References values for forced spirometry. Group of the European Community Respiratory Health Survey

Several studies have demonstrated an excess risk for asthma among cleaning workers. The aim of this analysis was to compare clinical, immunological and functional characteristics associated with asthma in cleaners and other occupational groups.Cleaners, workers exposed to high molecular weight (MW) agents, workers exposed to low MW agents, and office workers were identified from an international communitybased epidemiological study. Influence of sex, smoking, age and atopy on the relationships with asthma was investigated. Rates of respiratory symptoms, bronchial hyperresponsiveness, atopic sensitisation and lung function were compared between asthmatics from the four groups (case-case analysis).The risk for asthma in workers exposed to low MW agents was higher among nonatopics than among atopics. Case-case analysis showed no major differences in asthma characteristics between cleaners and workers exposed to high or low MW agents. Asthmatic cleaners had less atopy, more chronic bronchitis and a lower lung function as compared to office workers.Asthma in cleaning workers showed many similarities with that in workers known to be at risk for occupational asthma. Atopic sensitisation did not seem to play an important role in cleaning-related asthma. Eur Respir J 2002; 20: 679-685.

Section: Health Outcomementioning

confidence: 99%

Section: Health Outcomementioning

confidence: 99%

Asthma characteristics in cleaning workers, workers in other risk jobs and office workers

Zock¹,

Kogevinas²,

Sunyer³

et al. 2002

“…Moreover, reference equations for FEV6 and FEV1/FEV6 are only available for the USA population (NHANES III survey) [13] and only recently for European subjects in the 65-85-yrs category [14]. Adding to the complexity of the problem, reference equations obtained from different studies lead to significant differences in predicted FVC and FEV1 [15].…”

mentioning

confidence: 99%

Obstructive and restrictive spirometric patterns: fixed cut-offs for FEV1/FEV6 and FEV6

Vandevoorde¹,

Verbanck

Schuermans

et al. 2006

The purpose of this study was to determine fixed cut-off points for forced expiratory volume in one second (FEV1)/FEV6 and FEV6 as an alternative for FEV1/forced vital capacity (FVC) and FVC in the detection of obstructive and restrictive spirometric patterns, respectively.For the study, a total of 11,676 spirometric examinations, which took place on Caucasian subjects aged between 20-80 yrs, were analysed. Receiver-operator characteristic curves were used to determine the FEV1/FEV6 ratio and FEV6 value that corresponded to the optimal combination of sensitivity and specificity, compared with the commonly used fixed cut-off term for FEV1/FVC and FVC.The data from the current study indicate that FEV1/ FEV6 ,73% and FEV6 ,82% predicted can be used as a valid alternative for the FEV1/FVC ,70% and FVC ,80% pred cut-off points for the detection of obstruction and restriction, respectively. The statistical analysis demonstrated very good, overall, agreement between the two categorisation schemes. For the spirometric diagnosis of airway obstruction (prevalence of 45.9%), FEV1/FEV6 sensitivity and specificity were 94.4 and 93.3%, respectively; the positive and negative predictive values were 92.2 and 95.2%, respectively. For the spirometric detection of a restrictive pattern (prevalence of 14.9%), FEV6 sensitivity and specificity were 95.9 and 98.6%, respectively; the positive and negative predictive values were 92.2 and 99.3%, respectively.This study demonstrates that forced expiratory volume in one second/forced expiratory volume in six seconds ,73% and forced expiratory volume in six seconds ,82% predicted, can be used as valid alternatives to forced expiratory volume in one second/forced vital capacity ,70% and forced vital capacity ,80% predicted, as fixed cut-off terms for the detection of an obstructive or restrictive spirometric pattern in adults.

“…Only two sets of standards have been published on lifetime nonsmokers in Caucasian-American elderly subjects [14,15]. Although significant differences between Caucasians of American and European origin have been suggested [16], no study has collected pulmonary measurements for both sexes across a large sample of elderly European subjects. ENRIGHT et al [14] derived spirometric prediction equations from a reference population of healthy individuals aged 65-85 yrs.…”

mentioning

confidence: 99%

Spirometric reference equations for European females and males aged 65-85 yrs

García‐Río¹

2004

116

The aim of this study was to describe spirometric reference equations for healthy never-smoking European adults aged 65-85 yrs and to compare the predicted values of this sample with those from other studies including middle-aged and/or older adults.Reference equations and normal ranges for forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory volume in six seconds (FEV6), FEV1/FVC ratio and FEV1/FEV6 ratio were derived from a healthy subgroup of 458 subjects aged 65-85 yrs. Spirometry examinations followed the 1994 American Thoracic Society recommendations and the quality of the data was continuously monitored and maintained. Reference values and lower limits of normal were derived using a piecewise polynomial model with age and height as predictors.The reference values of FEV1 and FVC from the present study were higher than those given by prediction equations from the European Community for Coal and Steel. By contrast, use of prediction equations from Caucasian-American elderly subjects (Cardiovascular Health Study) consistently overpredicted FVC and FEV1 in females by 8.5 and 2.1%, respectively. In males, equations from the Cardiovascular Health Study overpredicted FVC by 2.8%, whilst underpredicting FEV1 by 2.5%.In conclusion, these results underscore the importance of using prediction equations appropriate to the origin, age and height characteristics of the subjects being studied. Spirometry is probably the most important tool used in screening for pulmonary disease and is the most frequently performed pulmonary function test. Although the average age of patients tested at pulmonary function laboratories each year is y60 yrs old, many of the reference equations commonly used for the prediction of normal spirometric values in North America and Europe have been derived from studies that included relatively small numbers of individuals w65 yrs old [1][2][3][4][5][6][7][8][9]. In fact, predicted values for older individuals are often based upon few observations or extrapolations from data acquired in studies of younger adults. However, the application of prediction equations derived from primarily younger adult populations to older adults may be inappropriate because the relationship between lung function, age and height may change with age. In fact, the current international guidelines recommend that spirometry reference equations should, in general, not be extrapolated for ages or heights beyond those covered by the data that generated them [10,11].Valid reference values for spirometric parameters in healthy elderly Afro-Americans [12] and Japanese-American elderly males [13] have been previously reported. Only two sets of standards have been published on lifetime nonsmokers in Caucasian-American elderly subjects [14,15]. Although significant differences between Caucasians of American and European origin have been suggested [16], no study has collected pulmonary measurements for both sexes across a large sample of elderly European subjects. ENRIGHT et al. [14...