Change in Prevalence of Restrictive Lung Impairment in the U.S. Population and Associated Risk Factors: the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2007-2010

Details

• Journal Article:
  Multidisciplinary Respiratory Medicine
• Personal Author:
  Kurth, Laura M. ; Hnizdo, Eva
• Description:
  Background: Data for the U.S adult population from the National Health and Nutrition Examination Survey (NHANES) were used to evaluate risk factors for a restrictive pattern on spirometry and estimate the change in its prevalence from the 1988-1994 to 2007-2010 sampling periods. Several previous epidemiologic studies used the Global Initiative for Chronic Obstructive Lung Disease fixed forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) > 0.70 criteria for classifying restrictive pattern rather than the age-defined American Thoracic Society (ATS)/European Respiratory Society (ERS) lower limit of normal (LLN) criteria, which may lead to misclassification. Methods: Spirometry measurements from NHANES data for the 1988-1994 and 2007-2010 periods were analyzed to estimate the age-standardized prevalence of a restrictive pattern on spirometry and the change in prevalence over time for adults aged 20-79. A restrictive pattern was defined based on ATS/ERS LLN criteria as FEV1/FVC > LLN and FVC < LLN, and a moderate to more severe restrictive pattern was further evaluated using FEV1 < 70% predicted. The associations between demographic and other individual risk factors for restrictive lung impairment were examined using multivariable logistic regression models for the two consecutive time periods. Results: The overall age-standardized prevalence of restrictive pattern decreased significantly from 7.2% (1988-1994) to 5.4% (2007-2010) (p = 0.0013). The prevalence of moderate to more severe restrictive pattern also decreased significantly from 2.0% to 1.4% (p = 0.023). Factors positively associated with restrictive pattern on spirometry included age, female sex, white race, lower education, former and current smoking, and comorbidities including doctor-diagnosed cardiovascular disease, doctor-diagnosed diabetes, and abdominal obesity. Conclusions: The overall prevalence of restrictive pattern and moderate to more severe restrictive pattern decreased between the 1988-1994 and 2007-2010 survey periods despite a population increase in the proportion of comorbidities associated with restrictive pattern (i.e. diabetes and abdominal obesity). This suggests a decline in individual risk factors for restrictive pattern and a need for future research. [Description provided by NIOSH]
• Subjects:
  Aging Epidemiology Lung Lung Diseases Morbidity Mortality NHANES Occupational Health Prevalence Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety Spirometry

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• Keywords:
  Author Keywords: FEV1/FVC; NHANES; Prevalence; Restrictive Lung Function; Spirometry Spirometry; Lung-disorders; Lung; Lung-disease; Lung-function; Epidemiology; Humans; Men; Women; Age-groups; Physical-fitness; Physical-capacity; Physiological-function; Physiology; Mortality-rates; Morbidity-rates; Pulmonary-system; Pulmonary-system-disorders; Surveillance;
• Source:
  Multidiscip Respir Med 2015 Feb; 10:7
• ISSN:
  1828-695X
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  9 pdf pages
• Volume:
  10
• NIOSHTIC Number:
  nn:20046009
• Contact Point Address:
  Laura Kurth, Safety and Health/Centers for Disease Control and Prevention, 1095 Willowdale Road, Morgantown, WV 26505
• Email:
  vrz6@cdc.gov
• Federal Fiscal Year:
  2015
• NORA Priority Area:
  Construction ; Mining
• Peer Reviewed:
  True
• Collection(s):
  National Institute for Occupational Safety and Health CDC Public Access
• Main Document Checksum:
  urn:sha-512:beba8d87bcc0eeb34625fe345a94a6295015097cb0b9cc83faba6a5dc83d528739b5a8481d500dc749288abd697e334c586f7473beaee3beee52b8ba17e75087
• Download URL:
  https://stacks.cdc.gov/view/cdc/28489/cdc_28489_DS1.pdf
• File Type:
  [PDF - 395.21 KB ]