A multi-center study indicated that, Millions of smokers who didn’t meet the criteria for chronic obstructive pulmonary disease (COPD), may still have impaired lung function.
Recently researchers followed individuals with “tobacco exposure and preserved spirometry” (TEPS) to find out how their lung function changed over time.
Spirometry test is widely used to assess pulmonary function, or how well an individual’s lungs will work in terms of lung volumes, airflow rates and other parameters. Spirometry measures how much air you can breathe and how fast you can exhale.
Spirometry shows an airflow obstruction for individuals with COPD which shows a problem with exhaling enough air in the normal amount of time.
In contrast, individuals with TEPS don’t have the same difficulty exhaling during spirometry. However, individuals with TEPS have respiratory symptoms similar to COPD, such as excess phlegm in the lungs, chronic cough or difficulty in breathing.
The new study indicates that 1,397 applicants between the age from 40 to 80 years who had smoked cigarettes for more than 20 pack-years. A pack-year is equal of smoking one pack of cigarettes a day for one year.
From these individuals, 226 had TEPS with respiratory symptoms, which is known as symptomatic TEPS. There were 269 individuals who had asymptomatic TEPS, or no respiratory symptoms. Researchers concluded that individuals with symptomatic TEPS showed a similar decline in lung function during follow-up as individuals with asymptomatic TEPS.
However, most of the individuals with symptomatic TEPS had worsening respiratory symptoms and it becomes difficult to do their daily activities, compared to those with asymptomatic TEPS.
Dr. Fady Youssef, a pulmonologist said that, though some smokers in the study with respiratory symptoms were not detected with COPD, it doesn’t show an issue with the test.
In addition, he said that, there are other health effects connected to smoking which are outside of COPD-in specific, lung cancer and heart disease.
However, individuals with symptomatic TEPS were mostly female and black, compared to those with asymptomatic TEPS. Black applicants with symptomatic or asymptomatic TEPS were more likely to develop spirometry- defined COPD, compared to white applicants. A similar cultural trend was seen among present smokers against former smokers.
As a result of these differences, the researchers called for “an evaluation of the contribution of occupational and environmental exposures, socioeconomic status, and structural racism to the growth of these symptoms.”
A study suggests that, the use of fixed-ratio spirometry may lead to black individuals being under-diagnosed with COPD, even though they have symptoms of this condition. Dr. Elizabeth Regan, a physician researcher said that better diagnostic tools will lead to better care for all our patients, regardless of background.
