Chest
Volume 98, Issue 1, July 1990, Pages 62-70
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Introducing New Members of the Editorial Board Clinical Investigation
Relationships Between Pulmonary Function and Changes in Chronic Respiratory Symptoms: Comparison of Tucson and Cracow Longitudinal Studies

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Parallel analyses of data from two longitudinal studies, one in Poland and one in the United States, were performed to assess the relationships between pulmonary function and respiratory symptoms. Similar relationships were seen in the both cities using the same methods of analysis. The rate of FEV1 decline and its final level were related to the prior presence of attacks of breathlessness or to a syndrome that also included wheezing and diagnosed asthma. Initial FEV1 level was lower in subjects with dyspnea appearing during the follow-up than in the never-symptom group. These relationships were independent of smoking habits. The consistencies in the parallel analyses strengthen the relationships observed. In Tucson, Ariz, the FEV1 decline in smokers with persistent chronic cough was greater than that due to separate effects of the symptom and smoking. This suggests that chronic cough may be an indicator of an increased effect of tobacco smoke on pulmonary function.

Section snippets

Material and Methods

The detailed descriptions of the two studies and their methodologies have been provided previously.11, 12, 13, 14, 15 Briefly, the Cracow study was a random sample of adults aged 19 to 70 years in 1968. Standard questionnaires (derived from the BMRC respiratory questionnaire) were administered to 4,355 subjects and spirometric results (Vitalograph) were obtained on 3,047 subjects.11 The population was resurveyed in 1973 and again in 1981, using the same instruments. During the final (1981)

Characteristics of the Analyzed Groups

The Tucson and Cracow analyzed groups differed markedly with respect to age and smoking habits (Table 1). The Tucson sample was stratified according to age,13 while the age structure of the Cracow sample was representative for the Cracow population.11 As a result, the proportion of subjects aged 51 to 70 years was much greater in Tucson (31.7 percent of men analyzed here and 50.2 percent women) than in the Cracow group (21.0 percent and 21.8 percent, respectively). The proportion of men smoking

Discussion

This analysis shows that a number of associations between pulmonary function and symptoms are similar in different populations. These consistencies indicate that the relationships found in both studies are not due to chance and represent part of natural history of airflow obstruction.

The results of analysis of FEV1 levels and slopes were the most consistent for the symptoms of the “asthmatic” type, ie, for wheeze, attacks of breathlessness, and diagnosed asthma. In general, subjects with such

Acknowledgment

The Tucson study was supported by NHLBI SCOR grant No. HL14136. The Cracow Study was supported in part by grant P-05-109-N from NIHLB. Professors M.J. Wysocki, M.D., and W. Jedrychowski, M.D., were main contributors to the latter study. The first author (M.K.) was the recipient of International Fogarty Fellowship, grant No. 1-F05-TW03940

References (31)

  • Ebi-KrystonKL

    Respiratory symptoms and pulmonary function as predictors of 10-year mortality from respiratory disease, cardiovascular disease, and all causes in the Whitehall Study

    J Clin Epidemiol

    (1988)
  • CarpenterL et al.

    Respiratory symptoms as predictors of 27 year mortality in a representative sample of British adults

    Br Med J

    (1989)
  • PetoR et al.

    The relevance in adults of air-flow obstruction, but not of mucus hypersecretion, to mortality from chronic lung disease

    Am Rev Respir Dis

    (1983)
  • AnnesiI et al.

    Is respiratory mucus hypersecretion really an innocent disorder?

    Am Rev Respir Dis

    (1986)
  • VollmerWM et al.

    Respiratory symptoms, lung function, and mortality in a screening center cohort

    Am J Epidemiol

    (1989)
  • VestboJ et al.

    Respiratory symptoms and FEV1 as predictors of hospitalization and medication in the following 12 years due to respiratory disease

    Eur Respir J

    (1989)
  • FletcherCM et al.

    The natural history of chronic bronchitis and emphysema: an eight-year study of early chronic obstructive lung disease in working men in London

    New York, NY: Oxford University Press

    (1976)
  • HigginsMW et al.

    An index of risk for obstructive airways disease

    Am Rev Respir Dis

    (1982)
  • KauffmannF et al.

    Twelve years of spirometric changes among Paris area workers

    Int J Epidemiol

    (1979)
  • JedrychowskiW et al.

    Are chronic wheezing and asthma-like attacks related to FEV1 decline? the Cracow study

    Eur J Epidemiol

    (1988)
  • SawickiF

    Chronic nonspecific respiratory diseases in Cracow

    Epidemiol Rev

    (1972)
  • KrzyzanowskiM et al.

    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

    Am Rev Respir Dis

    (1986)
  • LebowitzMD et al.

    Tucson epidemiologic study of obstructive lung diseases, I: methodology and prevalence of disease

    Am J Epidemiol

    (1975)
  • BurrowsB et al.

    Longitudinal changes in FEV1 in adults: methodological considerations and findings in healthy non-smokers

    Am Rev Respir Dis

    (1986)
  • CamilliAE et al.

    Longitudinal changes in forced expiratory volume in one second in adults: effects of smoking and smoking cessation

    Am Rev Respir Dis

    (1987)
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    Manuscript received May 1; revision accepted December 12, 1989.

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