Spirometry reference values for Navajo children ages 6–14 years

Spirometry is the most important tool in diagnosing pulmonary disease and is the most frequently performed pulmonary function test. Since respiratory disease is the single greatest cause for morbidity and mortality on the Navajo Nation, the purpose of this study was to create new age and race‐specific pulmonary nomograms for Navajo children. Five hundred fifty‐eight healthy children, ages 6–14 years, attending Navajo Nation elementary schools in Arizona, were asked to perform spirometry to develop population‐specific and tribe‐specific nomograms for forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), and FEV1 Ratio (FEV1/FVC). Spirometry tests from 284 girls and 274 boys met American Thoracic Society quality control standards. Lung function values, except for FEV1/FVC, all increased with height. The lower limit of the normal range for FEV1/FVC was 80%. The spirometry reference equations from the healthy boys and girls were developed. Height and the natural log of height were significant predictors of FEV1, FVC, and FEF_25–75% in the gender‐specific models. The resulting population‐specific spirometry reference equations should be used when testing Navajo children ages 6–14 years. However, the use of the NHANES III spirometry reference equations for Caucasian children may not result in significant misclassification in clinical settings providing that a maximal effort is given by the Navajo child being tested. Pediatr Pulmonol. 2009; 44:489–496. © 2009 Wiley‐Liss, Inc.