Abstract:
OBJECTIVE:The functional consequences of pulmonary emphysema have been estimated from autopsy studies. This antemortem study correlates structure as assessed by criteria applied to chest radiographs and function in earlier disease. SUBJECTS AND METHODS:Four thousand one hundred seven male shipyard and construction workers had chest radiographs scored for asbestosis using International Labour Office criteria and for emphysema using five criteria: hyperlucent lung fields, low flat diaphragms on posteroanterior views, low flat diaphragms on lateral radiographs, a wide retrosternal space, and bullae. Total lung capacity (TLC) was measured by planimetry of radiographs and forced vital capacity (FVC) and flows by spirometry: TLC minus FVC equaled residual volume (RV). All were expressed as percentage of predicted (% pred) adjusted for height, age, and duration of cigarette smoking. Linear regression modeling examined the influence of each emphysema criterion on function measurements. RESULTS:Four hundred three (10.1%) of 4,107 men had two or more emphysema criteria and 24.5% had asbestosis. Prevalence of 2 criteria varied by smoking status and was present in 20% of current smokers, 7.5% of ex-smokers, and 2% of never smokers. The TLC % pred and RV/TLC increased and % pred of FEV1/FVC and FEF25-75, FEV1, and FVC decreased with increasing radiographic emphysema criteria. Forty-four (10%) had normal results of spirometry with two or more radiographic emphysema criteria. CONCLUSION:Impairment of airway function worsened with each additional radiographic criteria of emphysema. These criteria were more strongly associated with an increase in RV/TLC than an increase in TLC.
journal_name
Chestjournal_title
Chestauthors
Kilburn KH,Warshaw RH,Thornton JCdoi
10.1378/chest.107.5.1225subject
Has Abstractpub_date
1995-05-01 00:00:00pages
1225-31issue
5eissn
0012-3692issn
1931-3543pii
S0012-3692(16)38184-3journal_volume
107pub_type
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