Time for new reference values for ventilatory lung function
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EUROPEAN JOURNAL OF MEDICAL RESEARCH
Eur J Med Res (2009) 14(Suppl. IV): 140-146
December 7, 2009 © I. Holzapfel Publishers 2009
TIME FOR NEW REFERENCE VALUES FOR VENTILATORY LUNG FUNCTION W. Marek 1, E. Marek 1, K. Mückenhoff 2, H-J. Smith 3, P. Degens 4, N. Kotschy-Lang 5, M. Kohlhäufl 6
1 Institute
of Occupational Physiology, Augusta-Kranken-Anstalt, Bochum; 2 Institute of Physiology, Ruhr-Universität Bochum; 3 Cardinal Health, Höchberg; 4 Forschungsinstitut für Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Bochum; 5 Berufsgenossenschaftliche Klinik für Berufskrankheiten Falkenstein; 6 Klinik Schillerhöhe, Center for Pulmonolgy and Thoracic Surgery, Academic Teaching Hospital, University of Tübingen, Stuttgart-Gerlingen, Germany
Abstract Objective: The anthropometrical data of our aging population has significantly changed within the last five decades. Therefore the question arises whether or not the commonly used reference values of the European Community (ECCS) for lung function, may still be accepted today. Measured values for elderly are classified by extrapolation beyond the range of reference equations. Material and methods: Lung function was examined by pneumotachography for recording static lung volumes and flow-volume-curves in 257 asymptomatic non smoking males, aged 20-90 years. Results were compared to the reference values of ECCS, SAPALDIA, LuftiBus, and NHANES. Results: For analysis age and height dependence of investigated respiratory parameters (VC, FVC, FEV1, FEV1 %FVC, PEF, MEF75,50,25) can for simplicity be described by linear functions (y = a . height(H)-b . age (A)+c). The forced expiratory volume in one second, FEV1, was calculated by FEV1 = 0.0432 . H-0.0347 . A -2.114; where H - height, A - age; r = 0.78. Mean FEV1 for younger subjects was found to be 106.1 ± 11.2% of the ECCS reference values and 97.8 ± 11.7% in older subjects. For all parameters investigated linear regressions on age were steeper than described by the ECCS reference values. The regression of lung function to height largely follows the ECCS prescriptions. Summar y: Bochum lung function values of healthy subjects showed a steeper age descent compared to the reference values of the ECCS. The alternatively discussed reference values of the SAPALDIA-, NHANES- or LuftiBus-Study are higher, but do not cover all necessary parameters and/or the age range. A multi centre study for contemporary reference values is recommended. Key words: lung function, reference values, elderly males, spirometry, forced expiration
INTRODUCTION
The structure of our aging population has significantly changed along with anthropometrical data in the last five decades. Therefore the question arises whether or not the commonly used reference values of ventilatory lung function, which were suggested by the European
Community for Coal and Steel (ECCS) [1, 2], may still be accepted today, since these values were obtained in the sixties and seventies from subjects with a restricted range of age and body height. Birth cohort effects
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