Estimates of restrictive ventilatory defect in the mining industry. Considerations for epidemiological investigations: A Cross-sectional study

Nnaemeka U. Odo, Jeffrey H Mandel, David M Perlman, Bruce H Alexander, Paul D. Scanlon

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: (1) To assess the impact of American Thoracic Society and European Respiratory Society (ATS/ERS) 'acceptability' and 'usability' criteria for spirometry on the estimates of restrictive ventilatory defect in a population of taconite miners. (2) To compare estimates of restrictive ventilatory defect with three different pulmonary function tests (spirometry, alveolar volume (VA) and diffusing capacity (DL,co)). (3) To assess the role of population characteristics on these estimates. Design: Cross-sectional study. Setting: Current and former workers in six current taconite mining operations of northeastern Minnesota were surveyed. Participants: We attempted to enrol 3313 participants. Of these, 1353 responded while 1188 current and former workers fully participated in the survey and 1084 performed complete pulmonary function testing and were assessed. Primary and secondary outcome measures: We applied ATS/ERS acceptability criteria for all tests and categorised participants into groups according to whether they fully met, partially met or did not meet acceptability criteria for spirometry. Obstruction and restriction were defined utilising the lower limit of normal for all tests. When using VA, restriction was identified after excluding obstruction. Results: Only 519 (47.9%) tests fully met ATS/ERS spirometry acceptability criteria. Within this group, 5% had obstruction and 6%, restriction on spirometry. In contrast, among all participants (N=1084), 16.8% had obstruction, while 4.5% had restriction. VA showed similar results in all groups after obstruction was excluded. Impaired gas transfer (reduced DL CO) was identified in less than 50% of restriction identified by either spirometry or VA. Body mass index (BMI) was significantly related to spirometric restriction in all groups. Conclusions: Population estimates of restriction using spirometry or VA varied by spirometric acceptability criteria. Other factors identified as important considerations in the estimation of restrictive ventilatory defect included increased BMI and gas transfer impairment in a relatively smaller proportion of those with spirometric restriction. These insights are important when interpreting population-based physiological data in occupational settings.

Original languageEnglish (US)
Article numbere002561
JournalBMJ open
Volume3
Issue number7
DOIs
StatePublished - Jul 30 2013

Fingerprint

Spirometry
Industry
Cross-Sectional Studies
Body Mass Index
Thorax
Gases
Population
Respiratory Function Tests
Population Characteristics
Carbon Monoxide
Outcome Assessment (Health Care)
Lung

Cite this

Estimates of restrictive ventilatory defect in the mining industry. Considerations for epidemiological investigations : A Cross-sectional study. / Odo, Nnaemeka U.; Mandel, Jeffrey H; Perlman, David M; Alexander, Bruce H; Scanlon, Paul D.

In: BMJ open, Vol. 3, No. 7, e002561, 30.07.2013.

Research output: Contribution to journalArticle

@article{f91c25bbd900430f837eea94c950176b,
title = "Estimates of restrictive ventilatory defect in the mining industry. Considerations for epidemiological investigations: A Cross-sectional study",
abstract = "Objectives: (1) To assess the impact of American Thoracic Society and European Respiratory Society (ATS/ERS) 'acceptability' and 'usability' criteria for spirometry on the estimates of restrictive ventilatory defect in a population of taconite miners. (2) To compare estimates of restrictive ventilatory defect with three different pulmonary function tests (spirometry, alveolar volume (VA) and diffusing capacity (DL,co)). (3) To assess the role of population characteristics on these estimates. Design: Cross-sectional study. Setting: Current and former workers in six current taconite mining operations of northeastern Minnesota were surveyed. Participants: We attempted to enrol 3313 participants. Of these, 1353 responded while 1188 current and former workers fully participated in the survey and 1084 performed complete pulmonary function testing and were assessed. Primary and secondary outcome measures: We applied ATS/ERS acceptability criteria for all tests and categorised participants into groups according to whether they fully met, partially met or did not meet acceptability criteria for spirometry. Obstruction and restriction were defined utilising the lower limit of normal for all tests. When using VA, restriction was identified after excluding obstruction. Results: Only 519 (47.9{\%}) tests fully met ATS/ERS spirometry acceptability criteria. Within this group, 5{\%} had obstruction and 6{\%}, restriction on spirometry. In contrast, among all participants (N=1084), 16.8{\%} had obstruction, while 4.5{\%} had restriction. VA showed similar results in all groups after obstruction was excluded. Impaired gas transfer (reduced DL CO) was identified in less than 50{\%} of restriction identified by either spirometry or VA. Body mass index (BMI) was significantly related to spirometric restriction in all groups. Conclusions: Population estimates of restriction using spirometry or VA varied by spirometric acceptability criteria. Other factors identified as important considerations in the estimation of restrictive ventilatory defect included increased BMI and gas transfer impairment in a relatively smaller proportion of those with spirometric restriction. These insights are important when interpreting population-based physiological data in occupational settings.",
author = "Odo, {Nnaemeka U.} and Mandel, {Jeffrey H} and Perlman, {David M} and Alexander, {Bruce H} and Scanlon, {Paul D.}",
year = "2013",
month = "7",
day = "30",
doi = "10.1136/bmjopen-2013-002561",
language = "English (US)",
volume = "3",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "7",

}

TY - JOUR

T1 - Estimates of restrictive ventilatory defect in the mining industry. Considerations for epidemiological investigations

T2 - A Cross-sectional study

AU - Odo, Nnaemeka U.

AU - Mandel, Jeffrey H

AU - Perlman, David M

AU - Alexander, Bruce H

AU - Scanlon, Paul D.

PY - 2013/7/30

Y1 - 2013/7/30

N2 - Objectives: (1) To assess the impact of American Thoracic Society and European Respiratory Society (ATS/ERS) 'acceptability' and 'usability' criteria for spirometry on the estimates of restrictive ventilatory defect in a population of taconite miners. (2) To compare estimates of restrictive ventilatory defect with three different pulmonary function tests (spirometry, alveolar volume (VA) and diffusing capacity (DL,co)). (3) To assess the role of population characteristics on these estimates. Design: Cross-sectional study. Setting: Current and former workers in six current taconite mining operations of northeastern Minnesota were surveyed. Participants: We attempted to enrol 3313 participants. Of these, 1353 responded while 1188 current and former workers fully participated in the survey and 1084 performed complete pulmonary function testing and were assessed. Primary and secondary outcome measures: We applied ATS/ERS acceptability criteria for all tests and categorised participants into groups according to whether they fully met, partially met or did not meet acceptability criteria for spirometry. Obstruction and restriction were defined utilising the lower limit of normal for all tests. When using VA, restriction was identified after excluding obstruction. Results: Only 519 (47.9%) tests fully met ATS/ERS spirometry acceptability criteria. Within this group, 5% had obstruction and 6%, restriction on spirometry. In contrast, among all participants (N=1084), 16.8% had obstruction, while 4.5% had restriction. VA showed similar results in all groups after obstruction was excluded. Impaired gas transfer (reduced DL CO) was identified in less than 50% of restriction identified by either spirometry or VA. Body mass index (BMI) was significantly related to spirometric restriction in all groups. Conclusions: Population estimates of restriction using spirometry or VA varied by spirometric acceptability criteria. Other factors identified as important considerations in the estimation of restrictive ventilatory defect included increased BMI and gas transfer impairment in a relatively smaller proportion of those with spirometric restriction. These insights are important when interpreting population-based physiological data in occupational settings.

AB - Objectives: (1) To assess the impact of American Thoracic Society and European Respiratory Society (ATS/ERS) 'acceptability' and 'usability' criteria for spirometry on the estimates of restrictive ventilatory defect in a population of taconite miners. (2) To compare estimates of restrictive ventilatory defect with three different pulmonary function tests (spirometry, alveolar volume (VA) and diffusing capacity (DL,co)). (3) To assess the role of population characteristics on these estimates. Design: Cross-sectional study. Setting: Current and former workers in six current taconite mining operations of northeastern Minnesota were surveyed. Participants: We attempted to enrol 3313 participants. Of these, 1353 responded while 1188 current and former workers fully participated in the survey and 1084 performed complete pulmonary function testing and were assessed. Primary and secondary outcome measures: We applied ATS/ERS acceptability criteria for all tests and categorised participants into groups according to whether they fully met, partially met or did not meet acceptability criteria for spirometry. Obstruction and restriction were defined utilising the lower limit of normal for all tests. When using VA, restriction was identified after excluding obstruction. Results: Only 519 (47.9%) tests fully met ATS/ERS spirometry acceptability criteria. Within this group, 5% had obstruction and 6%, restriction on spirometry. In contrast, among all participants (N=1084), 16.8% had obstruction, while 4.5% had restriction. VA showed similar results in all groups after obstruction was excluded. Impaired gas transfer (reduced DL CO) was identified in less than 50% of restriction identified by either spirometry or VA. Body mass index (BMI) was significantly related to spirometric restriction in all groups. Conclusions: Population estimates of restriction using spirometry or VA varied by spirometric acceptability criteria. Other factors identified as important considerations in the estimation of restrictive ventilatory defect included increased BMI and gas transfer impairment in a relatively smaller proportion of those with spirometric restriction. These insights are important when interpreting population-based physiological data in occupational settings.

UR - http://www.scopus.com/inward/record.url?scp=84880622488&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880622488&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2013-002561

DO - 10.1136/bmjopen-2013-002561

M3 - Article

C2 - 23869101

AN - SCOPUS:84880622488

VL - 3

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 7

M1 - e002561

ER -