Is being breastfed as an infant associated with adult pulmonary function?

OBJECTIVE: Breastfeeding reduces the risk of asthma and respiratory infections in infants. Since respiratory infections are associated with reduced pulmonary function in adolescents, pulmonary function impairment may be carried into adulthood. Our aim was to determine whether a history of having been breastfed as an infant is a determinant of adult pulmonary function. METHODS: We analyzed data from a general population sample of residents of Erie and Niagara Counties between September 1995 and December 1999. We calculated forced expiratory volume in one second (FEV(1)) and forced vital capacity (FVC) prediction equations and used multiple linear regression models to study the association between having been breastfed as an infant and percentage predicted FEV(1) (FEV(1)%) and percentage predicted FVC (FVC%) after adjustment for covariates. RESULTS: Of 2305 subjects, 62% reported having been breastfed. After controlling for age, gender, weight, smoking status, pack-years of smoking, eosinophil counts and dietary factors, there was no association between having been breastfed (yes/no) and FEV(1)% or FVC% (regression coefficients 0.0049, p = 0.46 and 0.0055, p = 0.43, respectively). CONCLUSIONS: We did not find a strong or consistent association between having been breastfed as an infant and pulmonary function in adulthood.     

Phthalate exposure and pulmonary function

Exposure to phthalates is widespread because of their use in plastics, cosmetics, and other consumer products. Phthalate exposure has been associated with adverse respiratory outcomes in children. With urinary phthalate measures, we assessed the association between phthalate exposure and four pulmonary function parameters [forced vital capacity (FVC), forced expiratory volume at 1 sec (FEV1), peak expiratory flow (PEF), and maximum mid-expiratory flow] among the 240 adult Third National Health and Nutrition Examination Survey (NHANES III) participants with urinary phthalate data. Linear regression models controlled for race, age, age squared, standing height, body mass index, cumulative smoking, and current smoking. Monobutyl phthalate (MBP) was significantly associated with decrements in three measures of pulmonary function (FVC, FEV1, PEF) in males but not in females. For a change from the 25th to the 75th percentile in MBP level among men, FEV1 decreased 112 mL (SE = 51, p = 0.03). Monoethyl phthalate (MEP) was associated with lower FVC and FEV1 values in men. Monoethylhexyl phthalate (MEHP), the metabolite of the plasticizer commonly used in medical tubing, was not adversely associated with any of the pulmonary function parameters evaluated. Our results suggest that MBP and MEP, but not MEHP, may influence pulmonary function among adult males.     

Obstructive pulmonary function defects among Taiwanese firebrick workers in a 2-year follow-up study.

The purpose of the study was to follow up an earlier observation of pulmonary function among workers employed in firebrick-manufacturing factories. A 2-year follow-up study of pulmonary function among 442 workers in 30 firebrick-manufacturing factories was designed. Excluding 79 workers with a history of other occupational dust exposure, changes in pulmonary function of 291 firebrick workers were compared with pulmonary function in 72 control subjects over a period of 2 years. Baseline pulmonary function values (i.e., forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] and forced expiratory flow after 50% of vital capacity has been expelled [FEF50%] in smoking firebrick workers, and FEV1/FVC and FEF75% in nonsmoking firebrick workers) were significantly lower than those in the comparison group. The statistical method for repeated measurements was used for comparison of the difference between follow-up and baseline lung function. There was no significant difference in FVC and FEV1 changes between firebrick workers and those in the comparison group during the 2-year follow-up period. The decreases in FEV1/FVC, peak expiratory flow rate, maximal midexpiratory flow, and FEF50% in the firebrick workers were significantly greater than in the comparison group, after adjustment for smoking status. The FEV1, maximal midexpiratory flow, FEF50%, and FEF75% also showed a dose-response relationship with job titles. The decrement of pulmonary function in the 2-year follow-up period was the worst in burning work, followed by crushing and molding. The results show that workers in firebrick-manufacturing factories with exposure to silica-containing dusts may contract obstructive pulmonary function defects.     

Indoor air pollution and pulmonary function growth in preadolescent children

Results are reported from a study of the association between exposure to sidestream cigarette smoke or gas stove emissions and pulmonary function level and growth rate of 7,834 children seen at 2-5 annual visits between the ages of 6-10 years. Children whose mothers smoked one pack of cigarettes per day had levels of forced expiratory volume in one second (FEV1) at age eight that were 0.81% lower than children of nonsmoking mothers (p less than 0.0001), and FEV1 growth rates approximately 0.17% per year lower (p = 0.05). For a child of age eight with an FEV1 of 1.62 liters, this corresponds to a deficit in rate of change of FEV1 of approximately 3 ml/annum and a deficit of 13 ml at age eight. Children whose mothers smoked one pack per day had levels of forced vital capacity (FVC) at age eight that were 0.33% higher than children of nonsmokers (p = 0.12); however, their growth rates of FVC were 0.17% per year lower (p = 0.04). Because few mothers changed their smoking habits during the course of the study, it was not possible to determine whether the difference in rate of growth was due to current exposure or to an effect of prenatal and early childhood exposure on the course of development. The magnitude of the effect on FEV1 is consistent with deficits in FEV1 of up to 3% in early adult life due to childhood exposure to sidestream cigarette smoke. The importance of this relatively small effect will be evaluated further through follow-up of these children as they are exposed to other risk factors such as personal active smoking. The data provide some evidence for an association between gas stove exposure and pulmonary function level, especially at younger ages, but no evidence for an effect of gas stove exposure on growth rate.     

Association of dietary antioxidants and waist circumference with pulmonary function and airway obstruction

Dietary antioxidants, waist circumference, and pulmonary function were measured in the Fourth Scottish MONICA cross-sectional survey of 865 men and 971 women aged 25-64 years. Waist circumference was inversely related to forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC), even after adjustment for age, height, weight, working status, energy intake, and smoking variables in a multiple linear regression model (men: beta = -0.017 for FEV1 l/cm, p < 0.01 and beta = -0.008 for FVC, p = 0.04; women: beta = -0.009 for FEV1, p < 0.01 and beta = -0.007 for FVC, p = 0.01). After additional adjustment for waist circumference, estimated vitamin C and beta-carotene intakes were positively associated with lung function in men (vitamin C: beta = 0.102 for FEV1 l/mg/day, p = 0.03; beta-carotene: beta = 0.073 for FVC l/g/day, p = 0.02). Retinol and vitamin E were not significantly related to lung function for either sex. A case-control study of airway obstruction showed that waist circumference was significantly associated, while vitamin C could be protective. The study suggests that adequate intake of antioxidants and avoidance of increasing girth could help to preserve lung function.     

吻合器痔固定术与外剥内扎术治疗重度痔的临床研究

目的 对比评价吻合器痔固定术与外剥内扎术治疗重度痔的临床效果。方法 将60例患者随机分为吻合器痔固定术组（吻合器组）和外剥内扎术组（对照组），每组各30例。对手术时间、疼痛持续时间、注射止痛药次数、住院时间、恢复正常工作时间、术后并发症发生率、创面愈合时间及住院费用等指标进行比较研究。结果两组总的症状改善满意度分别为93％（吻合器组）和83％（对照组）。在手术时间、疼痛持续时间、注射止痛药次数、术后住院时间、恢复正常工作时间、术后并发症发生率及创面愈合时间方面，吻合器组明显优于对照组。结论吻合器痔固定术是一种安全、有效、痛苦小、并发症少、创面愈合快、患者满意度高的治疗痔出血和脱垂的新技术，具有临床应用和推广价值。     

Longitudinal analysis of the development of pulmonary function in childhood

In order to evaluate, longitudinally, the development of pulmonary function in childhood, maximal expiratory flow volume (MEFV) curves, height, and weight of 441 fourth grade school children were measured in 1980, and again two and four years later. The same instruments were used to measure pulmonary function, height, and weight in all three surveys. In addition, pulmonary function tests were performed by the same examiner in all three surveys. Three hundred and twenty five children had acceptable results for MEFV curves at all of three surveys. Two simple linear models were fitted to the distribution of pulmonary function measurements. One has age, height, functional level of the individual child, and the interaction of age and height as explanatory variables. In the other model, the natural logarithm of pulmonary function measurements was considered as a dependent variable, and age, height, and functional level of the individual child were employed as explanatory variables. The models explained the distribution of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal expiratory flows (MEFs) quite well both in males and in females. These results suggest that the development of FVC and FEV1 against height was not linear, and that age was an independent contributor to the development even after adjusting for height. Tracking in the development of MEFs as well as FVC and FEV1 was observed, suggesting that functional development of MEFs for an individual child could be evaluated accurately utilizing percentile curves as in the case of FVC and FEV1.     

呼出气一氧化氮联合白介素-17、白介素-27检测对儿童支气管哮喘的临床诊断价值

目的 检测呼出气一氧化氮(FeNO)、白介素-17(IL-17)、白介素-27(IL-27)与肺功能指标的相关性,及对儿童支气管哮喘的临床诊断价值。方法 选取2019年1月—2020年4月在南阳市中心医院诊断为支气管哮喘的84例儿童和同时期来本院就诊的56例健康儿童为研究对象。检测患者外周血中IL-17、IL-27水平和FeNO水平,记录肺功能相关指标,包括一秒用力呼气容积(FEV₁)、一秒用力呼气容积与肺活量比值(FEV₁/FVC)、峰值呼气流速(PEF)和残气量与肺总量比值(RV/TLC)。Pearson相关分析检测IL-17、IL-27和FeNO与肺功能指标的相关性。ROC工作曲线评估FeNO联合IL-17、IL-27检测对儿童哮喘的诊断价值。结果 对照组、稳定期和急性加重期患儿IL-17、IL-27、FeNO、FEV₁、FEV₁/FVC、PEF和RV/TLC之间差异均有统计学意义(F＝137.241、92.074、94.296、16.325、174.263、31.174、115.207,P<0.001)。哮喘患儿IL-17水平与FEV₁、FEV₁/FVC、PEF呈负相关(r=-0.690、-0.576、-0.613),与RV/TLC呈正相关(r=0.581)。IL-27水平与FEV₁、FEV₁/FVC、PEF呈负相关(r=-0.786、-0.818、-0.549),与RV/TLC呈正相关(r=0.513)。FeNO水平与FEV₁、FEV₁/FVC、PEF呈负相关(r=-0.667、-0.662、-0.637),与RV/TLC呈正相关(r=0.543)。IL-17诊断儿童哮喘的灵敏度为52.4%,特异度为76.2%,曲线下面积为0.684(95%CI:0.614～0.725);IL-27诊断儿童哮喘的灵敏度为68.5%,特异度为63.2%,曲线下面积为0.768(95%CI:0.710～0.805);FeNO诊断儿童哮喘的灵敏度为70.6%,特异度为65.3%,曲线下面积为0.792(95%CI:0.723～0.840);联合检测诊断儿童哮喘的灵敏度为86.9%,特异度为81.4%,曲线下面积为0.905(95%CI:0.802～0.941),与单独检测相比差异有统计学意义(P<0.05)。结论 IL-17、IL-27、FeNO水平与肺功能指标相关,联合检测可显著提高诊断儿童支气管哮喘灵敏度和特异度。     

幽门螺杆菌感染AECOPD患者肺功能和凝血功能的变化

目的探究慢性阻塞性肺疾病急性加重期(AECOPD)患者幽门螺杆菌(Helicobacter pylori,Hp)的感染现状及其对肺功能、凝血功能的影响。方法选取2018年1月-2019年12月在合肥市滨湖医院就诊的112例AECOPD患者为研究组,采用14C呼气试验检测Hp感染情况,根据是否存在Hp感染分为Hp感染组和Hp未感染组,另选取112例同期慢性阻塞性肺疾病(COPD)患者为对照组。分析两组和研究组内Hp感染与Hp未感染患者凝血功能、肺功能指标和APACHEⅡ评分的差异。结果 AECOPD组患者凝血功能指标中血浆纤维蛋白原(FIB)和D二聚体(DD)均高于对照组,抗凝血酶原Ⅲ(AT-Ⅲ)低于对照组(P<0.05);肺功能指标第1秒钟用力呼气容积(FEV1)、用力肺活量(FVC)和FEV1/FVC均低于对照组(P<0.05);112例AECOPD患者中Hp感染阳性68例,感染率为60.71%;Hp感染组APACHEⅡ评分高于Hp未感染组;凝血功能指标血浆FIB和DD高于未感染组,AT-Ⅲ低于未感染组(P<0.05);肺功能指标FEV1、FVC和FEV1/FVC低于未感染组(P<0.05)。结论 AECOPD组患者Hp感染阳性率较高,合并Hp感染可以加重AECOPD患者的肺功能和凝血功能障碍,推进疾病的恶性进展。     

Plasma fibrinogen and lung function: the CARDIA Study

BACKGROUND: We hypothesized that fibrinogen, as a marker of chronic inflammation, is inversely associated with forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) in healthy persons. METHODS: The CARDIA cohort started in 1985 and included black and white men and women, aged 18-30, from the general population. Spirometry testing conducted at years 5 and 10 [FVC, FEV(1), and their ratio (FEV(1)/FVC)] was studied relative to plasma fibrinogen levels measured at year 5 (cross-sectional n = 4,040) and at year 7 (longitudinal n = 3,001), controlling for race, sex, age, height, smoking, asthma, body mass index, physical activity, birth control pill use, and alcohol intake. RESULTS: In cross-sectional analyses, FVC at year 5 was lower by 166 ml (95% confidence interval 116-216 ml) in the highest vs lowest year 5 fibrinogen quartile. At year 10, holding year 5 FVC and change in fibrinogen (year 7-year 5) constant, the difference in FVC between the highest and the lowest year 5 fibrinogen quartiles widened by 67 ml (95% CI 31-103 ml). The corresponding differences for FEV(1) were 166 ml (95% CI 146-253 ml) at year 5 and 45 ml (95% CI 11-80 ml) widening by year 10. The FEV(1)/FVC ratio was unrelated to plasma fibrinogen. CONCLUSION: These findings are consistent with the hypothesis that fibrinogen, possibly as a marker for chronic low-grade inflammation, is associated with modest deterioration of lung function in healthy young adults.     

Peripheral leukocyte count and pulmonary function in a national sample of women and men.

The inverse relationship between peripheral leukocyte count and forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), previously reported in employed men, was investigated in women and men in a representative national sample. Leukocyte count was negatively correlated with FEV1 and FVC in most age, sex, and smoking subgroups in whites. In linear regression analyses controlling for age, height, and smoking variables, leukocyte count was significantly associated with FEV1 and FVC in white men (P < .05) and white women (P < .002). In "never smokers," significant independent associations were seen for leukocyte count and FVC in white men (P = .01) and FEV1 in white women (P = .02). These findings confirm an independent association of leukocyte count with pulmonary function in white men and extend the findings to white women.     

Pulmonary function and urban air pollution in preschool children

Epidemiologic evidence indicates that respiratory disease in infancy and childhood has respiratory health consequences in later life. Pulmonary function is considered a good index of early effects. This study assessed the relationship of pulmonary function in preschool children in Leipzig, Germany, and exposure to high levels of air pollution during early childhood. Spirometric measures were taken of 235 preschoolers (126 boys, 109 girls, mean age 5.1 +/- 1.3 years) attending 16 randomly selected daycare centres, using the 'Bosch Spiro 501' spirometer. The results showed decrements in the average FVC (85.5% predicted [pred]) and FEV1 (90.2% pred) differing with spatial variations in the ambient air pollution burden of the children's residential area. Exposure to a pollution profile of heavy traffic and/or domestic heating showed markedly lower FVC (78.9% and 85.5% pred, respectively) and FEV1 (82.4% and 88.5% pred). Miller's Diagnostic Quadrant Model of Disease Classification, categorizing pulmonary function data for preliminary diagnostic purposes, assessed the lung function values (FVC% pred/relative FEV1 [FEV1/FVC]%) of a significant number of children as 'restrictions' (n = 52; 22.1%). Summarizing: variations in spirometric indices were observed across exposure groups with a significant number of children showing signs of a restrictive ventilatory function. These cross-sectional data, however, do not permit to conclude with any degree of certainty that this is indicative of an early sign of a functional deficit.     

Association between 24-hour urinary cadmium and pulmonary function among community-exposed men: the VA Normative Aging Study

BACKGROUND: High levels of cadmium exposure are known to cause emphysema in occupationally exposed workers, but little has been reported to date on the association between chronic environmental cadmium exposure and pulmonary function. OBJECTIVE: In this study we examined the association between pulmonary function and cadmium body burden in a subcohort of the Normative Aging Study, a community-based study of aging. METHODS: We examined 96 men who had cadmium measured in single 24-hr urinary specimens collected in 1994-1995 and who had one to three tests of pulmonary function between 1994 and 2002 (a total of 222 observations). We used mixed-effect models to predict pulmonary function based on individual 24-hr urinary cadmium output, adjusted for age, height, time elapsed from the baseline, and smoking status. We assessed effect modification by smoking status. RESULTS: Among all subjects, a single log-unit increase in baseline urinary cadmium was inversely associated with forced expiratory volume in 1 sec (FEV(1)) percent predicted [beta = -7.56%; 95% confidence interval (CI) -13.59% to -1.53%]; forced vital capacity (FVC) percent predicted (beta = -2.70%; 95% CI -7.39% to 1.99%), and FEV(1)/FVC ratio (beta = -4.13%; 95% CI -7.61% to -0.66%). In models including an interaction between urinary cadmium and smoking status, there was a graded, statistically significant reduction in FEV(1)/FVC ratio across smoking status in association with urinary cadmium. CONCLUSIONS: This study suggests that chronic cadmium exposure is associated with reduced pulmonary function, and cigarette smoking modifies this association. These results should be interpreted with caution because the sample size is small, and further studies are needed to confirm our findings.     

无明显肺病的成年人群体重不足与肺功能的相关性

目的探讨呼吸科就诊的无明显肺病的成年人群体重不足与肺功能的关系。方法选取2019年1~6月于重庆三峡中心医院医院呼吸科门诊就诊的2350例无明显肺病的成年人群为研究对象,按照BMI指数分为体重不足组(BMI≤18.5 kg/m2),正常体重组(BMI在18.525 kg/m2)和为超重组(BMI≥25 kg/m2)。结果与体重不足和正常体重组相比,超重组人群的生化指标更差。低体重组的剧烈运动频率显著低于其他两组(P<0.001)。低体重组肺功能指标均明显低于其他两组(P均<0.001),低体重组FEV1/FVC明显高于其他两组(P均<0.001),FEV1%预计值<80%和FVC%预计值<80%的比率也明显高于其他用两组(P均<0.001)。低体重组的肺功能降低的风险显著的升高,且与超重组相比,此风险分别在FEV1%预计值<80%和FVC%预计值<80%的优势比为2.1倍(95%CI:1.98~2.21)和4.90倍(95%CI:4.62~5.18)。结论在无明显肺病的成年人群中,体重不足与肺功能减弱显著相关。     

陶瓷作业工人肺功能测试结果分析

目的了解陶瓷作业工人肺功能损害的情况,为预防尘肺病发生提供依据。方法选择某陶瓷厂200名接尘工人,平均年龄为（32.31±8.25）岁,另选取非接尘工人50名为对照组,平均年龄为（34.88±9.75）岁,采用意大利的spirolabII型的肺功能仪,测试的项目包括肺活量（VC）、用力呼吸肺活量（FVC）、第1s用力呼气量（FEV1）、一秒率（FEV1%）、最大呼气中段流速（FEF25-75）、最大呼气25%、50%、75%肺活量时流量（FEF25%、FEF50%、FEF75%）;应用SPSS13.0统计软件统计分析。结果接尘组的肺功能指标FEV1、FEV1%、FEF25-75、FEF50%、FEF75%明显低于对照组,差异有统计学意义（P〈0.05）;接尘工龄在10年～、15年～、20年～组的工人肺功能指标中VC、FVC、FEF25-75、FEF50%、FEF75%的测试均值明显低于接尘工龄〈5年组,差异有统计学意义（P〈0.05）。结论陶瓷粉尘对作业工人的肺功能有损害作用,且随着接尘工龄的增加肺功能受损害程度增加。     

Airway disease caused by phenolic (phenol-formaldehyde) resin exposure.

A standardized respiratory questionnaire and pulmonary function tests, including measurement of forced vital capacity (FVC), one-second forced expiratory volume (FEV1.0), and maximum expiratory flow rate at 50% FVC (MEF50%), were administered to five groups of employees in a filter-manufacturing plant to determine the acute and chronic effects of exposure to phenolic resin fumes. Employees exposed for more than five years had lower FEV1.0/FVC and MEF50%/FVC ratios than a group that had smoked more but that had never been consistently exposed to resin fumes. The existence of chronic airway obstruction was also evident by a slight excess of chronic cough and sputum production in the exposed groups. However, in spite of the high proportions of subjects reporting acute respiratory symptoms, we found only small decreased in pulmonary function during the workday and workweek.     

Enhanced response to ozone exposure during the follicular phase of the menstrual cycle.

Exposure to ozone (O3), a toxic component of photochemical smog, results in significant airway inflammation, respiratory discomfort, and pulmonary function impairment. These effects can be reduced via pretreatment with anti-inflammatory agents. Progesterone, a gonadal steroid, is known to reduce general inflammation in the uterine endometrium. However, it is not known whether fluctuations in blood levels of progesterone, which are experienced during the normal female menstrual cycle, could alter O3 inflammatory-induced pulmonary responses. In this study, we tested the hypothesis that young, adult females are more responsive to O3 inhalation with respect to pulmonary function impairment during their follicular (F) menstrual phase when progesterone levels are lowest than during their mid-luteal (ML) phase when progesterone levels are highest. Nine subjects with normal ovarian function were exposed in random order for 1 hr each to filtered air and to 0.30 ppm O3 in their F and ML menstrual phases. Ozone responsiveness was measured by percent change in pulmonary function from pre- to postexposure. Significant gas concentration effects (filtered air versus O3) were observed for forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), and forced expiratory flow between 25 and 75% of FVC (FEF25-75; p < .05). More importantly, the pulmonary function flow rates, FEV1 and FEF25-75, showed a significant menstrual phase and gas concentration interaction effect, with larger decrements observed in the F menstrual phase when progesterone concentrations were significantly lower. We conclude that young, adult females appear to be more responsive to acute O3 exposure during the F phase than during the ML phase of their menstrual cycles.(ABSTRACT TRUNCATED AT 250 WORDS)     

咳嗽变异性哮喘患儿血清微小RNA-155、趋化性细胞因子8表达及其临床意义

目的 研究咳嗽变异性哮喘(CVA)患儿血清微小RNA-155(miR-155)、趋化性细胞因子8(CXCL8)表达水平及其临床意义。方法 选取2017年3月-2019年2月于北京市大兴区妇幼保健院接受治疗的CVA患者86例作为试验组,另选取同期在本院进行体检的健康儿童90例作为对照组。收集受试者一般临床资料,检测受试者痰嗜酸粒细胞(EOS)计数、呼出气一氧化氮(FeNO)及肺功能指标第1秒最大呼气量(FEV₁)、最大呼气峰流速(PEF)、第1秒用力呼气容积/用力肺活量(FEV₁/FVC)。Pearson法分析miR-155、CXCL8水平与EOS、FeNO及肺功能指标的相关性。受试者工作特征曲线(ROC)分析血清中miR-155、CXCL8水平对CVA的预测价值。结果 与对照组相比,试验组EOS、FeNO、miR-155、CXCL8水平均升高(t=11.606、27.562、19.721、10.754, P＜0.05),FEV₁、PEF、FEV₁/FVC水平均降低(t=17.471、10.975、33.605, P<0.05)。Pearson法分析结果显示,miR-155、CXCL8与EOS、FeNO水平均呈正相关(P＜0.05),与FEV₁、PEF、FEV₁/FVC均呈负相关(P＜0.05)。miR-155、CXCL8水平预测CVA的曲线下面积分别为0.821(95%CI:0.675~0.967)、0.851(95%CI:0.741~0.961);联合检测预测CVA的曲线下面积为0.935(95%CI:0.914~0.975)。结论 CVA患儿血清中miR-155、CXCL8水平均升高,对CVA具有一定的预测价值,可能作为诊断CVA的潜在血清学标志物。     

Interactive effect of paraoxonase-1 Q192R polymorphism and smoking history on the lung function decline in grain workers

PURPOSE: This retrospective longitudinal study investigated the association between the Q192R polymorphism of the high-density lipoprotein-associated multifunctional antioxidant enzyme, paraoxonase-1 (PON1), and lung function decline, while taking into account smoking history. METHODS: The demographic, occupational, and respiratory symptom information and lung function variables were obtained from 216 male Saskatchewan grain workers. RESULTS: An interaction between the PON1 genotypes and smoking status was observed. Current smokers with the 192R allele had a lower forced expiratory volume in the first second (FEV(1)) and FEV(1) per forced vital capacity (FVC). The annual decline rate of FEV(1)/FVC in current smokers was greater among 192R allele carriers than noncarriers (0.58+/-0.05 vs. 0.35+/-0.04 %/yr, p<0.0001). A similar result was observed with FEV(1) (40.9+/-6.4 vs. -33.0+/-7.0 mL/yr, p=0.10). The annual decline rate of FVC was not influenced by the genotypes. CONCLUSIONS: These results strengthened the previous findings of our cross-sectional study, suggesting that the 192R allele may be a novel genetic risk factor for airway injury among current smokers.     

Environmental tobacco smoke exposure and pulmonary function among adults in NHANES III: impact on the general population and adults with current asthma

The impact of environmental tobacco smoke (ETS) exposure on adult pulmonary function has not been clearly determined. Because adults with asthma have chronic airway inflammation, they may be a particularly susceptible group. Using data from the Third National Health and Nutrition Examination Survey (NHANES III), I examined the cross-sectional relationship between serum cotinine, a biomarker of ETS exposure, and pulmonary function among 10,581 adult nonsmokers and 440 nonsmoking adults with asthma whose cotinine and spirometry data were available. I generated residuals, which are observed minus predicted values (based on Crapo equations), for forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio to adjust for age, sex, and height. In addition, I used multivariate linear regression to control for sociodemographic characteristics and previous smoking history. Most adults with and without asthma had detectable serum cotinine levels, indicating recent ETS exposure (85.7% and 83.4%, respectively). Among nonsmoking male participants, I found no evidence that ETS exposure was related to decreased pulmonary function. In the nonsmoking female stratum, the highest cotinine tertile was associated with a lower FEV1 [-100 mL; 95% confidence interval (CI), -143 to -56 mL], FVC (-119 mL; 95% CI, -168 to -69 mL), and FEV1/FVC ratio (-1.77%; 95% CI, -2.18% to -1.36%). Among women with asthma, the highest cotinine tertile was also associated with decreased FEV1 (-261 mL; 95% CI, -492 to -30 mL), FVC (-291 mL; 95% CI, -601 to 20 mL), and FEV1/FVC ratio (-1.6%; 95% CI, -3.3% to 0.19%). In conclusion, ETS exposure is associated with decreased pulmonary function in adult females, especially those with asthma. This analysis should provide further impetus for public policies that promote smoke-free environments.