Prevalence Of Lung Function Abnormalities Research Articles

Pulmonary functions test in asymptomatic rheumatoid lung disease patients: a hospital-based study

BackgroundAs a common extra-articular symptom of rheumatoid arthritis (RA), pulmonary involvement affects 20–67% of patients and accounts for 10–20% of RA-related deaths. This study aimed to assess the impact of RA on pulmonary function tests (PFTs) in Sudanese RA patients attending the rheumatology clinics of the Omdurman Military Hospital.MethodsThis was an analytical, cross-sectional, hospital-based study of 32 RA patients who met the 2010 Rheumatoid Arthritis Classification Criteria of the American College of Rheumatology (RA ACR/EULAR) and who were nonsmokers and free of known respiratory or chronic diseases. Pulmonary function parameters (PFTs), including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio, and the peak expiratory flow rate (PEFR), were measured for each participant using a digital spirometer. A control group of Sudanese subjects of similar age, sex, and height was matched, and the results were compared with normal reference values.ResultsA high prevalence of lung function abnormalities (93.8%) was observed in RA patients, and 6.2% of them had normal PFT parameters. Restrictive lung disease was recorded in 78.1% of the patients, and obstructive lung disease was observed in 15.7% of the patients. All measured PFT parameters in the RA patients were significantly lower than the published reference normal values for Sudanese subjects, except for the FEV1/FVC ratio. The mean values of FEV1, FVC, the FEV1/FVC ratio, and the PRFR in RA patients were 1.8 ± 0.3 L/min, 2.1 ± 0.4 L/min, 87.1 ± 12.2%, and 223.6 ± 86.2 L/min, respectively, compared to 2.4 ± 0.1 L/min, 2.7 ± 0.1 L/min, 90.81 ± 2.6%, and 345.4 ± 16.2 L/min, respectively, in the control group (P values of 0.001, 0.001, 0.299, and 0.001, respectively). There was no statistically significant correlation between PFT results and disease duration, age, or BMI.ConclusionsRegardless of the duration of RA, restrictive lung abnormalities are frequent in asymptomatic RA patients. The PFT can serve as an indicator of RA. Spirometry has been advised as a baseline examination and for follow-up and to promote the early detection and management of pulmonary involvement in RA patients.

Comparative study of pulmonary functions test among different substances abusers

BackgroundSubstance use is a problem that affects people all over the world and is prevalent in different age groups. The lungs in particular, with their unique exposure to the environment and the bloodstream, are vulnerable to damage from substance use and can affect lung function. Efforts have generally focused on cigarettes, while there is little research on different substances of use. The study aimed to detect changes in pulmonary function tests in different substance users.MethodsAn analytical cross-sectional study was carried out among different substance users at the Abdalaal Elidridi Psychiatric Hospital. A total of 60 adults were included: 16 cannabis users, 16 heroin users, 16 methamphetamine users, and 12 alcohol users. Participants used only one substance. Height and weight were measured, and BMI was calculated. For each participant, pulmonary function tests (PFTs) including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio and peak expiratory flow rate (PEFR) were measured using an electronic spirometer, and the results were compared with normal reference values for Sudanese subjects matched for age, sex, and height.ResultsA high prevalence of lung function abnormalities (100.0%) is seen in all abusers. Obstructive lung disease is found in 80.0% of patients, and restrictive lung disease is found in 20.0% of cases. The measured FEV1/FVC ratio in different substance groups was lower than the expected normal values of (88.2 ± 2.9%). The mean FEV1/FVC ratio of alcohol was (83.6 ± 7.6%), for heroin, it was (77.3 ± 15.8%), for methamphetamine, it was (77.7 ± 17.8%) and for cannabis, it was (71.03 ± 11.3%), the latter was significantly lower than the other two groups (P < 0.001). Duration of substance use was inversely correlated with the FEV1/FVC ratio (r = -0.378, P 0.001), indicating that a longer duration of substance use correlates with lower FEV1/FVC ratios.ConclusionsObstructive lung abnormalities are frequent in substance abusers. All types of substances have a major deleterious effect on PFTs and harm the respiratory system. More action should be taken to address the effects of substances on the lungs. Awareness, early detection, and intervention are essential.

Lung Function and Respiratory Symptoms of Petrol Station Attendants in Central and North Jakarta and Its Contributing Factors

Background: To satisfy growing needs of petrol consumption in big city many new petrol stations has been built. Petrol station attendant is considered to have high risk exposure to dangerous pollutant from motor vehicle emission and petrol fumes, especially while filling up petrol tanks. Combination of those exhaust and petrol fumes is suspected to cause the reduction of lung function.&#x0D; Methods: This research is a cross sectional study in petrol station in Central Jakarta and North Jakarta region between August 2017 and February 2018. A total of 97 petrol station attendants were taken in this research using consecutive sampling technique. The subjects were interviewed with questionnaires, spirometry and chest radiograph. Measurements of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), particulate matter 2,5 (PM 2,5) and steam gasoline (benzene) concentrations were performed at the study sites.&#x0D; Results: In this study, 56.7% normal spirometry results, 42.3% abnormalities in the form of restriction, 1% obstruction and none of which experienced mixed disorders of restriction and obstruction. Most subjects (84.6%) did not experience respiratory complaints, 10.3% had a dry cough and 5.1% complained of cough with phlegm. There was a statistically significant association between peak expiratory flow and duration of work (p=0.011), but no significant association with other parameters such as forced vital capacity (FVC), %FVC, forced expiratory volume in the first second (FEV1), %FEV1 and the ratio of FEV1/FVC.&#x0D; Conclusion: Prevalence of lung function abnormalities of petrol station attendant is 43,3% and respiratory symptoms at 15,4% subject.

Prevalence of lung function abnormalities in smokers with coronary artery disease

The prevalence of lung function abnormalities appears to be higher in smoking patients with ischemic heart disease (IHD) than within the general adult population. However, the prevalence of lung function abnormalities in these patients has been poorly investigated. The aim of this study was to investigate the prevalence of lung function abnormalities in smoking patients with IHD. This cross-sectional study conducted in FSI hospital in Tunisia included smoking patients (≥ 10 pack-year) with suspected CAD. Pre and post-bronchodilator spirometry was performed according to international standards. Airflow limitation (AL) and restrictive lung function (RLF) are diagnosed according to international guidelines. Spirometry was undertaken for 122 men with mean age of 59.3 ± 9.5 years and mean pack-year of 52.3 ± 28.3. Mean CAD follow-up duration was 3.9 ± 4.5 years. Spirometry was normal in 63.9% of cases. AL was observed in 20.5% of patients: 5.7% had mild AL, 12.3% had moderate AL, 1.6% had severe AL and 0.8% had very severe AL. Most patients with AL (72%) had no previous spirometry testing or diagnosed pulmonary disease. Chronic obstructive pulmonary disease was the etiology of AL in 96% of patients. RLF was observed in 7.4% of patients and small airway disease in 8.2%. Obesity was the etiology of RLF. AL was associated with greater respiratory symptomatology, chest-X-ray abnormality and pulmonary arterial hypertension ( P < 0.05). Airflow limitation compatible with chronic obstructive pulmonary disease affects almost a fifth of patients with ischemic heart disease. While airflow limitation is associated with additional morbidity, it is largely undiagnosed and untreated.

The effect of HIV-associated tuberculosis, tuberculosis-IRIS and prednisone on lung function.

Residual pulmonary impairment is common after treatment for tuberculosis (TB). Lung function data in patients with HIV-associated TB are scarce, especially in the context of paradoxical TB-associated immune reconstitution inflammatory syndrome (TB-IRIS) and prophylactic prednisone. We aimed to determine the prevalence of lung function abnormalities in patients with HIV-associated TB and CD4 counts ≤100 cells·μL−1 and assess the effect of prophylactic prednisone and the development of paradoxical TB-IRIS on pulmonary impairment.We performed spirometry, 6-min walk test (6MWT) and chest radiography at baseline (week 0) and at weeks 4, 12 and 28 in participants of the PredART trial, which evaluated a 28-day course of prednisone to prevent TB-IRIS in patients with HIV-associated TB commencing antiretroviral therapy.153 participants underwent spirometry and/or 6MWT at one or more time points. Abnormal spirometry measurements were present in 66% of participants at week 0 and 50% at week 28; low forced vital capacity was the commonest abnormality. Chest radiographs showed little or no abnormalities in the majority of participants. Prednisone use resulted in a 42 m greater 6-min walk distance and a 4.9% higher percentage of predicted forced expiratory volume in 1 s at week 4; these differences were no longer significantly different from week 12 onwards. TB-IRIS did not significantly impair lung function outcome.Residual pulmonary impairment is common in HIV-associated TB. In patients with low CD4 counts, neither prophylactic prednisone as used in our study nor the development of TB-IRIS significantly affected week-28 pulmonary outcome.

Prevalence of Lung Function Abnormalities Following the Fort McMurray Wildfires

Air pollution contributes significant to the burden of respiratory diseases. Vehicular, industrial and increasingly, wildfire emissions are major sources of air pollution in Canada. Increased symptoms, hospitalizations and mortality immediately after wildfires are known; the long-term health impact have not been studied. The devastating 2016 Fort McMurray (FMM) wildfires forced the months-long evacuation of the entire town and destroyed many homes. Most residents returned several months later, chosing to stay and rebuild. The long-term health impact of wildfires, and the ongoing exposure to resuspended residual wildfire ash are not known. Our study aims to assess the long-term impact on lung health in the permanent residents of FMM.We report on the health status of the first 45 participants (26F, 19M; mean age&amp;#61;45&amp;#177;2 yrs, range 21-71 yrs) at 18 months after the onset of the fires. Target enrolment is 200 with follow-up of at least 5 years. All 45 are permanent residents (mean residency&amp;#61;16&amp;#177;12; range 3-46 yrs). 13 worked in the oils sands; 5 are current smokers and 18 ex-smokers. Spirometry revealed a higher than expected prevalence of airflow obstruction; 11% had an FEV1 (forced expiratory volume in 1 sec)/FVC (forced vital capacity) ratio &amp;lt;lower limit of normal (LLN). This was similar regardless of occupational exposures and smoking history; of the 22 never-smokers, 3 had FEV1/FVC&amp;lt;LLN, while 4 had FEV1/FVC&amp;lt;72.5%. 31% reported intermittent cough&amp;#177;sputum. Two had childhood asthma; only one is treated with inhaled steroids. One participant had COPD, treated with inhaled bronchodilators. The cohort was generally healthy with only 4 participants reporting underlying medical diseases other than lung disease. They were, however, obese with mean BMI&amp;#61;31&amp;#177;l.Our preliminary analyses found a higher than anticipated burden of unrecognized lung disease. Development of disease in this generally healthy young population will have significant social and public health impact in Canada.

Lung function abnormalities among service members returning from Iraq or Afghanistan with respiratory complaints

BackgroundService members deploying to Afghanistan (OEF) and Iraq (OIF) often return with respiratory symptoms. We sought to determine prevalence of lung function abnormalities following OEF/OIF. MethodsWe identified OEF/OIF patients who had unexplained respiratory symptoms evaluated using lung function testing. Lung function data were summarized and analyzed for associations with demographic and deployment characteristics. ResultsWe found 267 patients with unexplained cough or dyspnea, lung function testing and a history of OEF/OIF deployment. All patients had basic spirometry performed and 82 had diffusion capacity for carbon dioxide (DLCO) measured. The median (IQR) number of deployments and total days deployed were 1 (1–2) and 352.0 (209–583), respectively. There were 83 (36.6%) patients with abnormal spirometry, 53 (63.9%) of whom had an abnormal FEV1/FVC. Only one (1.2%) patient had an abnormal DLCO adjusted for alveolar volume. Of 104 patients who had post bronchodilator (BD) testing performed, six (5.8%) had a positive response by ATS criteria. We found no relationships between lung function and time in theater, deployment location, deployment frequency, or land based-deployment. Dyspnea and enlisted rank were associated with tobacco use and lower FEV1, and cough was associated with total number of deployments. ConclusionsService members with respiratory complaints following OEF/OIF have a high prevalence of abnormalities on spirometry. Tobacco use, enlisted rank and total number of deployments were associated with symptoms or spirometric abnormalities.

Pulmonary Function Abnormalities and Asthma Are Prevalent in Children with Sickle Cell Disease and Are Associated with Acute Chest Syndrome

Pulmonary diseases form major sources of morbidity and mortality in children with sickle cell disease (SCD). The objective of the study was to determine the prevalence of lung function abnormalities and asthma and their association with acute chest syndrome (ACS) in children with SCD. This was a cross-sectional retrospective study of 127 children with SCD; we collected information regarding ACS and asthma and pulmonary function test (PFT) data. Based on PFT results, the patients were assigned to one pattern of lung function [normal, obstructive lung disease (OLD), restrictive lung disease (RLD)]. Statistical analyses included Pearson correlation, prevalence odds ratio (POR), cross-tabulation, and multiple binary logistic regression. OLD was noted in 35% and RLD in 23% of the patients, with the remainder exhibiting a normal PFT pattern. Forty-six percent of patients had asthma, 64% of whom had a history of ACS. OLD (r = .244, P = .008, POR = 2.8) and asthma (r = .395, P < .001, POR = 5.4) were significantly associated with a history of ACS. There was a negative correlation between having normal PFT data and a history of ACS (r = −.289, P = .002, POR = .3). Asthma and pulmonary function abnormalities are prevalent in children with SCD, with OLD being more common than RLD. There is an association between asthma, OLD, and ACS, however causality cannot be proven due to the study design. We stress the importance of actively investigating for a clinical diagnosis of asthma in all patients with SCD and suggest that PFT data may help detect patients at lower risk for ACS.

Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age

Advances in neonatal care have resulted in increased survival of children born extremely pre-term (EP). Nevertheless the incidence of bronchopulmonary dysplasia and long-term respiratory morbidity remains high. We investigated the nature of pathophysiological changes at 11 yrs of age to ascertain whether respiratory morbidity in EP children primarily reflects alterations in the lung periphery or more centralised airway function in this population. Spirometry, plethysmography, diffusing capacity, exhaled nitric oxide, multiple-breath washout, skin tests and methacholine challenge were used during laboratory-based assessments in a subgroup of the 1995 EPICure cohort and in controls. Results were obtained in 49 EP and 52 control children. Lung function abnormalities were found in 78% of EP children, with evidence of airway obstruction, ventilation inhomogeneity, gas trapping and airway hyperresponsiveness. Levels of atopy and exhaled nitric oxide were similar between the groups. Prior wheeze was associated with significant reductions in forced flows and volumes. By contrast, abnormalities of the lung periphery appear to be mediated primarily through EP birth per se. The prevalence of lung function abnormalities, which is largely obstructive in nature and likely to have long-term implications, remains high among 11-yr-old children born EP. Spirometry proved an effective means of detecting these persistent abnormalities.

Pulmonary functions of wheat flour mill workers and controls in Ibadan, Nigeria

The impact of grain dust exposure on lung functions of grain handlers in Nigeria has remained largely undocumented. Lung functions of wheat flourmill workers and control subjects were assessed, and the prevalence of lung function abnormalities was compared among the occupational groups. Study subjects consisted of 91 flour-millers, 30 matched internal controls from the maintenance unit of the same flourmill factory and 121 matched external controls. A cross-sectional analytical design is utilized; data were collected using structured interviews, anthropometric measurements, spirometry, and area dust sampling. The flour-millers recorded significantly lower mean lung functions compared with control subjects (P < 0.05), for FEV(1) and FVC, when observed values were expressed as percentages of predicted normal values. Furthermore, 29% of flour-millers, compared with 15% of external controls and 10% of internal controls, presented with at least one abnormal test result of ventilatory function. The study concluded that wheat flour-mill workers in Nigeria are at an increased risk of developing abnormalities of lung functions compared with control subjects, and the dominant pattern of respiratory disease among them is airway obstruction.

Respiratory Symptoms and Physiologic Assessment of Ironworkers at the World Trade Center Disaster Site

To characterize respiratory abnormalities in a convenience sample of ironworkers exposed at the World Trade Center (WTC) disaster site for varying lengths of time between September 11, 2001, and February 8, 2002. Cross-sectional study. The Mount Sinai Medical Center, a large tertiary hospital. Ninety-six ironworkers engaged in rescue and recovery with exposure onset between September 11, 2001, and September 15, 2001, who responded to an invitation to undergo respiratory evaluation. Medical and exposure history, physical examination, spirometry, forced oscillation (FO), and chest radiographs. The relationships of prevalence of respiratory symptoms and presence of obstructive physiology to smoking, exposure on September 11, duration of exposure, and type of respiratory protection were examined using univariate and linear and logistic regression analyses. Seventy-four of 96 workers (77%) had one or more respiratory symptoms (similar in smokers [49 of 63 subjects, 78%] and nonsmokers [25 of 33 subjects, 76%]). Cough was the most common symptom (62 of 96 subjects, 65%), and was associated with exposure on September 11. Chest examination and radiograph findings were abnormal in 10 subjects (10%) and 19 subjects (20%), respectively. FO revealed dysfunction in 34 of 64 subjects tested (53%), while spirometry suggested obstruction in only 11 subjects (17%). Lack of a respirator with canister was a risk factor for large airway dysfunction, and cigarette smoking was a risk factor for small airway dysfunction. No other relationships reached statistical significance. Respiratory symptoms occurred in the majority of ironworkers at the WTC disaster site and were not attributable to smoking. Exposure on September 11 was associated with a greater prevalence of cough. Objective evidence of lung disease was less common. Spirometry underestimated the prevalence of lung function abnormalities in comparison to FO. Continuing evaluation of symptoms, chest radiographs, and airway dysfunction should determine whether long-term clinical sequelae will exist.

Lung function abnormalities in repaired oesophageal atresia and tracheo-oesophageal fistula.

Respiratory complications are common after neonatal repair of oesophageal atresia and tracheo-oesophageal fistula. The prevalence of lung function abnormalities and the relation between gastrointestinal complications and lung function has not been studied in a large number of patients. Lung volumes and flow-volume loops were measured in 155 patients without spinal curvature aged 6-37 years who had undergone surgery for oesophageal atresia and tracheo-oesophageal fistula. Sixty four of the 155 patients had evidence of mild lower airways disease, with values for FEV1 more than two standardised scores below the predicted value in 39 (25%) and above 2 standardised scores for the residual volume (RV)/total lung capacity (TLC) ratio in 64 (41%). Restrictive lung disease (TLC more than 2 standardised scores below predicted) was present in 28 (18%). Severe lung function abnormalities were present in under 10% of the 155. Half the subjects had some evidence of extra-thoracic tracheal obstruction, with a high ratio of expiratory to inspiratory flow for peak flow in 76 (50%) and at 50% of vital capacity in 59 (38%). Patients with radiological gastro-oesophageal reflux in early childhood had more airways obstruction and smaller lung volumes. Patients with current gastrointestinal symptoms were similar in their lung function to symptom free patients. Minor lung function abnormalities are common in patients after repair of oesophageal atresia. Early diagnosis and management of gastro-oesophageal reflux may help to minimise these lung function abnormalities.

Pulmonary abnormalities in Crohn's disease

Abnormalities of pulmonary function in Crohn's disease have been described, although the results are conflicting and anecdotal accounts of lung involvement are few. In this study we assessed the prevalence of lung function abnormalities in Crohn's disease, and the relative contributions of age, sex, smoking and past medical history, and Crohn's disease activity to the pulmonary abnormalities found. Twenty-nine patients with Crohn's disease and 29 age-, sex- and smoking-matched volunteer controls underwent detailed respiratory assessment. Airways obstruction due to chronic bronchitis and asthma was present in 13 patients with Crohn's disease, but was not more prevalent than in the control group. FEV1 was similar in both Crohn's disease and control subjects (84.2 +/- 21.2% predicted, mean +/- SD; 93.7 +/- 16.3%, respectively: n.s.). The vital capacity was significantly lower in the Crohn's disease patients than in controls (86.7 +/- 16.6%; 95.9 +/- 12.7%; P less than 0.01), but this may have been influenced by the higher prevalence of past or intercurrent medical illnesses affecting the chest in Crohn's disease patients. No patient had evidence of fibrosing alveolitis or bronchiectasis. The haemoglobin corrected transfer factor was significantly lower in the Crohn's disease patients than in controls (100.4 +/- 17.4%; 113.2 +/- 25.1: P less than 0.05) but the diffusing coefficient was not significantly different. There was a significant correlation (r = 0.44, P less than 0.05) between the residual volume and the Crohn's disease activity index but otherwise no close relationship was observed between Crohn's disease activity, extent or duration and the indices of lung function. These findings suggest that the lungs are relatively unaffected by Crohn's disease.