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Time trends in repeated spirometry in children.

G Hoek1, B Brunekreef

  • 1Dept of Epidemiology and Public Health, University of Wageningen, The Netherlands.

The European Respiratory Journal
|May 1, 1992
PubMed
Summary
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Pulmonary function tests in children revealed unexpected time-dependent changes, independent of air pollution. These lung function trends, including peak expiratory flow (PEF) and forced vital capacity (FVC), must be considered in air pollution studies.

Area of Science:

  • Environmental Health
  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Repeated pulmonary function testing is crucial for assessing acute health effects of air pollution.
  • Understanding baseline lung function trends in children is essential for accurate exposure assessment.
  • Previous studies have not fully accounted for time-dependent variations in spirometry independent of environmental factors.

Purpose of the Study:

  • To investigate time-dependent trends in spirometric variables in children, independent of air pollution.
  • To determine if these trends differ based on testing intervals.
  • To inform the methodology of future air pollution impact studies on respiratory health.

Main Methods:

  • Spirometry was performed 6-10 times over ~3 months in 1,621 children aged 7-11 years.

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  • Pulmonary function data, including peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), were analyzed.
  • Children were divided into groups based on testing intervals (1 week vs. 3 weeks) to assess the impact of frequency.

    • Main Results:

    • Peak expiratory flow (PEF) showed a greater than expected increase over time.
    • Maximal mid-expiratory flow (MMEF) exhibited a decrease with time.
    • Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) demonstrated smaller than expected increases.
    • Deviations were more pronounced in children tested weekly compared to those tested bi-weekly.
    • Time-dependency relationships were non-linear for FVC/FEV1 and approximately linear for PEF/MMEF.

    Conclusions:

    • Significant, unexpected time-dependent changes in pulmonary function occur in children.
    • These spirometric trends vary by lung function parameter and testing frequency.
    • Accounting for these intrinsic temporal variations is critical for accurately interpreting air pollution effects on respiratory health in longitudinal studies.