Decrements In Forced Vital Capacity Research Articles

Metrics of progression and prognosis in untreated adults with thymidine kinase 2 deficiency: An observational study

This historical cohort study evaluated clinical characteristics of progression and prognosis in adults with thymidine kinase 2 deficiency (TK2d). Records were available for 17 untreated adults with TK2d (mean age of onset, 32 years), including longitudinal data from 6 patients (mean follow-up duration, 26.5 months). Pearson's correlation assessed associations between standard motor and respiratory assessments, clinical characteristics, and laboratory values. Longitudinal data were assessed by linear regression mixed models. Respiratory involvement progressed at an annual rate of 8.16% decrement in forced vital capacity (FVC). Most patients under noninvasive ventilation (NIV) remained ambulant (12/14, 86%), reduced FVC was not associated with concomitant decline in 6-minute walk test (6MWT), and 6MWT results were not correlated with FVC. Disease severity, assessed by age at NIV onset, correlated most strongly at diagnosis with: creatinine levels (r = 0.8036; P = 0.0009), followed by FVC (r = 0.7265; P = 0.0033), mtDNA levels in muscle (r = 0.7933; P = 0.0188), and age at disease onset (r = 0.7128; P = 0.0042). This population of adults with TK2d demonstrates rapid deterioration of respiratory muscles, which progresses independently of motor impairment. The results support FVC at diagnosis, mtDNA levels in muscle, and age at disease onset as prognostic indicators. Creatinine levels may also be potentially prognostic, as previously reported in other neuromuscular disorders.

Firefighters and COVID-19: An Occupational Health Perspective.

Firefighters and COVID-19: An Occupational Health Perspective.

Cross-Shift Changes in Pulmonary Function and Occupational Exposure to Particulate Matter among E-Waste Workers in Ghana

Objectives: To examine the association between cross-shift changes in pulmonary function (PF) and personal inhalation exposure to particulate matter (PM) among informal electronic-waste (e-waste) recovery workers with substantial occupational exposure to airborne pollutants from burning and other e-waste recovery activities.Methods: Using a cross-shift design, pre- and post-shift spirometry and concomitant personal inhalation exposure to personal PM (sizes <1, < 2.5, and the coarse fraction, 10-2.5 µm in aerodynamic diameter) were measured among e-waste workers (n=142) at the Agbogbloshie e-waste site and a comparison population (n=65) in Accra, Ghana. Linear mixed models measured associations between percent changes in PF and personal PM; self-reported exposures; and (image-based) activities. Results: Following 4 hour (+ 44 min) work-shifts, decelerations in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) per hour were observed among e-waste workers (2.2% and 1.2%, respectively) and the reference population (1.5% and 0.8%, respectively). Despite significantly higher concentrations of personal PM (all sizes) among e-waste workers, increases in PM (all sizes) were not associated with decelerations in PF in either group. Indicative of a lag-effect, e-waste workers who worked “yesterday” had a larger decrement in FVC (2.4%, 95%CI: -4.04, -0.81) in comparison to those that did not work “yesterday”.Conclusions: The acute respiratory-related health effects due to PM exposure among e-waste workers remains unclear. Limitations included potential selection bias due to the “healthy worker” effect and challenges in eliciting valid PF assessments among e-waste workers, short shift duration, the lack of an inception cohort, and inability to measure pre-shift PF among e-waste workers who sleep at the site (89%). Cross-shift studies are useful for generating robust evidence in traditional work settings; however, they need to be adapted to informal settings where workers do not “clock-in” at the start of a shift.

Adverse respiratory effects associated with cadmium exposure in small-scale jewellery workshops in India

BackgroundCadmium (Cd) is an important metal with both common occupational and environmental sources of exposure. Although it is likely to cause adverse respiratory effects, relevant human data are relatively sparse.MethodsA...

GIS-Modeled Indicators of Traffic-Related Air Pollutants and Adverse Pulmonary Health Among Children in El Paso, Texas

Investigators examined 5,654 children enrolled in the El Paso, Texas, public school district by questionnaire in 2001. Exposure measurements were first collected in the late fall of 1999. School-level and residence-level exposures to traffic-related air pollutants were estimated using a land use regression model. For 1,529 children with spirometry, overall geographic information system (GIS)-modeled residential levels of traffic-related ambient air pollution (calibrated to a 10-ppb increment in nitrogen dioxide levels) were associated with a 2.4% decrement in forced vital capacity (95% confidence interval (CI): -4.0, -0.7) after adjustment for demographic, anthropomorphic, and socioeconomic factors and spirometer/technician effects. After adjustment for these potential covariates, overall GIS-modeled residential levels of traffic-related ambient air pollution (calibrated to a 10-ppb increment in nitrogen dioxide levels) were associated with pulmonary function levels below 85% of those predicted for both forced vital capacity (odds ratio (OR) = 3.10, 95% CI: 1.65, 5.78) and forced expiratory volume in 1 second (OR = 2.35, 95% CI: 1.38, 4.01). For children attending schools at elevations above 1,170 m, a 10-ppb increment in modeled nitrogen dioxide levels was associated with current asthma (OR = 1.56, 95% CI: 1.08, 2.50) after adjustment for demographic, socioeconomic, and parental factors and random school effects. These results are consistent with previous studies in Europe and California that found adverse health outcomes in children associated with modeled traffic-related air pollutants.

Pulmonary Function Changes of Ozone Exposed Workers in a Film Manufacturing Company

1) Objectives: To investigate the pulmonary function changes of ozone exposure in Corona and Slitter workers exposed to an ozone level ranging from 0.022~0.061 ppm. Methods: Forty-two subjects were exposed for 8hrs to ozone every day. We perfomed pulmonary function testing immediately before and after work and self-administered, portable peak flow meter mea- surements were self-conducted by the workers over a 5-day (Monday to Friday) period. Results: Ozone concentrations in the workplace ranging from 0.050~0.061 ppm at Corona and 0.022~0.023 ppm at Slitter in 2006. A small decrement in forced-vital capacity were observed among Corona workers from 93.9% to 91.3% (p=0.012) and also in employment duration below ten years. We found no significant differences in before and after FVC and FEV1 among Slitter workers. All daily (Monday to Friday) peak expiratory flow rates declined in magnitude after two days of ozone exposure, compared with first day exposure. Conclusion: We concluded that daily ozone exposure in the workplace slightly decreased pulmonary function and that PEFR variability is greatest on the 2 nd day of ozone exposure.

Protective effect of ipratropium bromide on bronchoconstriction induced by sulfur dioxide exposure during apricot sufurization processes that causes asthma-like syndrome in agricultural environment

We previously showed that apricot sulfurization workers are exposed to high concentrations of sulfur dioxide (SO 2), resulting in an asthma-like syndrome. The aim of this study was to investigate whether pre-treatment of ipratropium bromide protects bronchoconstriction induced by SO 2 exposure during apricot sulfurization processes that causes asthma-like syndrome. Firstly, pulmonary function tests were measured before and immediately after SO 2 exposure due to processes of apricot sulfurization in 21 healthy volunteer apricot sulfurization workers who did not use any medication in apricot farms. One week later, same measurements were repeated in the same workers when they were working in same farm but they were administered two puffs of ipratropium bromide (20 μg per dose) before 30 min second SO 2 exposure for protection of SO 2-induced bronchoconstriction. Occupational SO 2 exposure caused significant decrement in forced vital capacity (FVC), forced expiratory volume (FEV 1) and forced mid-expiratory flow rate (FEF 25–75%) in the worker and these decrements were prevented by ipratropium bromide given 30 min before SO 2 exposure. This result suggests that pre-treatment of ipratropium bromide protects SO 2-induced bronchoconstriction in healthy worker during apricot sulfurization processes that causes asthma-like syndrome in agricultural environment.

GENDER DIFFERENCES IN PULMONARY FUNCTION OF ELITE ICE HOCKEY PLAYERS

It has been reported that a high percentage of ice arena athletes are susceptible to exercise-induced asthma (EIA). Few studies have been completed regarding gender differences in pulmonary functions of EIA positive (EIA+) athletes. Research suggests little gender difference. Pulmonary function testing was completed on 31 male (M) and 33 female (F) elite National Team ice hockey players using standard spirometry. Forced exhalation time (FET) and maximal decrements in forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), mid-expiratory flow rate (FEF25–75%), and peak flow (PEF) were measured after high-intensity on-ice exercise. A ± 7% post-exercise fall in FEV1 was considered EIA+; six members of each team (19.4% M, 18.2% F) were diagnosed as EIA+. Maximum fall in FEV1 was equal between genders (−10.1% M, 10.2% F) and large but non-significant differences were noted in PEF fall (−10.6% M, −20.4% F). M suffered greater falls in FVC (−14.3% vs. −4.0%, p = 0.002); F showed greater falls in FEF25–75% (−21.4% vs. +2.7%, p = 0.001). A non-integrated interpretation of FEF25–75% suggests small airway dysfunction in F and normal small airway function in M. However, the large post-exercise fall in FVC suggests small airway dysfunction in M. This concept is supported by the lack of interaction between EIA diagnosis and FET for either gender. We conclude that caution should be used when interpreting mid-expiratory flows for EIA diagnosis. Masking of FEF25–75% by large falls in FVC may be resolved by examining iso-volume mid-expiratory flow rates. Supported by the United States Olympic Committee.

Association between asbestos-related pleural plaques and resting hyperventilation.

This study reports an association between pleural plaques and resting hyperventilation in a group of workers exposed to asbestos. Information on exposure level, pack-years of cigarette smoking, chest radiographs, ventilation parameters, single-breath diffusing lung capacity, and arterial gases were obtained for 344 workers. After the exclusion of 37 workers for isolated parenchymal fibrosis, combined pleuroparenchymal fibrosis, or diffuse pleural thickening, 55 subjects with isolated pleural plaques were evaluated against 252 no-plaque workers. A quantitative pleural score revealed mild pleural disease. Forty-four workers with plaques (80%) had hypocapnia induced by resting hyperventilation. The quantitative pleural score correlated significantly with the partial pressure of carbon dioxide in arterial blood (correlation coefficient = 0.7). A decrement in forced vital capacity was associated with plaques, whether controlled for age, smoking, and exposure or not. It was concluded that the resting hyperventilation observed in some asbestos-exposed subjects is related to the presence of mild pleural plaques and a restrictive disorder.

Intraoperative Wound Infiltration With Bupivacaine in Patients Undergoing Elective Cholecystectomy

In a double-blind randomized trial, 50 patients scheduled for elective cholecystectomy received 50 mL of either 0.25% bupivacaine hydrochloride or physiologic saline by wound perfusion at the end of the operation before wound closure. The duration of incisional infiltration, total amount of postoperative analgesics administered, and total hospital stay were recorded. Pulmonary function tests were performed the day before surgery and 1 day after surgery. There was no difference between the two groups with regard to duration of analgesia, the amount of analgesics administered, or the total hospital stay. Both groups also had similar decrements in forced vital capacity and forced expiratory volume on the first postoperative day. We conclude that wound infiltration with 0.25% bupivacaine after elective cholecystectomy is not effective in reducing postoperative pain. Lung function disturbances cannot be prevented.

Pulmonary function and pleural fibrosis: Quantitative relationships with an integrative index of pleural abnormalities

Pleural fibrosis due to asbestos exposure was fully appreciated considerably later than pulmonary interstitial fibrosis due to similar exposure. This is well exemplified by the fact that pleura face on was included in the International Labour Office's International Classification of Radiographs of Pneumoconioses only in the last revision of the Classification. The functional relevance of pleural fibrosis, in particular circumscribed pleural fibrosis, has remained controversial. Since pleural fibrosis can occur at various sites (diaphragmatic plaques, chest wall in profile and face on, mediastinal) and can be of different thickness and extent, a comprehensive integrative assessment of pleural fibrosis was undertaken in order to permit a quantitative study of relationships between pleural fibrosis and pulmonary function. This approach was used for chest X-ray films of 1,584 asbestos insulation workers examined (1981-1983); 1,185 (75%) had pleural fibrosis. The distribution pattern of the integrative pleural index was found to be different in the subgroup with circumscribed (n = 975) from that with diffuse (n = 197) pleural fibrosis, with a higher profusion of high INDEX values in the latter. Stepwise regression analysis indicated that there was a significant inverse relationship between forced vital capacity (FVC) and the integrative index of pleural fibrosis in the subgroup with circumscribed pleural fibrosis. In the subgroup with diffuse pleural fibrosis, the obliteration of costophrenic angle(s), even with pleural fibrosis of limited extent, resulted in marked decrement in FVC% predicted; higher values of INDEX did not result in additional significant reductions of FVC. In those with both parenchymal and pleural abnormalities (n = 862) the pleural index was found to make a significant contribution, independent of that of parenchymal abnormalities, to decrements of FVC. Since pleural fibrosis has gradually become the predominant radiologically detectable abnormality in asbestos exposed workers, establishing its quantifiable functional relevance is useful.

Pulmonary function responses of young and older adults to mixtures of O3, NO2 and PAN.

The pulmonary function of 32 nonsmokers (eight men and eight women, 18-26 years of age; eight men and eight women, 51-76 years of age) was measured before and after two-hour exposures to (1) filtered air (FA), (2) 0.45 ppm ozone (O3), (3) 0.13 ppm peroxyacetyl nitrate + 0.45 ppm O3 (PAN/O3), (4) 0.60 ppm nitrogen dioxide + 0.45 ppm O3 (NO2/O3), and (5) 0.13 ppm PAN + 0.60 ppm NO2 + 0.45 ppm O3 (PAN/NO2/O3). Subjects alternated 20-minute periods of rest and exercise (ventilation = 25 L/min). Forced vital capacity (FVC) was measured pre-exposure and five-minutes after each exercise period. Forced expiratory volume in one sec (FEV1.0) and forced expiratory flow between 25 and 75 percent of FVC (FEF25-75%) were calculated from the FVC tests. Data were analyzed by 4-factor analysis of variance (sex, age, time period, exposure). The responses of men and women were similar. FA exposure induced no effects. The young subjects' decrements in FVC, FEV1.0 and FEF25-75% became significant (P less than 0.01) after the second exercise period of the O3, NO2/O3 and PAN/NO2/O3 exposures, while the PAN/O3 decrements were significant (P less than 0.01) after the first exercise period. Although PAN/O3 induced significant decrements earlier than the other conditions including O3, the mean pre- to post-exposure decrements for the four conditions including O3 were similar. In contrast, the older subjects had smaller and fewer significant decrements in pulmonary functions. They had significant mean decrements in FVC following the third exercise period of the NO2/O3 and PAN/NO2/O3 exposures, in FEV1.0 after the third exercise period of the PAN/O3 and NO2/O3 exposures, and in FEF 25-75% beginning after the second exercise period of the NO2/O3 exposure. The results suggest that older men and women are less responsive to O3 and mixtures of O3, NO2 and PAN than young men and women, and that O3 is responsible for the decrements observed in pulmonary function.

Pulmonary function responses of older men and women to ozone exposure

The pulmonary function of 8 men and 8 women (51 to 76 years of age), all nonsmokers, was measured before and after 2-h exposures to filtered air (FA) and 0.45 ppm ozone (O 3). The subjects alternated 20-min periods of rest and 20-min periods of cycle ergometer exercise at a workload predetermined to elicit a ventilatory minute ventilation ( dot V E ) of approximately 25 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and post-exposure. Forced vital capacity (FVC) was determined before and after exposure, and 5 min after each exercise period. Ventilatory minute volume ( dot V E ) was measured during the last 2 min of each exercise period, and heart rate was monitored throughout each exposure. The pulmonary function data were evaluated as the percentage change from pre- to post-exposure to partially remove the effect of differences between men and women in absolute lung volume. There were no statistically significant ( p > 0.05) differences between the responses of men and women to FA or O 3 exposure. There were no significant ( p > 0.05) changes in any variable consequent to FA exposure. Exposure to O 3 induced significant ( p > 0.01) decrements in FVC, FEV 3.0, and FEV 3.0 at post-exposure compared to pre-exposure. Ozone exposure induced no significant ( p > 0.05) effect on FEF25–75% or FEF75%. Men had a significantly ( p > 0.05) higher mean exercise V dot E than women (27.9 ± 0.29 L vs. 25.4 ± 0.8 L; mean ± SD. Since men and women had similar decrements in pulmonary function, even though the women inhaled less O 3, the data suggest that women may be somewhat more responsive to O 3 than men. We also compared the responses of our older subjects with those of young men and women that we studied with the same protocol, and with published results of other investigators who have studied young men and women. This comparison suggests that older individuals may be less responsive to O 3 than young individuals.

Effects of peroxyacetyl nitrate alone and in combination with ozone in healthy young women.

Metabolic and pulmonary functions were investigated in 10 nonsmoking, young adult women who were exposed for 2 h (21 °C WBGT) to four conditions: 1) filtered air (FA), 2) 0.27 ppm peroxyacetyl nitrate (PAN), 3) 0.48 ppm ozone (O3), and 4) 0.48 ppm O3 + 0.27 ppm PAN (PAN/O3). The subjects alternated 15-min periods of rest and 20-min periods of bicycle ergometer exercise eliciting a of 25 L. Functional residual capacity (FRC) was determined preand post-exposure. Forced vital capacity (FVC) was determined before and after exposure, as well as 5 min after each exercise period. Heart rate was monitored throughout the exposure, and metabolic functions were measured during the last 2 min of each exercise period. There were no changes in any variable consequent to FA or PAN exposure. During O3 and PAN/O3 exposures, a decrease in V T, a concomitant increase in f R, and no change in occurred. Both O3 and PAN/O3 induced significant (p < 0.05) decrements in FVC, FEV1.0, FEV2.0, FEV3.0, FEF25-75%, IC, ERV, and TLC, bu...

Duration of increased pulmonary function sensitivity to an initial ozone exposure.

The metabolic and pulmonary function effects were investigated in six non-smoking young adults who were exposed for 2 hours (22 degrees C WBGT) to: filtered air (FA) 0.45 ppm ozone (DAY1); and two days later to a second exposure to 0.45 ppm ozone (DAY2). The subjects alternated 20-minute periods of rest and 20-minute periods of bicycle ergometer exercise at a workload predetermined to elicit a ventilatory minute volume (VE) of 27 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and post-exposure. Forced vital capacity (FVC) was determined before and after exposure, as well as 5 minutes after each exercise period. Heart rate was monitored throughout the exposure, and VE, oxygen uptake (VO2), respiratory rate (fR), and tidal volume (VT) were measured during the last 2 minutes of each exercise period. There were no changes in any variable consequent to FA exposure. Both ozone exposures induced significant (P less than 0.05) decrements in FVC; FEV1.0 (forced expiratory volume in 1 second); FEV3.0 (forced expiratory volume in 3 seconds); FEF25-75% (average flow rate between 25% and 75% of FVC); and total lung capacity (TLC). The decrements following the DAY2 ozone exposure were significantly greater than following DAY1, and averaged 7.2 percentage points greater than those following the DAY1 exposure.

The Physiology of Marathon Running.

In brief: The marathon is one of the greatest tests of human endurance. This review article describes the physiological demands and responses of the respiratory, cardiovascular, and muscular systems to marathon running, focusing on the chain of oxygen transport needed to fulfill the aerobic requirements of marathon running. During the race, runners use about 75% of VO2 max. Increased levels of ventilation (> 80 liters· min(-1)) have been observed during the marathon. This can lead to decrements in forced vital capacity and respiratory muscle fatigue. Prolonged muscle activity during the run can cause muscle injury such as inflammation and necrosis of muscle fibers. Techniques for augmenting performance include endurance and interval training, diet manipulation, and racing strategy.

Pulmonary function adaptation to ozone in subjects with chronic bronchitis

Twenty smokers with chronic bronchitis were exposed to 0.41 ppm ozone for 3 hr-day for 5 consecutive days and reexposed 4 days later to determine (1) if they are sensitive to ozone, (2) if they adapt, and (3) if the adaptation lasts longer than 4 days. There were significant decrements in forced vital capacity (FVC) and forced expiratory volume in 3 sec (FEV 3) on the first day of the 5-day repeated exposures and also on reexposure 4 days following cessation of the sequential exposures. Symptoms experienced were mild and did not predominate on any exposure days. These results suggest that individuals with chronic bronchitis adapt rapidly to ozone and lose this adaptive phenomenon within 4 days. The small decreases seen in FVC and FEV 3 (⩽3%) appear to impose no more than minimal limitations on their daily activities.

Lung function after marathon running at warm and cold ambient temperatures.

using maximal expiratory flow-volume curves we studied the effects of endurance exercise on lung function in 46 and 41 runners before and after completion of a marathon race (42.2 km) at different ambient temperatures. There was a significant decrease (-3.9%; -5.9%) in the post-race forced vital capacity in runners at each marathon. The mean values for forced expiratory volume in one second did not change. Post-race peak flow at 50% of forced vital capacity were significantly decreased in runners participating in subfreezing conditions (-2 degrees C to -4 degrees C), but were unchanged when the ambient temperature was above freezing. These data demonstrated that healthy persons may develop bronchoconstriction during endurance exercise in subfreezing temperatures. The decrement in forced vital capacity noted in marathon runners competing at above freezing temperatures may be related to fuel metabolism and running performance.