance measurements and in particular its comparison with flow-volume parameters is highly dependent both on type and extent of exposure [2].…”

mentioning

confidence: 99%

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A five year follow-up of lung function among chemical workers using flow-volume and impedance measurements

Keman¹,

Willemse²,

Wesseling³

et al. 1996

Eur Respir J

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A A f fi iv ve e y ye ea ar r f fo ol ll lo ow w--u up p o of f l lu un ng g f fu un nc ct ti io on n a am mo on ng g c ch he em mi ic ca al l w wo or rk ke er rs s u us si in ng g f fl lo ow w--v vo ol lu um me e a an nd d i im mp pe ed da an nc ce e m me ea as su ur re em me en nt ts s S. Keman*, B. Willemse*, G.J. Wesseling**, E. Kusters + , P.J.A. Borm* A five year follow-up of lung function among chemical workers using flow-volume and impedance measurements. S. Keman, B. Willemse, G.J. Wesseling, E. Kusters, P.J.A. Borm. ERS Journals Ltd 1996. ABSTRACT: Impedance of the respiratory system, measured using the forced oscillation technique (FOT), has repeatedly been proposed as a tool for occupational health screening.The aim of this study was to compare the outcome of impedance measurements and flow-volume curves, and to study relationships between lung function decline and specific exposures and smoking. Both measurements were applied in 136 chemical workers from seven main production/personnel groups during a 5 year followup (1990)(1991)(1992)(1993)(1994)(1995).The prevalence of airway obstruction (forced expiratory volume in one second (FEV1) <80% of predicted) at both time-points was about 5% but did not necessarily include the same subjects. The average decline in FEV1 over 5 yrs was 200 mL (predicted decline 160 mL). Although most impedance parameters correlated to flow-volume parameters in both years, a rapid 5 year decline of FEV1 (>330 mL) was only accompanied by a significant decrease in the reactance at 8 Hz (X8) and an increase in the resonance frequency (f0). Interestingly, decline in FEV1 was significantly dependent on age, years of employment, pack-years, FEV1, and all impedance parameters at the start in 1990 (r=0.35; p=0.01). Similarly, the increase in f0 was significantly dependent on age, years of employment, pack-years, f0, FEV1, forced vital capacity (FVC), peak expiratory flow (PEF) and maximal mid-expiratory flow (MMEF) at the start (r=0.56; p<0.01). Those with a rapid decline in FEV1 were relatively more represented among acid workers (relative risk (RR)=2.14), maintenance workers (RR=2.1) and bulk/transport workers (RR=1.78), but none of these was significant. Lung function, however, was significantly lower in the bulk/transport workers (n=14) compared to the rest, based both on flow-volume (FEV1, FVC) and impedance (X8, f0) measurements. Smoking had a significant effect on most flow-volume parameters but only for frequency dependence among the impedance outcomes.It is concluded that alterations in impedance parameters do reflect changes in flow-volume curves induced by age, smoking and occupational exposure. Therefore, these data are a valuable extension to current cross-sectional data. Eur Respir J., 1996Respir J., , 9, 2109 Although a decline in forced expiratory volume in one second (FEV1) is generally considered as a gold standard to detect airflow limitation, different (mechanical) alterations of the respiratory system can influence this parameter. Impedance measurements of ...

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Forced oscillation technique (FOT): a new tool for epidemiology of occupational lung diseases?

Cited by 31 publications

References 15 publications

The forced oscillation technique in clinical practice: methodology, recommendations and future developments

The forced oscillation technique in clinical practice: methodology, recommendations and future developments

Low diagnostic value of respiratory impedance measurements in children

A five year follow-up of lung function among chemical workers using flow-volume and impedance measurements

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