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Rise and Fall of the FEV₁^*

^* From the University of Western Ontario (Dr. Morgan), London, Ontario, Canada; and Alderson-Broaddus College (Dr. Reger), Phillipi, WV.

Correspondence to: Wm. Keith C. Morgan, MD, Department of Medicine, London Health Sciences Centre, University Campus, 339 Windermere Rd, London, Ontario, Canada N6A 5A5

Background: Most studies of the rate of decline in ventilatory capacity in normal subjects take into account a relatively restricted number of factors, such as age, smoking, and dust exposure. There is increasing evidence to suggest that such a limited approach is inadequate.

Objective: To carry out a prospective study of those factors influencing the rate of decline of the ventilatory capacity in a cohort of automobile workers.

Design: Prospective cohort study.

Setting: Southern Ontario, Canada.

Participants: A cohort of 181 workers employed in assembling and spray painting the chassis of new cars, a minority of whom used paints containing isocyanates.

Measurements: All participants underwent annual anthropometric measurements. Spirometry was carried out at yearly intervals, and a questionnaire relating to respiratory symptoms and smoking habits was completed annually by all participants. Daily monitoring of the isocyanate levels was carried out.

Results: There was no indication of any effect from isocyanate exposure. The annual decline in the FEV₁ was similar to that found in other studies, with the respective annual decrements for smokers, ex-smokers, and nonsmokers being 0.055 L, 0.046 L, and 0.035 L, respectively. The decline of the FEV₁ in those > 35 years old and < 35 years old differed appreciably. The decrements in the FEV₁ in subjects < 35 years old were influenced as much by excessive weight gain as by cigarette smoking. Loss of weight in those significantly overweight was frequently associated with improved lung function.

Conclusions: While age and smoking play an important role in determining the rate of decline in the ventilatory capacity, it is clear that body weight plays a significant role and needs to be taken into account in all epidemiologic studies of the ventilatory capacity.

Key Words: decline of ventilatory capacity • FEV₁ • smoking • weight gain

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