Chest
Clinical InvestigationsPulmonary FunctionQuality of Spirometry Test Performance in Children and Adolescents*: Experience in a Large Field Study
Section snippets
Materials and Methods
Students from public schools in 12 middle-income communitieswith diverse air pollution patterns in southern California werestudied. In year 1 (1993), students in grades 4, 7, and 10 wereenrolled. In year 4, a new cohort of grade 4 students was enrolled. Subjects were evaluated annually from January through June byspirometry and by questionnaires on respiratory health and environmental exposures. They were tested at their schools, usually ingroups of ≥ 12. As many as six technicians performed
Results
Table 1gives descriptive statistics for each performance variable, based on9,355 test sessions over 3 years (5,561 test sessions over the earlier2 years for best vs second-best differences). The percentages of testsessions failing to meet each ATS and LHS (adult-based)maneuver-acceptability criterion and each reproducibility criterionwere the following: EOTV, 2%; FET, 5%; BEV, 7%; d, FVC, 3%;dFEV1, 7%; and d, PEF, 10%.
Table 2summarizes regression results for the four performance variables
Discussion
In general, the spirometry quality of the children and adolescentsin our study compared favorably with that of adults studiedelsewhere.78910111213 The thresholds specified by the, ATS1 and LHS6 spirometry acceptability and reproducibility criteria were set so that about 5% of adults failed tomeet each criterion when tested by an experienced technician using adiagnostic-quality spirometry system. Our results show that childrenaged ≥ 9 years also can meet each of the ATS criteria about 95% ofthe
Summary
We found that most schoolchildren who are ≥ 9 years can performforced expiratory spirometric maneuvers well enough to meet currentlyestablished adult-based maneuver acceptability criteria for BEV, EOTV,and FET, as well as within-test session maneuver reproducibility for, FEV1, FVC, and PEF. Factors related to age, size, gender, ethnicity, and subject-technician affinity can influenceperformance, but their overall effect is small with well-trainedtechnicians who have experience. Our findings
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Supported by the California Air Resources Board (contract No. A033–186), the National Institute of Environmental Health Sciences(grant No. 5P30ES07048–02), the US Environmental Protection Agency(contract No. CR824034–01-3), and the Hastings Foundation.
The statements and conclusions in this report are those of the authors and not necessarily those of the California Air Resources Board (or other sponsors). The mention of commercialproducts and their source or use in connection with the materialreported herein is not to be construed as actual or implied endorsementof such products.