The Use Of Pulmonary Function Testing And Questionnaires As Epidemiologic Tools In The Study Of Occupational Lung Disease

Our plain-English summary of The Use Of Pulmonary Function Testing And Questionnaires As Epidemiologic Tools In The Study Of Occupational Lung Disease, by B.A. Boehlecke, J.A. Merchant (1981).

The study

• Authors: B.A. Boehlecke, J.A. Merchant
• Published: Chest 79(Supplement 4):114S-122S, April (1981)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 000721. The article is still under copyright, so we describe it here rather than post it.

In plain English

This conference article reviewed how breathing tests (spirometry) and standardized questionnaires are used to study work-related lung disease. It reported no new group study; it drew on published work on cotton workers, coal miners, asbestos-exposed workers and healthy reference groups. Cited work found FVC and FEV1 the most reproducible spirometry measures. In a cited study in which two observers graded byssinosis in 183 male cotton workers, they agreed completely in 76 percent of cases. In another cited study, workers given an educational program about asbestos risks reported significantly more cough and phlegm a year later, while smoking and work histories were generally reproducible. From their own laboratory, the authors showed one 30-year-old male smoker whose FEV1 fell by over 700 ml in the first year but by about 80 ml per year over four years. The authors concluded that accurate equipment and standardized methods are vital, and that occupational and smoking histories are more reproducible than symptoms. They added that groups should be compared on their full range of results, not just the share labeled abnormal.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review and methods discussion of spirometry and respiratory questionnaires as epidemiologic tools, drawing on published studies; it includes one illustrative repeat-measurement case from the authors' laboratory
• Who was studied: No study population of its own. The studies reviewed included cotton workers, black and white coal miners, asbestos-exposed workers and general-population or healthy reference groups. The authors' own example was one 30-year-old male smoker.
• Exposure: Not an exposure study. Examples come from several sources, including cotton dust and byssinosis. One cited questionnaire-reliability study involved asbestos-exposed workers who were given an educational program about asbestos risks. That study's data included years employed as a pipe coverer and years of asbestos exposure.
• Main results:
  • In the cited repeat-testing data, FVC and FEV1 were the most reproducible spirometry measures. No significant difference in reproducibility was found between smokers and nonsmokers.
  • In the authors' own laboratory, an asymptomatic 30-year-old male smoker's FEV1 declined by over 700 ml in the first year. His smoking habits did not change, and his overall rate of decline over four years was approximately 80 ml per year.
  • In a cited study of asbestos-exposed workers, reported cough and phlegm increased significantly over a one-year period. During that year the workers were exposed to an educational program on asbestos risks. The table percentages are not legible in this scan.
  • In a cited study, two observers graded byssinosis in 183 male cotton workers. They reached complete agreement in 76 percent of cases and agreed on presence or absence of byssinosis in 93 percent.
  • In a cited study of coal miners matched for age, height and smoking history, black subjects had an FEV1 approximately 14 percent lower than white subjects.
  • In cited data from a healthy population, a fixed percent-of-predicted cutoff was applied to men over 60. By that cutoff, 12 percent had an abnormally low FEV1 and 29 percent an abnormal FEF.
• The authors' conclusion: The authors concluded that pulmonary function tests and questionnaires are valuable tools and that accurate equipment and standardized methods are vital. They found FVC and FEV1 the least variable spirometry measures. Occupational and smoking histories were more reproducible than symptoms. They advised that groups be compared by the distribution of observations, not just the prevalence of abnormal findings.

Topics

Medical terms in this study, explained in our Lexicon: Occupational Lung Disease, Spirometry, FEV1.

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