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. 1990 Jan;45(1):32–37. doi: 10.1136/thx.45.1.32

Decline of lung function and development of chronic airflow limitation: a longitudinal study of non-smokers and smokers in Busselton, Western Australia.

J K Peat 1, A J Woolcock 1, K Cullen 1
PMCID: PMC475638  PMID: 2321175

Abstract

Data collected during seven population health surveys over 18 years in Busselton, Western Australia, were examined to determine the effect of smoking on lung function and to investigate the development of chronic airflow limitation. Lung function was measured and details of respiratory illness and smoking histories were collected from subjects attending surveys at three year intervals from 1966 to 1984. Data from ex-smokers and asthmatic patients (diagnosis based on answer to questionnaire) were excluded. Regression of height adjusted forced expiratory volume in one second (FEV1) on age was calculated individually for 759 non-smokers and 225 regular smokers with four or more observations. Decline in height adjusted FEV1 was similar for men and women. In smokers the rate of decline in FEV1 was greater than in non-smokers and was related to the amount smoked, to the extent that a smoker could expect a 20-30% greater rate of decline than a non-smoker of the same age. Chronic airflow limitation (defined as FEV1/FEV less than 65% or FEV1 less than 65% predicted on at least two occasions) was common, occurring in 24% of men and 18% of women who were regular smokers and in 5% of male and 8% of female non-smokers. These figures are higher than those reported in other populations, especially for women and for non-smokers. Not all chronic airflow limitation was associated with respiratory symptoms, confirming that the condition may be unrecognised until it is advanced.

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Selected References

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  1. Bande J., Clément J., Van de Woestijne K. P. The influence of smoking habits and body weight on vital capacity and FEV1 in male Air Force personnel: a longitudinal and cross-sectional analysis. Am Rev Respir Dis. 1980 Nov;122(5):781–790. doi: 10.1164/arrd.1980.122.5.781. [DOI] [PubMed] [Google Scholar]
  2. Barter C. E., Campbell A. H. Relationship of constitutional factors and cigarette smoking to decrease in 1-second forced expiratory volume. Am Rev Respir Dis. 1976 Mar;113(3):305–314. doi: 10.1164/arrd.1976.113.3.305. [DOI] [PubMed] [Google Scholar]
  3. Beaty T. H., Menkes H. A., Cohen B. H., Newill C. A. Risk factors associated with longitudinal change in pulmonary function. Am Rev Respir Dis. 1984 May;129(5):660–667. doi: 10.1164/arrd.1984.129.5.660. [DOI] [PubMed] [Google Scholar]
  4. Beck G. J., Doyle C. A., Schachter E. N. Smoking and lung function. Am Rev Respir Dis. 1981 Feb;123(2):149–155. doi: 10.1164/arrd.1981.123.2.149. [DOI] [PubMed] [Google Scholar]
  5. Bossé R., Sparrow D., Garvey A. J., Costa P. T., Jr, Weiss S. T., Rowe J. W. Cigarette smoking, aging, and decline in pulmonary function: A longitudinal study. Arch Environ Health. 1980 Jul-Aug;35(4):247–252. doi: 10.1080/00039896.1980.10667500. [DOI] [PubMed] [Google Scholar]
  6. Bossé R., Sparrow D., Rose C. L., Weiss S. T. Longitudinal effect of age and smoking cessation on pulmonary function. Am Rev Respir Dis. 1981 Apr;123(4 Pt 1):378–381. doi: 10.1164/arrd.1981.123.4.378. [DOI] [PubMed] [Google Scholar]
  7. Brown P. J., Greville H. W., Finucane K. E. Asthma and irreversible airflow obstruction. Thorax. 1984 Feb;39(2):131–136. doi: 10.1136/thx.39.2.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Burrows B., Cline M. G., Knudson R. J., Taussig L. M., Lebowitz M. D. A descriptive analysis of the growth and decline of the FVC and FEV1. Chest. 1983 May;83(5):717–724. doi: 10.1378/chest.83.5.717. [DOI] [PubMed] [Google Scholar]
  9. Burrows B., Earle R. H. Course and prognosis of chronic obstructive lung disease. A prospective study of 200 patients. N Engl J Med. 1969 Feb 20;280(8):397–404. doi: 10.1056/NEJM196902202800801. [DOI] [PubMed] [Google Scholar]
  10. Burrows B., Knudson R. J., Camilli A. E., Lyle S. K., Lebowitz M. D. The "horse-racing effect" and predicting decline in forced expiratory volume in one second from screening spirometry. Am Rev Respir Dis. 1987 Apr;135(4):788–793. doi: 10.1164/arrd.1987.135.4.788. [DOI] [PubMed] [Google Scholar]
  11. Burrows B., Knudson R. J., Cline M. G., Lebowitz M. D. Quantitative relationships between cigarette smoking and ventilatory function. Am Rev Respir Dis. 1977 Feb;115(2):195–205. doi: 10.1164/arrd.1977.115.2.195. [DOI] [PubMed] [Google Scholar]
  12. Burrows B., Knudson R. J., Lebowitz M. D. The relationship of childhood respiratory illness to adult obstructive airway disease. Am Rev Respir Dis. 1977 May;115(5):751–760. doi: 10.1164/arrd.1977.115.5.751. [DOI] [PubMed] [Google Scholar]
  13. Burrows B., Lebowitz M. D., Barbee R. A., Knudson R. J., Halonen M. Interactions of smoking and immunologic factors in relation to airways obstruction. Chest. 1983 Dec;84(6):657–661. doi: 10.1378/chest.84.6.657. [DOI] [PubMed] [Google Scholar]
  14. Camilli A. E., Burrows B., Knudson R. J., Lyle S. K., Lebowitz M. D. Longitudinal changes in forced expiratory volume in one second in adults. Effects of smoking and smoking cessation. Am Rev Respir Dis. 1987 Apr;135(4):794–799. doi: 10.1164/arrd.1987.135.4.794. [DOI] [PubMed] [Google Scholar]
  15. Campbell A. H., Barter C. E., O'Connell J. M., Huggins R. Factors affecting the decline of ventilatory function in chronic bronchitis. Thorax. 1985 Oct;40(10):741–748. doi: 10.1136/thx.40.10.741. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Dockery D. W., Speizer F. E., Ferris B. G., Jr, Ware J. H., Louis T. A., Spiro A., 3rd Cumulative and reversible effects of lifetime smoking on simple tests of lung function in adults. Am Rev Respir Dis. 1988 Feb;137(2):286–292. doi: 10.1164/ajrccm/137.2.286. [DOI] [PubMed] [Google Scholar]
  17. Ferris B. G., Chen H., Puleo S., Murphy R. L. Chronic nonspecific respiratory disease in Berlin, New Hampshire, 1967 to 1973. A further follow-up study. Am Rev Respir Dis. 1976 Apr;113(4):475–485. doi: 10.1164/arrd.1976.113.4.475. [DOI] [PubMed] [Google Scholar]
  18. Fletcher C., Peto R. The natural history of chronic airflow obstruction. Br Med J. 1977 Jun 25;1(6077):1645–1648. doi: 10.1136/bmj.1.6077.1645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Glindmeyer H. W., Diem J. E., Jones R. N., Weill H. Noncomparability of longitudinally and cross-sectionally determined annual change in spirometry. Am Rev Respir Dis. 1982 May;125(5):544–548. doi: 10.1164/arrd.1982.125.5.544. [DOI] [PubMed] [Google Scholar]
  20. Higgins I. T., Gilson J. C., Ferris B. G., Jr, Waters M. E., Campbell H., Higgins M. W. Environmental epidemiology. IV. Chronic respiratory disease in an industrial town: a nine-year follow-up study. Preliminary report. Am J Public Health Nations Health. 1968 Sep;58(9):1667–1676. doi: 10.2105/ajph.58.9.1667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Higgins M. W., Keller J. B., Becker M., Howatt W., Landis J. R., Rotman H., Weg J. G., Higgins I. An index of risk for obstructive airways disease. Am Rev Respir Dis. 1982 Feb;125(2):144–151. doi: 10.1164/arrd.1982.125.2.144. [DOI] [PubMed] [Google Scholar]
  22. Higgins M. W., Keller J. B., Landis J. R., Beaty T. H., Burrows B., Demets D., Diem J. E., Higgins I. T., Lakatos E., Lebowitz M. D. Risk of chronic obstructive pulmonary disease. Collaborative assessment of the validity of the Tecumseh index of risk. Am Rev Respir Dis. 1984 Sep;130(3):380–385. doi: 10.1164/arrd.1984.130.3.380. [DOI] [PubMed] [Google Scholar]
  23. Kauffmann F., Drouet D., Lellouch J., Brille D. Twelve years spirometric changes among Paris area workers. Int J Epidemiol. 1979 Sep;8(3):201–212. doi: 10.1093/ije/8.3.201. [DOI] [PubMed] [Google Scholar]
  24. Kauffmann F., Neukirch F., Korobaeff M., Marne M. J., Claude J. R., Lellouch J. Eosinophils, smoking, and lung function. An epidemiologic survey among 912 working men. Am Rev Respir Dis. 1986 Dec;134(6):1172–1175. doi: 10.1164/arrd.1986.134.6.1172. [DOI] [PubMed] [Google Scholar]
  25. Krzyzanowski M., Jedrychowski W., Wysocki M. Factors associated with the change in ventilatory function and the development of chronic obstructive pulmonary disease in a 13-year follow-up of the Cracow Study. Risk of chronic obstructive pulmonary disease. Am Rev Respir Dis. 1986 Nov;134(5):1011–1019. doi: 10.1164/arrd.1986.134.5.1011. [DOI] [PubMed] [Google Scholar]
  26. Morris J. F., Koski A., Johnson L. C. Spirometric standards for healthy nonsmoking adults. Am Rev Respir Dis. 1971 Jan;103(1):57–67. doi: 10.1164/arrd.1971.103.1.57. [DOI] [PubMed] [Google Scholar]
  27. Peat J. K., Woolcock A. J., Cullen K. Rate of decline of lung function in subjects with asthma. Eur J Respir Dis. 1987 Mar;70(3):171–179. [PubMed] [Google Scholar]
  28. Pride N. B. Smoking and the development of progressive airflow obstruction. Ann Acad Med Singapore. 1985 Jul;14(3):496–502. [PubMed] [Google Scholar]
  29. Speizer F. E., Tager I. B. Epidemiology of chronic mucus hypersecretion and obstructive airways disease. Epidemiol Rev. 1979;1:124–142. doi: 10.1093/oxfordjournals.epirev.a036206. [DOI] [PubMed] [Google Scholar]
  30. Tager I. B., Weiss S. T., Rosner B., Speizer F. E. Effect of parental cigarette smoking on the pulmonary function of children. Am J Epidemiol. 1979 Jul;110(1):15–26. doi: 10.1093/oxfordjournals.aje.a112783. [DOI] [PubMed] [Google Scholar]
  31. Taylor R. G., Joyce H., Gross E., Holland F., Pride N. B. Bronchial reactivity to inhaled histamine and annual rate of decline in FEV1 in male smokers and ex-smokers. Thorax. 1985 Jan;40(1):9–16. doi: 10.1136/thx.40.1.9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Tockman M. S., Anthonisen N. R., Wright E. C., Donithan M. G. Airways obstruction and the risk for lung cancer. Ann Intern Med. 1987 Apr;106(4):512–518. doi: 10.7326/0003-4819-106-4-512. [DOI] [PubMed] [Google Scholar]
  33. Yan K., Salome C. M., Woolcock A. J. Prevalence and nature of bronchial hyperresponsiveness in subjects with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1985 Jul;132(1):25–29. doi: 10.1164/arrd.1985.132.1.25. [DOI] [PubMed] [Google Scholar]
  34. van der Lende R., Kok T. J., Reig R. P., Quanjer P. H., Schouten J. P., Orie N. G. Decreases in VC and FEV1 with time: indicators for effects of smoking and air pollution. Bull Eur Physiopathol Respir. 1981;17(5):775–792. [PubMed] [Google Scholar]

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