Effect of lifetime cigarette consumption on time domain spirogram indices

A cross-sectional analysis on the dose-related change in time domain spirogram indices induced by lifetime cigarette consumption was conducted to examine the ability of those indices to detect early changes in the lung periphery in comparison with conventional spirometric indices. The subjects were asymptomatic healthy male workers from three occupational cohorts including asbestos workers and welders. They were asked to perform the forced expiration maneuver at least three times to obtain reliable results. A total of 893 subjects were enrolled in the study, and 484 of them who were aged 30 years or more and were free from chronic respiratory symptoms and abnormalities in chest radiography and spirometry, were analyzed. Although conventional indices, such as forced expiratory volume in one second and maximal midexpiratory flow, were not significantly different between smokers and nonsmokers, the standard deviation of transit times and of time constant distribution in smokers were significantly elevated compared with nonsmokers. Furthermore a dose-related change according to lifetime cigarette consumption was observed in those indices. We conclude that time domain spirogram indices, especially the standard deviation of time constant distribution, would be more useful than conventional indices in detecting early changes in the lung periphery.