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Spirometric reference values from a sample of the general U.S. population

J L Hankinson1, J R Odencrantz, K B Fedan

  • 1Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.

American Journal of Respiratory and Critical Care Medicine
|January 5, 1999
PubMed
Summary

New spirometric reference values were developed for diverse racial and ethnic groups. These lung function values, based on age and height, aid in diagnosing respiratory conditions across populations.

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Area of Science:

  • Pulmonary Medicine
  • Public Health
  • Biostatistics

Background:

  • Spirometric reference values are crucial for diagnosing lung diseases.
  • Existing reference values may not adequately represent diverse racial and ethnic populations.
  • The third National Health and Nutrition Examination Survey (NHANES III) provides a large dataset for developing updated values.

Purpose of the Study:

  • To establish comprehensive spirometric reference values for Caucasian, African-American, and Mexican-American populations.
  • To account for age, height, and racial/ethnic differences in lung function.
  • To provide updated data for clinical diagnosis and research.

Main Methods:

  • Utilized data from 7,429 asymptomatic, non-smoking participants aged 8-80 from NHANES III.

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  • Conducted spirometry according to 1987 American Thoracic Society recommendations.
  • Employed a piecewise polynomial model using age and height as predictors to derive reference values.
  • Main Results:

    • Caucasian subjects exhibited higher mean Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1) than Mexican-American and African-American subjects.
    • FVC and FEV1 relative to height were similar between Caucasian and Mexican-American subjects, but lower in African-American subjects.
    • Observed differences in body build, such as height and trunk:leg ratio, may contribute to variations in lung function measurements.

    Conclusions:

    • Developed age- and height-specific spirometric reference values for three major US race/ethnic groups.
    • These reference values offer improved diagnostic utility for a wider demographic range.
    • The findings highlight the importance of race/ethnicity and body composition in interpreting spirometry results.