Longitudinal Limits of Normal Decline in Lung Function in an Individual

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Objectives:The objectives of this study were to propose a method of calculating longitudinal limits of normal decline (LND) in forced expiratory volume in 1 second to identify individuals with an excessive decline in lung function and to compare the method with other published LND methods.Methods:We used longitudinal data from 11 workplace-based spirometric monitoring programs conducted from 1987 to 2001 on 12,729 workers to evaluate effectiveness of each LND method in identifying a “true” excessive decline in forced expiratory volume in 1 second defined using two criteria: slope >60 mL/year or >90 mL/year estimated over 5 or more years of follow up.Results:In comparison to the LND proposed by the American College of Occupational and Environmental Medicine, the proposed method had 5.0 to 2.7 times higher sensitivity over years 1 through 5 for the >60-mL/yr criterion.Conclusions:The proposed LND method was more effective than the other methods for identifying excessive declines.

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