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Correspondence |

CT Scan Segmental Airway Lumen AreaCT Scan Segmental Airway Lumen Area FREE TO VIEW

David J. Ross, MA, MSc; Victoria J. Sebbage, MBBS
Author and Funding Information

From Western Sussex Hospitals Trust.

CORRESPONDENCE TO: David J. Ross, MA, MSc, Western Sussex Hospitals Trust, Chichester, PO19 6SE, England; e-mail: djross@nhs.net


FINANCIAL/NONFINANCIAL DISCLOSURES: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(1):e33. doi:10.1378/chest.15-0677
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To the Editor:

In a recent issue of CHEST (March 2015) Thomson and colleagues1 conclude that airway lumen is reduced in patients with asthma who smoke compared with those who have never smoked, although they did not detect an expected increase in wall thickness. An alternative explanation not discussed would be that both smoking and airway size reflect socioeconomic status (SES) in early life. The association of lower SES with poorer lung function persists throughout life,2 and smoking is strongly correlated with social class in the United Kingdom.3 It is unfortunate the article presents body surface area rather than height, because the latter is a marker of childhood SES4 and may be more informative.

On a prosaic note, the left bronchial 3 (ie, more proximal airway) lumen area in both columns of Table 1 in their article1 is 8 mm2 (with appropriate CIs), much smaller than both the equivalent on the right (22 mm2) and in the more distal airways. Hopefully, this is a transcription error, because such internal inconsistency could undermine an otherwise comprehensive and excellent body of work.

References

Thomson NC, Chaudhuri R, Spears M, et al. Poor symptom control is associated with reduced CT scan segmental airway lumen area in smokers with asthma. Chest. 2015;147(3):735-744. [CrossRef] [PubMed]
 
Gray LA, Leyland AH, Benzeval M, Watt GC. Explaining the social patterning of lung function in adulthood at different ages: the roles of childhood precursors, health behaviours and environmental factors. J Epidemiol Community Health. 2013;67(11):905-911. [CrossRef] [PubMed]
 
Eastwood P. Statistics on Smoking. Leeds, England: Health and Social Care Information Centre; 2013.
 
Ward K, Hubbard R. Is adult height related to the risk of having chronic obstructive pulmonary disease? J Epidemiol Community Health. 2011;65(3):226-229. [CrossRef] [PubMed]
 

Figures

Tables

References

Thomson NC, Chaudhuri R, Spears M, et al. Poor symptom control is associated with reduced CT scan segmental airway lumen area in smokers with asthma. Chest. 2015;147(3):735-744. [CrossRef] [PubMed]
 
Gray LA, Leyland AH, Benzeval M, Watt GC. Explaining the social patterning of lung function in adulthood at different ages: the roles of childhood precursors, health behaviours and environmental factors. J Epidemiol Community Health. 2013;67(11):905-911. [CrossRef] [PubMed]
 
Eastwood P. Statistics on Smoking. Leeds, England: Health and Social Care Information Centre; 2013.
 
Ward K, Hubbard R. Is adult height related to the risk of having chronic obstructive pulmonary disease? J Epidemiol Community Health. 2011;65(3):226-229. [CrossRef] [PubMed]
 
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