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Interpreting periodic lung function tests in individuals: the relationship between 1- to 5-year and long-term FEV1 changes.

Abstract：

STUDY OBJECTIVE:Spirometry is performed to monitor lung health, but variability between tests can hinder recognition of excessive FEV(1) declines. We sought to describe the relationship between FEV(1) changes over 1 to 5 years and FEV(1) declines over longer terms, using 21,821 test results from 1,884 workers who participated in an annual health monitoring program at a chemical plant between 1973 and 2003. METHODS:Test results from workers with five or more valid results over > or = 10 years were included in our analysis (mean initial worker age, 35 years; range, 18 to 62 years; 91% male; 35% current smokers and 41% nonsmokers). For each worker, long-term FEV(1) slopes (milliliters per year) were calculated by simple linear regression using all available results and compared to changes in FEV(1) between two tests over 1 to 5 years, expressed in both milliliters and percentage of initial value. RESULTS:Long-term (mean, 18 years; range, 10 to 30 years) slopes averaged - 29.1 mL/yr (- 27, - 29, and - 37 mL/yr for male never-smokers, former smokers, and current smokers, and - 20, - 26, and - 27 mL/yr for female never-smokers, former smokers, and current smokers, respectively). Excessive short-term and long-term declines were defined by lower fifth percentile values. Individuals with abnormal short-term declines were found to be 3 to 18 times more likely to ultimately show excessive long-term declines; with the strength of the association increasing with the length of the short-term testing interval. Better test operating characteristics resulted if abnormal short-term FEV(1) change was based on percentage change (ie, percentage per year) rather than absolute change (ie, milliliters per year). CONCLUSIONS:Our findings provide guidance for interpreting periodic spirometry results from individuals exposed to respiratory hazards.

journal_name

Chest

journal_title

Chest

authors

Wang ML,Avashia BH,Petsonk EL

doi

10.1378/chest.130.2.493

subject

Has Abstract

pub_date

2006-08-01 00:00:00

pages

493-9

issue

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)51866-7

journal_volume

130

pub_type

杂志文章

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Interpreting periodic lung function tests in individuals: the relationship between 1- to 5-year and long-term FEV1 changes.