A review and analysis of variation between spirometric values reported in 29 studies of healthy African adults

128

Tubercle and Lung Disease: Supplement

Twice daily peak flow (PF) measurements are being used to investigate potential adverse respiratory effects of emissions from waste incinerators. These measurements are obtained for 35 consecutive days each year from participants in a three year study of respiratory health and air quality in three communities with waste incinerators and nearby comparison communities. Households within a 2 mile radius of the biomedical, municipal, and industrial waste incinerators of interest were contacted by telephone. All non-smokers ages 8-80 were offered participation in the study which includes yearly spirometry and a questionnaire on respiratory symptoms and exposures. Participants were later solicited to record three measurements of PF each morning and each evening for a specified 35 day period after performing baseline spirometry and receiving training on use of a portable peak flow meter. Volunteers were solicited until target numbers were reached. A comparison group was selected by the same procedure from households near the center of a community within 5 miles of the incinerator community but lacking any point source of air pollution. Both groups recorded the peak flows and respiratory symptoms over the same 35 day period. The average number of days with both AM and PM peak flows ranged from 29.1 f .8 to 33.1 f .6 over the six communities. The table shows the first year’s number of participants (n), mean AM and PM PF (% predicted) & mean standardizing change in PF (A) over the day (%) + SEM for the incinerator (i) and control (c) community pairs. All communities showed a small increase in PF from AM to PM with a trend for incinerator communities to have slightly greater rise than the matched control community. No important differences were present in respiratory Further symptom incidence between communities. analysis is underway to determine if peak flow changes or symptoms are associated with measured air quality, but these data suggest no detectable acute effect from incinerator emissions. (Supportedby a grant from the Agency of Toxic Substances and Disease Registry, and in part by the UNC Center for Environmental Lung Biology.)

103+2

108+2

110f2

106f2

Medicine

108f2

and

108+2

472 ETIO-EPIDEMIOLOGICAL

APPEARANCE OF ASTHMA AMONG MALAGASY PEOPLE

Andrianarisoa, A. C. F., Raholimina, V. R., Schaffner, M.; Faculte de Medecine, B. P. 375, Universite Antananarivo, Madagascar 3200

asthmatic patients, have been studied.

aged 18 months up to 78 years,

The asthma prevalence varies from 0.80% to 12% and it often reaches men; predilection age is ranging from 20 to 40 years. Endemicity is strongly marked on the Island, medium on the Highlands and Coast. Hospitalization rate corresponds inhabitants one dies of asthma per year. 12th place of mortality causes.

East Coast of the low on the West to 4%. In 10,000 Thus, it takes the

The crisis is activated by home dust for X0 to 100% of the subjects. Teeth infections predominate among children (70%) and ear, nose and larynx diseases among adults (60%). Our patients present an atopical state (60%) and come from a modest social class (75%). Malagasy asthmatic patients present calcium and protide deficiencies, but more important is an intestinal ascaridiose in 94% of them.

473 A REVIEW AND ANALYSIS OF VARIATION BETWEEN SPIROMETRIC VALUES REPORTED IN 29 STUDIES OF HEALTHY AFRICAN ADULTS White, N. W. *, Hanley,J., Lalloo, I/., Becklake, M. R.; *Respiratory Clinic, Groote Schuur Hospital I U. C. T., Cape Town, South Africa

Within- and between-population variation in spirometry measurements is addressed in a review of 29 studies, published between 1965 and 1990, on 9690 men and 2638 women of sub-Saharan African ancestry. FVC and FEVl were age and height standardised at BTPS. Between population differences were related to geographic region and sample source (workforce versus community) due to the healthy worker effect. The effects of altitude, variation in sample mean height and date of study publication were significant variables in multivariate models explaining between-population differences. Altitude was the most important variable with an effect of 263 mV1000m. (95% CI X20-410) on FVC in men. In women variation in sample mean height was also important with taller populations having larger values for FVC (64 ml/cm). In men, secular trends were evident with date of study being associated with negative trends in the U.S.A. (-35.3 ml/ year), and positive trends (14.7 ml/year) in other regions. These differences in trend could not be explained. In conclusion, population selection factors, altitude, date of study and other biological sources of variation need to be taken into account in the evaluation of between- and within-population comparisons of spirometric measurements.

474 ASSESSMENT OF CONCENTRATIONS LAMININ Pl IN SERA OF PATIENTS WITH PULMONARY DISEASES

OF

Voss, B., Poller, W., Wiethege, Th., Bdhm, S.; Professional Associations’ Research Institute for Occupational Medicine at the Ruhr University - BGFA, Gilsingstr. 14, 44789 Bochum, FRG

Chronic obstructive lung diseases probably are associated with changes in the ability of lung cells to maintain the normal extracellular connective tissue matrix. Clinically air flow obstruction can not only be recognised but quantified. However, the pathological processes including fibrogenesis and total occlusion of some small airways are less well measurable. A severe distortion of the structural integrity of the lung can be assumed for the ARDS. Since different peptides of the connective tissue are delivered either into the broncho-alveolar fluid and/or into the circulation, the assessment of the structural changes of the lung tissue by measurement of connective tissue peptides may be conceivable. Sera of 96 patients with COPD (age 23-80, 28 women, 68 men, 32 non-smokers, 64 smokers) and 31 patients with ARDS were investigated by radioimmunoassays specific