Quantitative diagnosis in pulmonary medicine - making virtue out of necessity.
Occupational safety and health symposia 1979. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 80-139, 1980 Jun; :19-22
Diagnostic procedures for pulmonary functions were discussed. The individual response to a particular challenge depends on a large number of factors. Various agents can deposit at any point in the complex lung system. Genetically determined variables are important. Nutritional factors and secondary intoxicants may have a role in the toxic manifestation of an agent. The inhaled agent may interact with other diseases. Small airways with diameters less than approximately 2 millimeters can be the site of disease without an obvious impairment of the parameters of the spirometric pulmonary function. The author does not consider maximum mid expiratory flow rate a good test because of poor reproducibility and variability among subjects. The computerized analysis of moments and slope ratios in the spirograms are useful in the early detection of disease in individuals and in groups of subjects. Breath nitrogen test is a good indicator of diseased lung. The measurement of response to a bronchoconstrictive aerosol, such as histamine, methacholine, carbachol, and toluene-diisocyanate (584849) was of particular interest to occupational medicine. Woodworkers, particularly those exposed to red cedar dust, have enhanced responsiveness to histamine and wheezing. There is evidence that continued smoking results in the more rapid progression of abnormal pulmonary function than that associated with aging. The rate of decline reverts to the normal slope if the person quits smoking. Exercise testing provides useful information on the cardiovascular and respiratory system. At rest the expired ventilation might be 6 liters per minute (l/min) and the oxygen consumption 0.25l/min (ventilation/consumption, 24:1); during very heavy exercise the two rates may rise to 100 and 4l/min, respectively (ventilation/consumption, 25:1). In patients with obstructive lung disease, the ventilation/consumption ratios rise to 40:1 or even 50:1 which impair performance in physically demanding jobs.
NIOSH-Contract; Pulmonary-disorders; Pulmonary-function-tests; Medical-screening; Physiological-response; Lung-burden; Clinical-diagnosis; Diagnostic-tests; Synergism
DHHS (NIOSH) Publication No. 80-139; Contract-210-79-0009
Occupational safety and health symposia 1979