Decline in lung function and mortality: implications for medical monitoring.
Sircar K; Hnizdo E; Petsonk E; Attfield M
Occup Environ Med 2007 Jul; 64(7):461-466
Aim: To investigate the risk of death associated with selected cut-off points for rate of decline of forced expiratory volume in one second (FEVj). Methods: Mortality rates of a cohort of 1730 coal miners who had performed two pulmonary function tests 12.8 years apart were followed up for an additional 12 years. Based on previous studies, cut-off points for FEVI rate of decline (ml/year) were selected as 30, 60 and 90 ml/year. Cox proportional hazard regression was used to estimate multivariate risk ratio of death n each category. Results: The risk ratios (compared to "below 30 ml/year") were 1.39 (95% Cl 0.99 to 1.97) in the "60 to less " than 90 ml/year category and 1.90 (95% Cl 1.32 to 2.76) in the "90 ml/year and above" category. Rates of decline above 90 ml/year were consistently related to excess mortality. In non-smokers and those with neither restrictive nor obstructive patterns at the first survey, rates of decline above 60 ml/year were significantly associated with increased mortality. Conclusions: Risk of death increases in individuals with rates of decline above about 60 ml/year and is statistically significant with declines of 90 ml/year or more. These results should be useful to healthcare providers in assessing lung function declines observed in individuals.
Statistical-analysis; Pulmonary-function; Pulmonary-function-tests; Pulmonary-system-disorders; Lung-disorders; Lung-function; Coal-miners; Mortality-rates; Mortality-data; Respiratory-system-disorders; Pulmonary-system-disorders; Surveillance
Dr K Sircar National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV 26505
Occupational and Environmental Medicine