Expiratory Flow Meter Research Articles

The effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to 18 years diagnosed with asthma: a systematic review protocol.

REVIEW QUESTION / OBJECTIVE The objective of this review is to identify the best available quantitative evidence related to the effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to18 years with a diagnosis of asthma. INCLUSION CRITERIA Types of participants This review will consider studies that include children, five to 18 years of age, of any gender, race, or ethnicity with a clinical diagnosis of asthma, who has participated in school-based asthma education programs that include their caregivers. Studies that include children younger than age five and older than age 18, with respiratory diseases other than asthma, who have not participated in school-based asthma education programs that include their caregivers will be excluded. Types of intervention(s) This review will consider studies that evaluate the effectiveness of school-based family asthma education interventions on the quality of life and number of asthma exacerbations of children with asthma compared to absence of school-based family asthma education programs. Types of outcomes This review will consider studies that include the following outcome measures: primary outcomes of quality of life and asthma exacerbations, and secondary outcomes of absences from school or work, physical activity intolerance, and emergency hospital visits as a result of asthma exacerbations. Quality of life can be measured by a valid and reliable tool such as the Pediatric Asthma Quality of Life Questionnaire. The number of asthma exacerbations can be measured by valid and reliable tools such as the TRUNCATED AT 250 WORDS

Metrological Aspects of Peak Expiratory Flow-Meters After Prolonged Use

SESSION TITLE: Pulmonary Physiology Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: There is scant information about the accuracy and reproducibility of the readings after prolonged use of mechanical peak expiratory flow-meters (PEF-meters) for monitoring of large airway function, both for clinical research purposes and routine management of asthma. The aim of this study was to test the reliability of peak expiratory flow (PEF) values measured with PEF-meters that have been used a prolonged period (two devices of five different types) using a clinical calibration procedure. METHODS: Five types of adult PEF-meters were tested before (new devices) and after a period of use of several years: Assess-Healthscan (8 years), Mini-Wright-Clement Clarke (7 years), Vitalograph-Vitalograph (5 years), PocketPeak-Ferraris (3 years) and Truzone-Monaghan (2 years). Comparisons with values from a Lily pneumotachograph (PT) (Pneumoscreen - E. Jaeger, Germany) were performed. In the first series of comparisons every PEF-meter was connected downstream in series with the PT and the same subject performed 40 partial to maximal forced expiratory maneuvers (MFEM), during a period of 160 minutes. In the second series of comparisons 30 adult patients performed randomized MFEM on each PEF-meter and on the PT, during a period of 30 minutes. RESULTS: ANOVA analysis revealed some differences in the accuracy of the different PEF-meters before and after a prolonged using period: the closest agreements to the PT before were Truzone and Mini-Wright, and after Assess and Mini-Wright. The best reproducibility for the before and after using period values was obtained in Assess and PocketPeak. CONCLUSIONS: The period for using of PEF-meters in a good conditions is much longer than that usually accepted and the replacement of PEF-meters should be restricted to cases of physical damage or obvious malfunction. Our results don't involve in any way the brand name of PEF-meters because we have the possibility to assess only two devices from every PEF-meters type and the number is statistically too small to characterise the brand name of PEF-meter type. CLINICAL IMPLICATIONS: These findings proved that PEF-meters can be used safely a longer period than expected, if their maintenance is flawless. DISCLOSURE: The following authors have nothing to disclose: Paraschiva Postolache, Octavian Petrescu, Floarea Mimi Nitu, Roxana Maria Nemes No Product/Research Disclosure Information

Pico de fluxo da tosse em pré-escolares: taxa de sucesso e reprodutibilidade teste-reteste

It is important to evaluate lung function in preschoolers. There are few studies related to pulmonary function tests with this part of the population. The purpose of this study was to evaluate the success rate and test-retest reproducibility of the cough peak flow (CPF) in a sample with children between four and six years old. The CPF was tested in 44 healthy children (26 boys, 18 girls), selected according to the ATS-DLD-78-C questionnaire, used to detect the presence of common respiratory diseases or induced by environmental exposure. An expiratory peak flow meter (Piko-I Electronic Peak Flow Meter, Pulmonary Data Services, USA) was used to measure CPF. The success rate was defined as the percentage of children able to perform the test according to the acceptability and reproducibility criteria. To evaluate the test-retest reproducibility, 10 children (according with the sample calculation) were reevaluated after three weeks. The study was approved by the Ethics Research Committee of the Institution. The test-retest reproducibility was evaluated by the paired t-test, considering a significance of p<0.05 and intraclass correlation coefficient (ICC). The results showed a success rate of 91% for CPF, with 80%, 88% and 100% for children with four, five and six years, respectively. Regarding the test-retest reproducibility, there was no significant difference between data of the first assessment and reassessment (p=0.39) and an ICC of 0.84 was observed. These results suggest an elevated success rate in the performance of CPF and an excellent test-retest reproducibility for this variable in healthy preschoolers.

Improving asthma care

The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php This practice profile is based on NS689 Hazeldine V (2013) Pharmacological management of acute asthma exacerbations in adults. Nursing Standard. 27, 33, 43-49. I care for many people with coexisting conditions, including asthma, in a nursing and residential care home. The CPD article helped me to change practice in this setting. Although the prevalence of asthma is slowly declining, it affects an estimated 3.8 million people in the UK. There have been advances in diagnosing and managing asthma, but exacerbations remain a problem, and early recognition of such exacerbations can save lives. Where I work, several service users experience asthma and other respiratory pathologies. All service users are monitored regularly using the National Early Warning Score (NEWS) observation chart, which includes temperature, pulse, blood pressure, respiratory rate, peripheral oxygen level and consciousness measurements. These parameters are measured routinely in the nursing and residential care home and recorded on clinical charts. It was interesting to read that the signs and symptoms of an acute asthma exacerbation can include cough, wheeze, dyspnoea, chest tightness and variable airflow obstruction. Patients with asthma and other respiratory conditions could be monitored more effectively using a peak expiratory flow (PEF) meter. PEF meters are low cost, portable, and easy to use. Using this meter, along with the NEWS observations, allows for greater monitoring of asthma and other respiratory conditions. Individuals with asthma ideally require a recorded PEF from within the last two years for comparison purposes. This would help nurses to determine if a service user was experiencing an acute asthma exacerbation. A series of PEF readings were taken for service users, initially only for those with asthma, to record baseline levels. PEF can be used with a traffic light system, and this is how it is used at the care home: Red (danger) – PEF less than 50% of the individual’s personal best indicates a medical alert. Advice should be obtained as soon as possible. At the care home, the service user’s GP or nurse practitioner responds as appropriate. Yellow (caution) – PEF 50-79% of the individual’s personal best indicates that the asthma is worsening. Medical review of the service user should be obtained. At the care home, the GP or nurse practitioner responds as appropriate. Green (safe) – PEF 80-100% of the individual’s personal best indicates that the asthma is under control and that the person should continue to be monitored. The rapid assessment of a service user during an asthma exacerbation is important. At the care home, individuals with asthma usually only develop exacerbations when they have an acute illness, such as a chest infection or pneumonia. Monitoring PEF and using the NEWS observation chart will help to improve the care I give NS

Peak Expiratory Flow Rates in Normal Healthy School Children of Central Karnataka, India

Background: PEFR is the easiest and most cost effective method to evaluate respiratory functions. PEFR can be measured by a simple instrument Peak expiratory flow meter. Measuring PEFR has been suggested as an important tool in asthma management by all International guidelines. The aim of this study was to determine the PEFR values in healthy school children of central Karnataka, India. Method: PEFR was measured in Two thousand and two hundred school children using mini Wright's Peak flow meter. All PEFR measurements were obtained in standing position and the best out of three trials were recorded. Height and weight were recorded. Regression analysis was used to calculate the predicted normal values of PEFR and also to assess its relation to weight and height. Results: Positive correlation was seen between age, height, weight and PEFR. The boys had higher values of PEFR than girls at all heights. The prediction equation based on height was PEFR = 5.63 (Ht) - 474.43, r = + 0.902 for boys and PEFR = 5.30 (Ht) - 451, r = + 0.876 for girls. Conclusion: PEFR values in this study were comparatively low to those of North Indian and western school children, High to those of other children of south India. The prediction equation obtained from the study can be used to detect PEFR values in central part of Karnataka.

Using Orem's self‐care model for asthmatic adolescents

The aim of the study was to determine the effect of Orem's self-care model on the self-care of adolescents with asthma. In this experimental design, adolescents with asthma (N = 80) received home visits and individualized care based on theory-guided nursing diagnoses. Patients in the experimental group were visited in their homes eight times, and those in the control group were visited two times. The five self-care skills of medicine usage, peak expiratory flow meter usage, applying an asthma action plan, keeping a daily follow-up schedule, and protecting against triggering factors differed significantly between the first and last visits in the experimental group, whereas the self-care skills of adolescents in the control group did not change. Applying Orem's self-care model increased the self-care skills of adolescents with asthma.

Variations in the peak expiratory flow rate with various factors in a population of healthy women of the malwa region of punjab, India.

The present study was undertaken to study the variations in the Peak Expiratory Flow Rate (PEFR) with various factors like age, height, weight, body surface area (BSA) and the Body Mass Index (BMI) in healthy women of the Malwa region of Punjab, India. Three hundred healthy women who were aged 20-50 years were selected from the Malwa region of Punjab and their PEFRs were determined. The influences of age, height, weight, BSA and BMI on the PEFR were studied. The PEFR test was performed by using a mini Wright Peak Expiratory flow meter. The mean PEFR of the women of the Malwa region of Punjab was found to be 395.87 ± 56.81 litres/minute. The PEFR increased with an increase in the age, height, weight and the BSA, but it decreased with an increase in the BMI. This study generated the preliminary values of PEFR for the women of the Malwa region of Punjab, India.

Development of a Self-Power Peak Expiratory Flow Meter

For a regular Digital Peak Respiratory Flow Metter, a strain gauge or similar probe is used to detect the strength of the blowing. The signal is then be analyzed by computer. In this innovative Self-Power Peek Respiratory Flow Meter, however, a generator is used. The generator is “one stone for two birds”: it serves as the digital signal generator to present the air flow data; it also provides the energy source to re-power the batteries. This allows people to use the equipment whenever and anywhere without worry of recharge or change batteries. Another advantage of the machine is its reliability. The blowing chamber is separated from the generator by magnetic (shaft-less) coupling, therefore, the moisture from blowing has no way to corrode the electric circuit or contaminate the instrument. Because of this innovative instrument is “Green”, “Digital” and easy of use, the application would be expanded. The Coreless Permanent Magnet Disk Generator technology (AFPM) is utilized to eliminate the cogging torque. Moreover, energy saving circuit design also implemented to make the self-power instrument a reality.

Focus on Diagnosis: Spirometry

1. Kamakshya P. Patra, MD 1. Department of Pediatrics, Mayo Clinic, Rochester, MN. * Abbreviations: FEF25%–75%: : forced expiratory flow, midexpiratory phase FEV1: : forced expiratory volume fraction in 1 second FVC: : forced vital capacity PEFR: : peak expiratory flow rate Office spirometry, traditionally done by the pulmonary specialist, has become commonplace in the pediatric primary care office. The National Asthma Education and Prevention Program guidelines recommend routine use of spirometry for the initial diagnosis and ongoing management of asthma. A nationwide survey demonstrated that only 21% of physicians used spirometry for the management of children with asthma, as per the guidelines. And, approximately one half of the physicians were unable to interpret the results of spirometry. Office spirometry has been shown to result in change in asthma management in 15% of children. In 45% of cases, the severity of asthma was underrated by the providers in the absence of spirometry. A peak flow meter, which measures peak expiratory flow rate (PEFR), is a simple, inexpensive, and portable device that may be helpful in the management of asthma. However, PEFR is effort-dependent and does not reflect small airway function. The average cost of a good spirometer is in the $1,500 to $2,000 range. There must be training of the office personnel who perform the spirometry, and the spirometer should be calibrated at least daily. In general, patients must be at least age 4 to 4.5 years to perform reliable forced vital capacity (FVC) maneuvers required for spirometry. A 7-year-old girl has experienced wheezing since age 3 years and has been diagnosed as having asthma. Her symptoms did not improve despite therapy with albuterol, corticosteroids, salmeterol, and monteleukast. She was referred to the pediatric pulmonology clinic for persistent symptomatology. Spirometry was performed, which revealed a fixed obstruction. Flow volume loops revealed truncation of inspiratory and expiratory limbs (Fig 1). Computed tomography scan of the …

Focus on Diagnosis

Focus on Diagnosis

Correlation of Nutritional Status and Peak Expiratory Flow Rate in Normal South Indian Children Aged 6 to 10 Years

BACKGROUND: Many studies have been proved the relation between the nutritional habit and respiratory functions in south Indian children. The increase in respiratory problems due to increase in Body Mass Index (BMI) in children has been a major worldwide problem. Deposition of fat over the chest wall alters the Peak Expiratory Flow Rate (PEFR) among pulmonary function test parameters. Among all the pulmonary function test parameters Peak expiratory flow rate (PEFR) directly indicate the nutritional status which is also an easy and non invasive method for estimating the lung function in children. AIM: To assess the effect of Body Mass Index (BMI) and Skin Fold Thickness (SFT) on PEFR in children aged 6 to 10 years of both the sexes. METHODS: We recruited 258 children aged 6 to 10 years of both sexes for our study. The anthropometric parameters including height, weight and BMI were measured. PEFR was measured using Peak Expiratory Flow Meter. The skin fold thickness was measured by using Digital skin fold caliper. Results were statistically analyzed by using Pearson Correlation co efficient test and ANOVA. RESULTS: In our study as age progresses the height of the children in both sexes also increases. Our results showed positive correlation between height, BMI and SFT with PEFR. Our results also showed as increase in age BMI remains constant however SFT showed positive correlation in our study population. CONCLUSION: We concluded that among the factors determine the nutritional status including BMI, effect of SFT on PEFR play an important role in the maintenance of normal pulmonary functions in children. Thus our study proved that the reason for the respiratory problem may be due to abnormal SFT which determines the total body fat apart from BMI.

Investigating the potential of hand-held expiratory flow meters in COPD screening programmes

Investigating the potential of hand-held expiratory flow meters in COPD screening programmes

Knowledge, attitude and practice of nurses toward peak expiratory flow meter in primary health care centers in Kuwait

BackgroundPeak expiratory flow meter (PEFM) is an easy to use, relatively cheap device that can be used for guiding management of bronchial asthma by the patients at home according to a preset plan by health care workers. ObjectiveThe aim of the study is to reveal the extent of knowledge and perception of nurses about PEFM and factors affecting their knowledge. MethodsOut of the total primary health care centers in Kuwait, 50% were randomly selected. Out of 699 nurses currently working in the selected centers, 516 nurses were interviewed for this study with an overall response rate of 73.8%. ResultsThe results of this study showed that nurses had a relatively low total knowledge score percent of 64.7 ± 7.3%. The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate (39.0 ± 24.1%). The highest percent knowledge score was that of benefits of use and content instructions for teaching patients (78.3 ± 19.5% and 78.1 ± 12.0%, respectively). Sociodemographic factors did not affect the total knowledge score. Receiving training, availability of PRFM in the health center and being responsible about taking the measurements for patients proved to significantly affect the level of knowledge of nurses. ConclusionTraining nurses about use of PEFM and providing primary health care centers with the devices would plan an important role to improve knowledge of nurses and hence improve domestic health care of patients with obstructive lung diseases.

Knowledge, attitude and practice of physicians and nurses toward peak expiratory flow meter in primary health care centers in Kuwait

BackgroundPeak expiratory flow meter (PEFM) may reduce diagnostic delay and improve decision-making in asthma by providing an objective assessment of their flow. Knowledge of nurses and physicians in primary health care can play an essential role to enhance the response of patients about the measurements of peak expiratory flow (PEF). ObjectiveThe aim of the study was to reveal the extent and pattern of knowledge and perception of physicians and nurses about PEFM. MethodsOut of the total primary health care centers in Kuwait; only 50% were randomly selected. A total of 895 physicians and nurses were interviewed out of 1324 individuals currently working in the selected centers for this study with an overall response rate of 74.4%. The questionnaire contained a knowledge section consisted of seven domains with a total of 41 questions. ResultsThe results of this study showed that physicians had a relatively higher total knowledge score percent than nurses (66.2 ± 10.5% compared with 64.7 ± 7.3%, P = 0.004). Physicians tended to have higher knowledge score for steps of use, defining normal values, and concepts of measurements domains of knowledge, while nurses had significantly higher score values for benefits of use, indicators of use, general concepts, and instructions for learning patients’ knowledge domains of PEFM. ConclusionDue to different patterns of knowledge and practice of nurses and physicians, training programs should be specifically tailored for each group to bridge the gap of knowledge and improve deficient practices.

Knowledge, attitude and practice of physicians toward peak expiratory flow meter in primary health care centers in Kuwait

BackgroundPeak expiratory flow meter (PEFM) may reduce diagnostic delay and improve decision-making in asthma by providing an objective assessment of their flow and hence identify air flow variability that is essential for management of air way diseases. ObjectivesThis study was designed to reveal extent of knowledge and perception of physicians about peak expiratory flow meter and factors affecting their knowledge. MethodsOut of the total primary health care centers in Kuwait; only 50% were randomly selected. Out of 625 physicians working in the selected centers, 469 physicians were interviewed with an overall response rate of 75.0%. ResultsThe results of this study showed that physicians had a relatively low total knowledge score percent of 66.2±10.5%. The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate (49.9±29.3%). The highest percent knowledge score was that of instructions for learning of patients about PEF (76.2±11.7%). Socio-demographic factors, receiving training, availability of PEF in the health center and being responsible about taking the measurements for patients showed inconsistent impact on the level of knowledge of physicians. ConclusionsFurther training of physicians about use of PEF and providing primary health care centers with PEF would play an important role to improve knowledge of physicians and hence improve domestic health care of patients with airway diseases.

Reference population equations using peak expiratory flow meters: an over view

Many formulae for predicting lung function values for Nigerians have been produced by a lot of investigators. The same principle but different statistical methods were adopted by different authors in generating these equations, hence the variability observed among these formulae. Most equations in current use are based on linear statistical models which are subject to change and they did not express the lower limit of normal. Therefore, in this study an attempt was made to give an over view of the currently available PEFR prediction equations that are in use in some of our out patient clinics in Nigeria. Some recommendations were also given on how to improve on future prediction formulae. Keywords: Reference population equations, PEFR, over view

Effect of occupational exposure to local powdered tobacco (snuff) on pulmonary function in south eastern Nigerians

The effect of occupational exposure to local powdered tobacco (snuff) on pulmonary function was studied. Snuff industry workers in Onitsha and Enugu markets were studied and compared with age, weight, and height-matched control not exposed to any known air pollutant. The pulmonary indices studied include forced vital capacity [FVC], forced expiratory volume in one second [FEV1] and ratio of FEV1/FVC as percentage using a vitalograph spirometer and Peak Expiratory Flow Rate [PEFR], using a mini Wright Peak Expiratory Flow Meter. The respiratory and non-respiratory symptoms frequently associated with these workers were also analyzed and dust sampling in both test and control environments was also done. The mean anthropometric parameters, [age, height and body weight] between the two groups were not statistically different. The results obtained showed statistically significant impairment of lung function of workers chronically exposed to snuff. FVC, FEV1 and PEFR in the exposed [test] subjects were significantly decreased in comparison with the control subjects [P<0.05]. However, the mean value of FEV1/FVC [%] of the test subjects was 86.8% which was within the normal range and was not significantly different from control. This signified that the test subjects had restrictive pattern of lung function defect. All respiratory symptoms, such as cough, chest tightness had a higher prevalence in test subjects than their control group. The lung function indices of snuff-producing workers proportionately decreased with their length of exposure in the industry. The respirable dust level in the vicinity [indoor] of the snuff-workers [1.11+/-0.35 mg/m3] was significantly [P<0.001] higher than in the control environment[0.37+/-0.086 mg/m3]. Although it was not possible to determine all the factors that may be responsible for lung function impairment, the dust sampling result showed that chronic exposure to Nigerian snuff [powered tobacco] dust impairs lung function and the effect is progressive with time.

Influence of self-reported socio-economic status on lung function of adult Nigerians

Objectives Low socio-economic status is known to be associated with reduced lung function in childhood and early adulthood, and an increased risk of cardiovascular disease in older adults. The lung function of people in developing nations is known to be lower than that of their counterparts in developed nations. This study assessed whether childhood socio-economic status is related to lung function in adults in Nigeria. Design Cross-sectional study. Setting Ife central local government, Ile-Ife, Nigeria. Participants One thousand nine hundred and thirty healthy adults aged 40 to 80 years took part in the study. Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV 1) were measured with a spirometer, and peak expiratory flow (PEF) was measured with a mechanical peak expiratory flow meter. The socio-economic status questionnaire gave equal importance to education, occupation and family income. Based on the score, the subjects were classified as lower, middle or higher status. Main outcome measures Spirometry, assessment of peak flow meter and questionnaire to assess socio-economic status. Results The results showed a difference between the group with the highest socio-economic status and the other two groups [mean (standard deviation) FVC: high 3.63 l (0.33), middle 3.57 l (0.41), low 3.38 l (0.35)]. The mean difference between the high and middle socio-economic groups was 0.07 l [95% confidence interval (CI) 0.02 to 0.11]. A similar difference existed for FEV 1: high 3.16 l (0.28), middle 3.06 l (0.31), low 2.94 l (0.34). The mean difference between the high and middle socio-economic groups was 0.11 l (95% CI 0.07 to 0.15). Values for PEF were: high 404.30 l/second (35.98), medium 390.56 l/second (41.53), low 376.03 l/second (45.81). The mean difference between the high and medium socio-economic groups was 13.74 l/second (95% CI 8.42 to 19.06). There was a weak but significant association between socio-economic status and FVC ( r = 0.28), FEV 1 ( r = 0.26) and PEF ( r = 0.25). Conclusion Self-reported low socio-economic status is associated with lower lung function among adult Nigerians. This may increase their risk for respiratory and cardiovascular disease.

Asthma in men and women: Treatment adherence, anxiety, and quality of sleep

The aim of this study was to compare female and male asthmatics with special emphasis on reported adherence, anxiety, and quality of sleep. The study included 470 subjects with current asthma from the Nordic countries, who took part in the European Community Respiratory Health Survey (ECRHS) II. Subjects were investigated with a structured clinical interview, including questions on the presence of respiratory symptoms and therapy. They were also asked to fill in the self-reported Hospital Anxiety Depression scale and the Basic Nordic Sleep Questionnaire. Inhaled corticosteroids (OR=0.55) and a doctor's appointment in the last 12 months (OR=0.54) implied a significantly reduced risk for non-adherence in normal situations. At exacerbation in asthma, women had a significantly decreased risk for non-adherence (OR=0.46). Female gender and anxiety were independent risk factors for both insomnia (OR=3.67 and 2.53, respectively) and daytime sleepiness (OR=2.53 and 2.04, respectively). Women with asthma have a more positive attitude towards their medication, have a higher reported adherence, and use inhaled corticosteroids more often than men. At the same time women report more often anxiety and insomnia than men. Awareness of sex differences in the manifestations and attitudes towards treatment of asthma is important in order to improve asthma management.

A Study on the Effect of Ambient Fine Particles on Peak Expiratory Flow Rates of Children

ISEE-0600 Background & Objectives: This study was conducted to investigate and assess children’s lung function decrement in association with exposure to ambient fine particles in Seoul. Methods: The study group consisted of the fourth grade children in a primary school located in Seongbuk-district, Seoul. We monitored ninety two children for PEFR three times a day by peak expiratory flow meter from 25 June to 19 July, 2007. However, each student’s lung function, FVC and FEV1, were measured on the first day. In addition, mass concentrations of PM10, PM2.5 and number concentration of particles (PNC) were measured everyday for 25 days. Results: The values showed 1.97 ± 0.30L in FVC, 1.81 ± 0.25L in FEV1 and 327.25 ± 43.91L/min in PEFR. The mean concentrations of PM10, Coarse (coarse particle mass, PM10-PM2.5), PM2.5 and PNC were 42.41, 15.45, 26.96 ug/m3 and 7,672 ± 3,498 particles/cm3. PEFR was decreased 7.028 L/min in PM10, 4.628 L/min in coarse and 6.040 L/min at one day before exposure (Lag 1) to daily IQR(Inter quartile range) increases of ambient fine particles (P < 0.05). According to the distance from a main street to residential areas, we classified this study group into three; A (more than 100M), B (50–100M) and C (near within 50M) group. Daily mean PEFR was 330.63 ± 35.82 L/min in group A, 331.14 ± 42.21 L/min in group B and 313.72 ± 38.82 L/min in group C. Group C showed lower value than group A and B in daily PEFR (P < 0.05). Conclusion: In the study for the investigation of the relationship between pulmonary function and ambient fine particles, it showed a significant decrease of the next day’s PEFR (Lag1) by the increase of PM10, Coarse and PM2.5. Daily mean PEFR was lower in students living nearby the roadside, which can be affected by particulates from traffics easily than in students in residential areas far from the roadside.