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. 1995 Aug;52(8):547–553. doi: 10.1136/oem.52.8.547

Predictors of spirometric test failure: a comparison of the 1983 and 1993 acceptability criteria from the European Community for Coal and Steel.

S Humerfelt 1, G E Eide 1, G Kvåle 1, A Gulsvik 1
PMCID: PMC1128292  PMID: 7663642

Abstract

OBJECTIVES--To identify, in this general population study, predictors of spirometric test failure on the 1983 and 1993 acceptability criteria from the European Community for Coal and Steel (ECCS). METHODS--All men aged 30-46 years living in western Norway (n = 45,380) were invited to join a cross sectional community survey. Respiratory symptoms, smoking habits, and marital status were found from self administered questionnaires, and measurements of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were performed with dry wedge bellow spirometers. RESULTS--Altogether 29,611 subjects (65%) participated in this survey. Spirometric recordings were obtained in 26,803 of these (91%) of whom 1.6% failed the 1983 criterion (< or = 300 ml between the two highest FVC values) and 9.5% failed the 1993 criteria (< or = 5% or 100 ml between the two highest FEV1 and the two highest FVC values). Spirometric failures on both criteria were more prevalent in never smokers, single men, and subjects with respiratory symptoms than in ever smokers, married, and asymptomatic subjects. Failure of the 1993 criteria increased with age and declining height. Morning cough and phlegm, breathlessness uphill, attacks of breathlessness, and wheezing were related to failure of the 1993 criteria after adjustment for demographic variables and smoking, whereas only breathlessness uphill was related to failure of the 1983 criterion. CONCLUSIONS--In men aged 30-46 years, spirometric test failures on both the 1983 and 1993 ECCS acceptability criteria occurred more often in never smokers than in smokers and ex-smokers after adjustment for other covariables. Spirometric test failure with the 1993 criteria also varied with height and most respiratory symptoms. The higher failure rates found in non-smokers, in shorter, and in single men could be due to late compression of the airways, smaller lung volumes, and poor general health, respectively.

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Selected References

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  1. Bakke P. S., Baste V., Gulsvik A. Bronchial responsiveness in a Norwegian community. Am Rev Respir Dis. 1991 Feb;143(2):317–322. doi: 10.1164/ajrccm/143.2.317. [DOI] [PubMed] [Google Scholar]
  2. Bakke P., Gulsvik A., Eide G. E., Hanoa R. Smoking habits and lifetime occupational exposure to gases or dusts, including asbestos and quartz, in a Norwegian community. Scand J Work Environ Health. 1990 Jun;16(3):195–202. doi: 10.5271/sjweh.1794. [DOI] [PubMed] [Google Scholar]
  3. Becklake M. R. Epidemiology of spirometric test failure. Br J Ind Med. 1990 Feb;47(2):73–74. doi: 10.1136/oem.47.2.73. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bjartveit K., Foss O. P., Gjervig T., Lund-Larsen P. G. The cardiovascular disease study in Norwegian counties. Background and organization. Acta Med Scand Suppl. 1979;634:1–70. [PubMed] [Google Scholar]
  5. Davis C., Campbell E. J., Openshaw P., Pride N. B., Woodroof G. Importance of airway closure in limiting maximal expiration in normal man. J Appl Physiol Respir Environ Exerc Physiol. 1980 Apr;48(4):695–701. doi: 10.1152/jappl.1980.48.4.695. [DOI] [PubMed] [Google Scholar]
  6. Eisen E. A., Dockery D. W., Speizer F. E., Fay M. E., Ferris B. G., Jr The association between health status and the performance of excessively variable spirometry tests in a population-based study in six U.S. cities. Am Rev Respir Dis. 1987 Dec;136(6):1371–1376. doi: 10.1164/ajrccm/136.6.1371. [DOI] [PubMed] [Google Scholar]
  7. Eisen E. A., Oliver L. C., Christiani D. C., Robins J. M., Wegman D. H. Effects of spirometry standards in two occupational cohorts. Am Rev Respir Dis. 1985 Jul;132(1):120–124. doi: 10.1164/arrd.1985.132.1.120. [DOI] [PubMed] [Google Scholar]
  8. Eisen E. A. Standardizing spirometry: problems and prospects. Occup Med. 1987 Apr-Jun;2(2):213–225. [PubMed] [Google Scholar]
  9. Enright P. Can we relax during spirometry? Am Rev Respir Dis. 1993 Aug;148(2):274–274. doi: 10.1164/ajrccm/148.2.274. [DOI] [PubMed] [Google Scholar]
  10. Gulsvik A. Prevalence and manifestations of obstructive lung disease in the city of Oslo. Scand J Respir Dis. 1979 Oct;60(5):286–296. [PubMed] [Google Scholar]
  11. Gulsvik A. Prevalence of respiratory symptoms in the city of Oslo. Scand J Respir Dis. 1979 Oct;60(5):275–285. [PubMed] [Google Scholar]
  12. Hankinson J. L., Bang K. M. Acceptability and reproducibility criteria of the American Thoracic Society as observed in a sample of the general population. Am Rev Respir Dis. 1991 Mar;143(3):516–521. doi: 10.1164/ajrccm/143.3.516. [DOI] [PubMed] [Google Scholar]
  13. Humerfelt S., Gulsvik A., Skjaerven R., Nilssen S., Kvåle G., Sulheim O., Ramm E., Eilertsen E., Humerfelt S. B. Decline in FEV1 and airflow limitation related to occupational exposures in men of an urban community. Eur Respir J. 1993 Sep;6(8):1095–1103. [PubMed] [Google Scholar]
  14. Hyatt R. E., Flath R. E. Relationship of air flow to pressure during maximal respiratory effort in man. J Appl Physiol. 1966 Mar;21(2):477–482. doi: 10.1152/jappl.1966.21.2.477. [DOI] [PubMed] [Google Scholar]
  15. Jacobsen B. K., Thelle D. S. The Tromsø Heart Study: responders and non-responders to a health questionnaire, do they differ? Scand J Soc Med. 1988;16(2):101–104. doi: 10.1177/140349488801600207. [DOI] [PubMed] [Google Scholar]
  16. Kellie S. E., Attfield M. D., Hankinson J. L., Castellan R. M. Spirometry variability criteria--association with respiratory morbidity and mortality in a cohort of coal miners. Am J Epidemiol. 1987 Mar;125(3):437–444. doi: 10.1093/oxfordjournals.aje.a114549. [DOI] [PubMed] [Google Scholar]
  17. Krowka M. J., Enright P. L., Rodarte J. R., Hyatt R. E. Effect of effort on measurement of forced expiratory volume in one second. Am Rev Respir Dis. 1987 Oct;136(4):829–833. doi: 10.1164/ajrccm/136.4.829. [DOI] [PubMed] [Google Scholar]
  18. Laszlo G. European standards for lung function testing: 1993 update. Thorax. 1993 Sep;48(9):873–876. doi: 10.1136/thx.48.9.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ng'Ang'a L. W., Ernst P., Jaakkola M. S., Gerardi G., Hanley J. H., Becklake M. R. Spirometric lung function. Distribution and determinants of test failure in a young adult population. Am Rev Respir Dis. 1992 Jan;145(1):48–52. doi: 10.1164/ajrccm/145.1.48. [DOI] [PubMed] [Google Scholar]
  20. Standardization of spirometry--1987 update. Statement of the American Thoracic Society. Am Rev Respir Dis. 1987 Nov;136(5):1285–1298. doi: 10.1164/ajrccm/136.5.1285. [DOI] [PubMed] [Google Scholar]
  21. Stoller J. K., Basheda S., Laskowski D., Goormastic M., McCarthy K. Trial of standard versus modified expiration to achieve end-of-test spirometry criteria. Am Rev Respir Dis. 1993 Aug;148(2):275–280. doi: 10.1164/ajrccm/148.2.275. [DOI] [PubMed] [Google Scholar]
  22. Tibblin G. A population study of 50-year-old men. An analysis of the non-participation group. Acta Med Scand. 1965 Oct;178(4):453–459. doi: 10.1111/j.0954-6820.1965.tb04290.x. [DOI] [PubMed] [Google Scholar]

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