Published models and local data can bridge the gap between reference values of lung function for children and adults

The aim of this study was to create reference equations for pulmonary function tests (PFTs) that span the age range from childhood to young adulthood. PFT results (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of FEV1 to FVC (FEV1/FVC), total lung capacity (TLC), transfer factor) of 348 healthy 13-24 yr old Caucasian never-smokers from a local population study were compared with 13 selected sets of published reference equations. Predicted and observed PFT results differed significantly for 63 of 92 reference equations tested, and most equations accounted poorly for the increase in PFT variables which takes place during adolescence. We selected the equations with the best fit and adjusted their parameters, so that the level and variance of predicted values agreed with the local data. For subjects older than 18 yrs, we selected the European Community for Steel and Coal (ECSC) equations. For subjects younger than 18 yrs, we chose European summary equations for FVC, FEV1, and FEV1/FVC, and recent British equations for TLC and transfer factor. The customized reference equations are the best available (maximum likelihood) for analysing PFTs of patients tested in our laboratory. Our approach can be used whenever generally accepted reference equations are lacking and a local sample of normal subjects is available.     

Alveolar lining fluid regulates mononuclear phagocyte 5-lipoxygenase metabolism

The lung clearance of technetium-99m diethylenetriamine penta-acetic acid (99mTc-DTPA) is a measure of respiratory epithelial permeability. Many factors may contribute to the wide range of normal values, including the method of correction for background activity. The aim of this study was to compare three methods of analysis, including their repeatability. 99mTc-DTPA lung clearance imaging was performed on eight nonsmokers (age 32+/-2 yrs, forced expiratory volume in one second (FEV1) 102.8+/-3.3% predicted yrs, mean+/-SEM and seven smokers (age 46+/-4 yrs, p<0.01, versus nonsmokers; FEV1 88.9+/-8.9%, p<0.05 versus nonsmokers) on two occasions each. The smokers were asked to refrain from smoking for 12 h. An uncorrected analysis was compared with two methods corrected for recirculating background activity using an intravenous correction and inter-renal and shoulder background regions of interest. The uncorrected method gave higher mean values for 50% lung clearance of 99mTc-DTPA (t50) values than the inter-renal (p<0.001) and shoulder (p<0.001) methods of correction in nonsmokers and the inter-renal method gave lower values than the shoulder-corrected method (p<0.05). In smokers there was no difference. There were no differences in mean t50 values obtained on two separate visits. There was no difference in the repeatability of the three methods of analysis. The three methods of analysis produced comparable results with no differences in repeatability.     

Determinants of survival in pulmonary Langerhans' cell granulomatosis (histiocytosis X). Groupe d'Etude en Pathologie Interstitielle de la Société de Pathologie Thoracique du Nord

The course of pulmonary Langerhans' cell granulomatosis (pulmonary LCG) is variable, difficult to predict and ranges from spontaneous remission to progressive respiratory insufficiency and death. To identify the determinants of survival, we performed a survival analysis on 45 patients with pulmonary LCG. The patients were aged 28 +/- 10 yrs (mean +/- SD) (range 12-62 yrs), 32 males and 13 females, almost exclusively current smokers (96%), and 78% presented symptoms at the time of diagnosis. Diagnosis was made by lung biopsy in 25 patients (56%) and by bronchoalveolar lavage (BAL) analysis in 20 patients (44%). The patients were followed for a median period of 6 yrs (range 1-29 yrs) after the diagnosis. During the period of observation, 33 (73%) patients survived (median follow-up period = 5.8 yrs; range, 1-29 yrs) and 12 (27%) died or underwent lung transplantation (median follow-up period = 8.4 yrs; range 1.4 - 16.1 yrs). The median survival was approximately 13 years. A univariate analysis demonstrated that diminished survival was significantly associated with: an older age at diagnosis (p = 0.0001); a lower forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio at diagnosis (p = 0.005); a higher residual volume/total lung volume (RV/TLC) ratio at diagnosis (p = 0.02); and steroid therapy during follow-up (p = 0.03). Additional predictive information on mortality was: age > 26 yrs (sensitivity 83%, specificity 64%); FEV1/FVC ratio < 0.66 (sensitivity 75%, specificity 86%); and a RV/TLC ratio > 0.33 (sensitivity 75%, specificity 63%). In multivariate Cox analysis, the combination of factors which gave the best prognostic value was FEV1/FVC ratio and age (p < 0.01). The present findings suggest that adverse prognosis factors at diagnosis in pulmonary Langerhans' cell granulomatosis include older age, lower FEV1/FVC ratio and higher RV/TLC ratio, with additional predictive information on mortality if aged > 26 yrs, FEV1/FVC ratio < 0.66, and RV/TLC ratio > 0.33.     

Spirometry of healthy adult South African men. Part I. Normative values

AIM: To determine normative spirometric values for black and white South African men. METHODS: A population of 796 bank personnel were subjected to spirometry and anthropometric measurements. An exhaustive questionnaire and radiographic screening process was used to identify a healthy population. Spirometry was performed using two calibrated instruments, a sleeve sealed piston spirometer (Autolink) and a bellows spirometer (Vitalograph). The methodological guidelines of the American Thoracic Society were observed. In the regression analysis Mallow's CP statistic was used to identify the best prediction models. RESULTS: Compelling evidence was found in support of incorporating sitting height in prediction equations. For the Autolink studies the prediction equations (based on age, standing height and weight) for forced vital capacity (FVC) (litres) were as follows: blacks: 0.053 height-0.030 age- 3.54; and whites: 0.056 height-0.038 age-3.07; for forced expiratory volume in the 1st second (FEV1) (litres) blacks: 0.036 height-0.032 age-1.18; and whites: 0.042 height-0.038 age-1.45. For the Vitalograph the equations were: FVC: blacks 0.048 height-0.024 age- 3.08 L; whites 0.056 height-0.031 age-3.42; FEV1: blacks 0.029 height-0.027 age-0.535; whites 0.042 height-0.036 age-1.84. CONCLUSION: The Vitalograph yielded significantly lower values than the Autolink for FVC measurements despite absolute consistency in methods. In view of the fact that the present study was conducted on healthy men, free from noxious industrial exposure, using state-of-the-art methods, these prediction equations may be regarded as the definitive norms for adult South African males.     

Should sperm donors be paid? A survey of the attitudes of the general public

Human immunodeficiency virus (HIV) infection has been associated with a wide spectrum of pulmonary disease. We report three HIV-seropositive patients with rapidly worsening airway obstruction associated with bronchiectasis. All subjects (age range 33-39 yrs) were cigarette smokers. Two had previously used intravenous drugs. The CD4 lymphocyte count ranged 40-250 cells x mm(-3). All individuals had complained of increasing dyspnoea for 3-6 months. Within 1 yr, they all developed severe airway obstruction with a decrease in both forced expiratory volume in one second (FEV1) and ratio of FEV1 to forced vital capacity (FEV1/FVC) to less than 60% of predicted value, and a decrease in mean forced expiratory flow at 25-75% of the forced vital capacity (FEF25-75) to less than 35% of predicted value. Computed tomography of the chest disclosed bilateral dilated and thickened bronchi. No classical causes of genetic or acquired bronchiectasis were identified in our patients. Recurrent bacterial bronchitis occurred in the follow-up period of the three patients. In conclusion, unusually rapid airway obstruction associated with bronchiectasis should be added to the wide spectrum of respiratory complications of human immunodeficiency virus infection.     

Microstimulation of movements from cerebellar-receiving, but not pallidal-receiving areas of the macaque thalamus under ketamine anaesthesia

We examined the effects from subjects, technicians and spirometers on within-session variability in successful recordings of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) in 4989 asymptomatic never-smoking men. All eligible men aged 30-46 years living in western Norway (n = 45,380) were invited to a cross-sectional community survey. Information on respiratory symptoms, smoking habits and occupational exposures was obtained from a self-administered questionnaire. Three successful FEV1 and FVC recordings were obtained in 26,368 attendants using three dry-wedge bellow spirometers operated by 10 different technicians. Within-subject standard deviation (SD) from three recordings of FEV1 and FVC was on average 102 and 106 ml, respectively, and increased with height (14 and 17 ml, respectively, per 10 cm) and body mass index (BMI) (11 and 14 ml, respectively, per 5 kg m-2). Between-subject SD of the mean of three FEV1 and FVC recordings was 591 and 754 ml, respectively, and increased in groups of increasing height (43 and 40 ml, respectively, per 10 cm). Small, but significant, differences were observed between technicians in within-subject SD and in levels of FEV1 and FVC. Homogeneity of between-subject variability, necessary for linear regression analysis, was obtained using FEV1 and FVC divided by height squared. In conclusion, within-subject variability in three successful spirometric recordings was small, but dependent on height and BMI of the subjects as well as technician performance. The observed heterogeneity in between-subject variation in FEV1 and FVC levels disappeared when each variable was divided by height squared. Novel multiple linear regression equations for FEV1/height2 and FVC/height2 were developed to be used in evaluating the effects from occupational airborne exposures in Nordic men aged 30-46 years.     

Monogenic determinants of familial Alzheimer''s disease: presenilin-2 mutations

An industry-wide pulmonary morbidity study was undertaken to evaluate the respiratory health of employees manufacturing refractory ceramic fibers at five US sites between 1987 and 1989. Refractory ceramic fibers are man-made vitreous fibers used for high temperature insulation. Of the 753 eligible current employees, 742 provided occupational histories and also completed the American Thoracic Society respiratory symptom questionnaire; 736 also performed pulmonary function tests. Exposure to refractory ceramic fibers was characterized by classifying workers as production or nonproduction employees and calculating the duration of time spent in production employment. The risk of working in the production of refractory ceramic fibers and having one or more respiratory symptoms was estimated by adjusted odds ratios and found to be 2.9 (95 percent confidence interval 1.4-6.2) for men and 2.4 (95 percent confidence interval 1.1-5.3) for women. The effect of exposure to refractory ceramic fibers on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), the ratio of the two (FEV1/FVC), and forced expiratory flow (liters/second) between 25 percent and 75 percent of the FVC curve (FEF(25-75)) was evaluated by multiple regression analysis using transformed values adjusted for height, by dividing by the square of each individual's height. For men, there was a significant decline in FVC for current and past smokers of 165.4 ml (p < 0.01) and 155.5 ml (p = 0.04), respectively, per 10 years of work in the production of refractory ceramic fibers. For FEV1, the decline was significant (p < 0.01) only for current smokers at 134.9 ml. For women, the decline was greater and significant for FVC among nonsmokers, who showed a decrease of 350.3 ml (p = 0.05) per 10 years of employment in the production of refractory ceramic fibers. These findings indicate that there may be important sex differences in response to occupational and/or environmental exposure.     

Evaluation of the incidence of clinical symptoms and risk factors for COPD based on the monitoring of refinery workers in Piock (1993-1996)

Work place environment plays an important role in development diseases because of the time spend in and different toxic factors placed in it. The aim of study was to assess the ventilatory efficiency in individuals employed in Generating Plant (GP) in relation to the pollution of the work place and the tobacco smoking habit during 3 years. The study covered a group of 144 male individuals employed at GP. (age 39.3 +/- 8.7 yrs, period of employment 20.3 +/- 8.6 yrs, smokers 53.5%. Lung function tests consisted of VC, FVC, FEV1, FEV1%VC, PEF, FEF50 counted from flow-volume curve and TGV, Rt measured using pletysmographic method. All tests were performed using pletysmograph (Masterlab) "Jaeger" placed on the ambulance near to the work place. The measurements were taken in May 1993 and 1996. Results were compared to with normal values (acc. ECSC). The anamnesis was obtained from all workers in the form of questionnaire projected for this study. All measurements were done during work time (9.00 a.m. to 2.00 p.m.). Mean values of the ventilation indices remained within the normal range but comparing results in smokers and non-smokers group significant differences in FEV1 and TGV were found. The symptoms of chronic bronchitis were present in 20.8% of persons. Spirometric criteria for the COPD diagnosis were found in 16 persons (11%). Only 5 persons (31%) were symptomatic. The mean decrease of FEV1 was 16.2 ml/yr, in the COPD group it was 82.5 ml/yr. The greater annual loss of FEV1 was found in the smokers and symptoms groups.     

Spirometry in life-long non-smoking, healthy Chinese women in Taiwan

To establish the spirometric values for normal, healthy Chinese women in Taiwan, the spirometry of 506 life-long non-smoking, healthy Chinese women was examined, including 140 subjects over the age of 60 years. Significant correlations among age, height and forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC%, peak expiratory flow (PEF), Vmax75, Vmax50, Vmax25 were found. However, there were no significant correlations between age and FEV1/FVC%, nor age and Vmax25 in the elderly group. FEV1 (FEV1*) and FVC (FVC*) were standardized to the overall mean height for elderly women using Cole's formula. The decline in FEV1* and FVC* with age were observed. The predicted value for the average 70-year-old woman with a height of 1.5 m derived from the present study is compared with those from other surveys of the elderly. The values from the present study are somewhat higher than the values from the Hong Kong study. The authors believe the fact that all of the present subjects were life-long non-smokers might explain the differences.     

Construction of anthropometric measuring chair (AMC) for lung function prediction

An anthropometric measuring chair (AMC) was constructed in order to predict lung function parameters (vital capacity--FVC and forced expiratory flow in the first second-FEV1) in normal Caucasian subjects. Design of a chair was aimed toward the fast and reliable recording of body dimensions, particularly of the human thorax. Static and dynamic measurements of thorax dimensions, arm span and sitting height were used to predict FVC and FEV1 with an accuracy better than standard prediction equations based only on body height and age. Computer program for automatic calculation of FVC and FEV1 according to prediction equations was constructed in VisualBasic 4.0 software. The prediction values for FVC and FEV1 based on anthropometric variables could be used in paraplegic, disproportional and handicapped individuals, where standard body height is unobtainable.     

Relationship between lung inflammation, changes in lung function and severity of exposure in victims of the Bhopal tragedy

The world's worst chemical industrial disaster, which occurred at Bhopal on 2-3 December, 1984, resulted in considerable respiratory morbidity in the exposed population. Therefore, a study was planned to evaluate the relationship between lower respiratory tract inflammation, lung function and severity of exposure. Sixty patients exposed to methyl isocyanate and presenting with respiratory symptoms were studied using bronchoalveolar lavage (BAL) 1-7 yrs after the accident. Pulmonary function tests included forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). An index of severity of exposure was derived retrospectively on the basis of the acute symptoms in the victims themselves or the occurrence of death among their family members. Total lung inflammatory cells (p < 0.01) and absolute numbers of macrophages (p = 0.01) and lymphocytes (p < 0.05) increased as severity of exposure increased. FEV1/FVC % (p = 0.05) was also significantly lower as severity of exposure increased. Moderately exposed subjects had significantly lower FEV1/FVC % (p < 0.05) compared to those mildly exposed. In nonsmokers, BAL neutrophils, both percentage and absolute numbers, showed significant negative correlations with FEV1 % predicted (rs = -0.350, p < 0.05; and rs = -0.374, p < 0.01, respectively). Neutrophil percentage was negatively correlated with FEV1/FVC % (rs = -0.378; p < 0.01). Absolute lymphocytes had significant negative correlations with FVC % pred (rs = -0.318; p < 0.05). Macrophages had significant positive correlations with FVC % pred (rs = 0.322; p < 0.05) and FEV1 % pred (rs = 0.433; p < 0.01). Radiographic abnormalities (International Labour Organization (ILO) classification) were associated with decline in FEV1 % pred (p < 0.05). This study suggests that pulmonary function abnormalities occur in gas-exposed subjects as a consequence of an abnormal accumulation of lung inflammatory cells (lymphocytes and neutrophils), and that the intensity of lung inflammation and reduction in pulmonary function are greater in severely exposed subjects. As it has been observed that decline in pulmonary function is associated with radiographic abnormalities, there is a suggestion that injury following toxic gas exposure can lead to irreversible lung damage.     

Respiratory findings in workers employed in the brick-manufacturing industry

We studied 233 male workers employed in two brick-manufacturing plants and 149 matched control workers. The mean age of the brick workers was 35 years, with a mean duration of employment in this industry of 16 years. The prevalence of chronic respiratory symptoms as well as acute symptoms during the work shift were recorded. Lung function was measured on Monday during the work shift by recording maximum expiratory flow-volume (MEFV) curves, from which the forced vital capacity (FVC), the one-second forced expiratory volume (FEV1) and flow rates at 50% and the last 75% of the FVC (FEF50, FEF75) were measured. The results of periodic chest roentgenograms were reviewed. There was a significantly higher prevalence of chronic cough (31.8%), chronic phlegm (26.2%), and chest tightness (24.0%) in exposed workers, compared with control workers (20.1%; 18.1%; 0%) (P < 0.05). This increased symptom frequency was also documented among nonsmokers studied by age and by length of employment, suggesting a work-related effect. Among work shift-related symptoms, high prevalences were noted for upper respiratory tract symptoms (e.g., dry throat, eye irritation, throat irritation). The measured FVC and FEV1 were significantly lower than predicted for brick workers and suggested a restrictive pattern. The mean FVC (as a percent of predicted) was 78.1% and FEV1 was 88.1%. The FEF50 and FEF25 were not significantly decreased. A multiple regression analysis with age, exposure, and smoking as predictors and lung function parameters as response variables showed a significant effect between exposure and FVC. Significant chest roentgenographic abnormalities were not documented. These findings of a restrictive lung function pattern in brick workers with normal chest roentgenograms may suggest early interstitial disease. Additionally, a bronchitic component, as suggested by the respiratory symptoms, may also be present.     

Validity of subjective assessment of changes in respiratory health status: a 30 year epidemiological study of workers in Paris

The validity of scales used for subjective assessment of health, particularly transitional indices, is under discussion. The aim of the present study was to assess the concurrent and predictive validity of a simple estimate of long-term subjective assessment of respiratory health changes. A longitudinal study of 915 workers was conducted over 30 yrs, with both retrospective self-assessment of respiratory health changes and objective measurements of spirometric values 12 yrs apart. An assessment of the reason for death during the subsequent 20 yrs was performed. Subjective assessment of respiratory deterioration over 12 yrs was significantly related to both cross-sectional lung function values and longitudinal lung function changes (forced expiratory volume in one second (FEV1) decline), an association which remained after adjustment for FEV1 level. It was also related to the same risk factors as decline in FEV1 (smoking, occupational exposure). Self-evaluation of respiratory deterioration was significantly predictive of death from all causes, with the highest (but nonsignificant) rate ratio for respiratory causes. Asthmatics exhibited greater long-term variability (objective and subjective) than nonasthmatics. Independent of dyspnoea, self-assessment of respiratory health deterioration was significantly related to FEV1. Subjective assessment of long-term changes in respiratory health provides valid information.     

Zebrafish vimentin: molecular characterization, assembly properties and developmental expression

In order to determine both clinical and spirometric changes due to high environmental concentrations of wheat dust at a wheat processing plant mill, 48 exposed men and 48 age and antroprometrically-matched, non-exposed apparently healthy men were studied. In both groups a medical and occupational history were taken, and spirometric measurements were carried out, that included Forced Vital Capacity (FVC), Forced Expiratory Volume at the first second (FEV1), Peak Flow Rate (PFR), Forced Percentual Expiratory Volume (FEV%), Forced Percentual Vital Capacity (FVC%), Forced Expiratory Flow at 25% (FEV25%), at 50% (FEV50%) and at 75% (FEV75%) of their Forced Vital Capacity, which were analyzed through Corzo's predictive equations and the lung deterioration's criteria by USA's Thoracic Association. The environmental wheat dust was determined by gravimetry and its concentration was higher than the legally admitted (3/5, 60%). There was a decrease in the PFR, FEV%, FEV25% and FEV75%. (p < 0.05). In addition, 4 restrictive and 1 obstructive syndrome were detected in the exposed workers and none in the control group. The spirometric values diminished in a positive correlation with the time of exposure and smoking habits. There was no correlation between the clinical findings and the dust concentration but it did exist with the spirometric values. It is concluded that in this plant, the wheat dust exposed workers have a diminished spirometric values.     

Morphology of peripheral airways in current smokers and ex-smokers

To investigate the effect of smoking status on pulmonary function and pathologic changes in the peripheral airways, we studied 97 patients who underwent thoracotomy for coin lesions. The patients were divided into 4 groups: nonsmokers (n = 9), current smokers (n = 51), and those who had ceased smoking for less than (n = 18) or more than (n = 19) 2 yr prior to surgery. We found that current smokers had evidence of air-flow obstruction with abnormal lung volumes when compared with nonsmokers. Ex-smokers had lung volumes similar to those of nonsmokers, but showed evidence of obstruction, with the FEV1/FVC between the values found for nonsmokers and current smokers. Examination of the small airways showed that the membranous bronchioles of current smokers and ex-smokers displayed only increased goblet cell metaplasia when compared with those in nonsmokers; the respiratory bronchioles of current and ex-smokers showed increases in intraluminal and airway wall inflammatory cells, wall fibrosis, and pigment deposition. We conclude that patients who currently smoke cigarettes have reduced lung function that is associated with abnormalities of airway structure. Although those who have stopped smoking have function that is closer to the nonsmoking group, there is no apparent difference in structural change between current and ex-smokers.     

Review of ECSC research work in ironmaking

The Treaty of the European Coal and Steel Community (ECSC), which expired in 2002, states in its Article 55 to promote technical and economic research with respect to the production and growing application of coal and steel. The results of funded research projects shall be made available to all representatives and partners concerned. For the European steel industry Article 55 was the basis for building up a steel research programme covering topics from raw materials to steel application and instigated a European network of researchers from the steel industry, research institutes and universities. On the basis of these research and development activities carried out by the ECSC steel research, the iron and steel industry has shown important advances in technology and environmental compatibility. Furthermore, the ECSC steel research has contributed to nearly all important technological developments. The main objective of the ECSC steel Research and Technology Development (RTD) programme was to sustain and develop the Community steel industry's competitiveness. The following report describes fundamental developments and activities within the framework of ECSC research with particular respect to hot metal production in the last 15 years.     

Follow-up study of changes in respiratory function in the same workers after an additional 6 years of exposure to pollutants in the rubber industry

Follow-up study of respiratory function was carried out in a group of 311 male workers employed in one rubber industry. The prevalence of respiratory symptoms and ventilatory capacity were recorded over te period of six years. Lung function was measured by recording maximum expiratory flow-volume (MEFV) curves on which forced vital capacity (FVC), one-second forced expiratory volume (FEVI) and flow rates at 50% and the last 25% of the vital capacity (FEF50, FEF25) were read. The prevalence of all chronic respiratory symptoms was higher during the follow-up study although not statistically significant (p > 0.05). During both studies smokers had significantly higher prevalence of chronic cough, chronic phlegm and chronic bronchitis than nonsmokers (p < 0.05 or < 0.025). Measured values of ventilatory capacity were significantly lower than predicted normal values during both studies (p < 0.01). Percentage of predicted values were lower during the follow-up study in comparison to that during the initial study. The mean lowest percentages were obtained for FEF25 (initial study: 77.4%; follow-up study: 70.5%). Smokers had larger mean annual decrease of FVC: 0.073 L; FEVI: 0.063 L; FEF50: 0.100 L/s; FEF25: 0.085 L/s than nonsmokers (FVC: 0.063 L; FEVI: 0.058 L; FEF50: 0.083 L/s; FEF25: 0.058 L/s). Workers exposed for more than 10 years had larger mean annual decrease of ventilatory capacity tests than hose with shorter exposure. Our data indicate that exposure to noxious agents in rubber industry may be responsible for the development of chronic respiratory symptoms and chronic lung function changes.     

Cigarette smoking is associated with unhealthy patterns of nutrient intake: a meta-analysis

The aim of this investigation was to assess the relationship between smoking status and nutrient intakes using a meta-analysis. Publications in English were sought through a Medline search using the following key words: food habits, eating, feeding behavior, diet, food, nutrition, nutritional status or assessment, tobacco use disorder, tobacco, nicotine and smoking. Scanning relevant reference lists of articles and hand searching completed the data collection. No attempt was made to search for unpublished results. Paper selection was based on nutritional surveys including comparisons of smokers with nonsmokers. Fifty-one published nutritional surveys from 15 different countries with 47,250 nonsmokers and 35,870 smokers were used in the analysis. The estimates of size effects were calculated with the mean and variance values of each nutrient intake and the size of the sample. Smokers declared significantly (all P < 10(-5)) higher intakes of energy (+4.9%), total fat (+3.5%), saturated fat (+8.9%), cholesterol (+10.8%) and alcohol (+77.5%) and lower intakes of polyunsaturated fat (-6.5%), fiber (-12.4%), vitamin C (-16.5%), vitamin E (-10.8%) and beta-carotene (-11.8%) than nonsmokers. Protein and carbohydrate intakes did not differ between smokers and nonsmokers. There was no evidence of heterogeneity among studies. In conclusion, the nutrient intakes of smokers differ substantially from those of nonsmokers. Some of these differences may exacerbate the deleterious effects of smoke components on cancer and coronary heart disease risk.     

Relationship between pulmonary test variables and asthma and wheezing: a validation of self-report of asthma

We investigated the relationship between the pulmonary test variable measurements and self-reported asthma and wheezing from a cross-sectional study conducted in Saskatchewan. Based on the responses to the questionnaire, the subjects were classified into asthmatic, wheezing, and asymptomatic groups. For both male and female subjects the mean values of forced expiratory volume in 1 s (FEV1), forced expiratory flow during the middle half of the forced vital capacity (FEF25-75), and FEV1/FVC ratio were lowest in asthmatics, followed by wheezing and asymptomatic groups, respectively. This trend was also observed in forced vital capacity (FVC) for men but not for women. After adjusting for current smoking status, the trend in the means across the three groups was statistically significant in men for FEV1 (p = 0.03), FEF25-75 (p = 0.002), and FEV1/FVC ratio (p = 0.002) and in women for FEF25-75 (p < 0.001) and FEV1/FVC ratio (p < 0.001). The differences in the adjusted means of FVC, FEV1, FEF25-75, and FEV1/FVC ratio between asymptomatic subjects and the other two groups were significant in both male and female subjects. Significant differences were also observed between asthmatics and wheezing groups in the adjusted means of FEF25-75 and FEV1/FVC ratio in male and female subjects. We conclude that the self-report of asthma has a high level of validity against the criterion of concurrently measured pulmonary test variables.