Single breath diffusing capacity in a representative sample of the population of Michigan, a large industrial state. Predicted values, lower limits of normal, and frequencies of abnormality by smoking history

A. Miller, J. C. Thornton, R. Warshaw, H. Anderson, A. S. Teirstein, I. J. Selikoff

Research output: Contribution to journalArticlepeer-review

315 Scopus citations

Abstract

Many predictive equations for the single breath CO diffusing capacity (DL(CO)sb) are based on small, selected populations and do not account for the effect of cigarette smoking. We performed this test on 582 white adults who were part of a stratified random sample of the population of Michigan, a large industrial state. Data on 511 subjects who had full clinical information and normal hemoglobin concentration provided prediction equations and lower 95% limits for current cigarette smokers, ex-smokers, and nonsmokers. These are the first equations, obtained by sampling the general population of an entire state. Significant differences in the level of DL(CO)sb were found between smoking categories. To obtain information on the frequency with which DL(CO)sb would be reported as abnormal in a general population, the test results for all 582 subjects were compared with reference values. Use of equations that do not take smoking into account classified 30% of the male and 28% of the female smokers as 'abnormal', whereas, only 5% of male and 9% of female smokers were classified as 'abnormal' using the smoking specific equations derived from our data. The Michigan equations are of value both in clinical medicine and occupational surveys. For both applications, it is essential to have reference values that are derived from (1) a large number of subjects who are (2) representative of the general population and (3) whose smoking habits are accounted for.

Original languageEnglish
Pages (from-to)270-277
Number of pages8
JournalAmerican Review of Respiratory Disease
Volume127
Issue number3
StatePublished - 1983
Externally publishedYes

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