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Clinical Investigations: COPD |

Respiratory Symptoms and Pulmonary Function in an Elderly Nonsmoking Population*

David J. Berglund, MD, MPH; David E. Abbey, PhD; Michael D. Lebowitz, PhD, FCCP; Synnøve F. Knutsen, PhD, MD; William F. McDonnell, PhD, MD
Author and Funding Information

*From the Center for Health Research (Drs. Berglund, Abbey, and Knutson), School of Public Health, Loma Linda University, CA; the Arizona Prevention Center (Dr. Lebowitz), University of Arizona, College of Medicine, Tucson, AZ; and the United States Environmental Protection Agency (Dr. McDonnell), Research Triangle Park, NC.



Chest. 1999;115(1):49-59. doi:10.1378/chest.115.1.49
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Objective: To examine risk factors for chronic airway disease (CAD) in elderly nonsmokers, as determined by pulmonary function tests (PFTs), and to correlate reported respiratory symptoms with PFT measures.

Design: An observational survey.

Setting: Several communities in California.

Measurements: Exposures and respiratory history were assessed by standardized questionnaire. PFTs were performed and prediction equations derived.

Results: Significant risk factors for obstruction on PFTs in multiple logistic regression included reported environmental tobacco smoke (ETS) exposure (relative risk [RR] = 1.44), parental CAD or hay fever (RR = 1.47), history of childhood respiratory illness (RR = 2.15), increasing age, and male sex. The number of years of past smoking was of borderline significance (RR = 1.29 for 10 years of smoking; p = 0.06). The prevalence of obstruction on PFTs was 24.9% in those with definite symptomatic CAD, compared with 7.5% in those with no symptoms of CAD. The prevalence of obstruction was 36.0% among those with asthma and 70.6% among those with emphysema. Also, symptomatic CAD correlated with reduction in lung function by analysis of covariance. The mean percent predicted FEV1 adjusted for covariates was 90.6% in persons with definite symptoms of CAD, compared with 97.8% in those without it (p < 0.001).

Conclusions: Age, sex, parental history, childhood respiratory illness, and reported ETS exposures were significant risk factors for obstruction on PFTs. Self-reported respiratory symptoms also correlated significantly with PFTs.


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