[Epidemiology of polycystic kidney].
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Adult↗
Biomedical subjects
D Drouet
Publications and source records attributed to D Drouet.
Occupational exposure and 12-year spirometric changes among Paris area workers.
A follow-up study over 12 years was conducted among 556 men aged 30 to 54 in 1960 and working at that time in factories around Paris (France). Various occupational exposures were recorded at the time of the 1960 survey after a technical study of each workplace. The annual rate of decline of FEV1 during 12 years was estimated for each subject from the measurements in 1960 and 1972. This rate (the FEV1 slope) was related independently of FEV1 level (which reflects the loss since the beginning of adult life) and of smoking habits to occupational exposure to dust, gases, and heat. FEV1 slope was significantly related to inhalation of mineral dust (even in the absence of silica) as well as to grain dust, and the slope was steeper with increased intensity of exposure to dust. Analysis of job changes showed that among heavily exposed subjects, those who changed jobs had a less steep slope than those who did not. Our results support the hypothesis of a causal role of exposure to dust in the development of chronic airflow obstruction and of a benefit when exposure to dust ceases. Exposure to dust, gas, and heat usually occurred together so data on gas and heat were analysed after taking account of exposure to dust. The influence of heat on FEV1 decline showed a clear trend. Results suggest that exposure to gases associated with exposure to dust or heat or both had a deleterious effect. After adjusting for age, smoking, and FEV1 level (ASLA) the following average slopes were obtained: 44 ml/a (for exposure to none or to only a slight amount of dust, or to gases alone), 51 ml/a (heat), 53 ml/a (noticeable dust), 55 ml/a (noticeable dust and heat), 60 ml/a (noticeable dust, heat, and high concentration of gases). Independently of the occupational exposures, ASLA FEV1 slopes among manual workers were related to skill, being 44 ml/a for skilled and 51 ml/a for unskilled men. Independently of social class and occupational exposures recorded, there were differences in FEV1 slopes by factory, suggesting that one should not rely on using one factory as the control of studies of occupational exposure to another.
Chemical Industry↗
Spirometric reference values--what for?
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Humans↗
Twelve years spirometric changes among Paris area workers.
The effects of smoking habits, socio-occupational factors and respiratory symptoms in the development of airflow obstruction have been studied in a working population of 575 men aged 30-54 in 1960 and surveyed in 1960 and 1972. On average, FEV1 decreased by 47 ml/annum. Apart from FEV1 level, which reflects loss since the beginning of adult life, three factors were independently related to FEV1 slope: tobacco consumption, occupational exposure and social class. The decrease of FEV1 with smoking was dose related and decelerated among those who stopped smoking. This follow-up study ruled against phlegm as a causal factor of early stage airflow obstruction, although its role is not excluded at later stages.
Adult↗
[I.P.P.B. therapy at home in chronic respiratory insufficiency in France. I. Survey method. Description of the prescribers. 1960-1977 prescription evolution (author's transl)].
In order to assess the usage of IPPB therapy at home in chronic respiratory insufficiency in France, a mail survey has been conducted among 2,062 chest physicians and physicians involved in intensive care. The response rate was 57%. Among those caring for chronic respiratory insufficient patients, 296, i.e. 38%, have prescribed IPPB to 3,778 patients from 1960 till 1977. A study among a sample of the non-spontaneous-responders allows the estimation of about 400 physicians who prescribed IPPB on the whole for France at this time. Those who prescribed, worked more often in hospital though 4% had only a private practice. Those involved in intensive care prescribed more often than the chest physicians (47% versus 37%). The development of this therapy was different according to the different regions in France. But, in a general way, the prescription of IPPB at home particularly spread out since 1975, 65% of all the prescriptions have been done in 1975, 76, 77.
France↗
[IPPB therapy at home in chronic respiratory insufficiency in France. II. Indications. Technics and surveillance (author's transl)].
A survey has been conducted among French chest physicians and physicians involved in intensive care. 296 physicians have prescribed IPPB at home to 3 778 patients with chronic respiratory insufficiency between 1960 and 1977. Acute respiratory failure was the first criteria considered in the indications (57% of the patients); hypercapnia, hypoxemia and right heart failure episode frequency were the other criteria of severity the most often taken into account. Since 1960, the indications among those with airflow obstruction have decreased, whereas they have increased for those with restrictive insufficiencies, expressing the questions raised about the efficacy of IPPB in these two types. 18% of the patients have had IPPB through tracheostomy canula. 70% of the patients have used a pressure cycling respirator and 30% a volume or flow cycling respiratory. This second type was quite always used in the case of IPPB through canula. Oxygen was added for half of the patients. The physicians have regularly followed the patients. Great importance was accorded to home care surveillance.
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[Twelve year FEV1 changes and smoking habits among 556 workers in the Paris-area (author's transl)].
The aim of the study was to analyse the effects of smoking, in particular to show its causal role in the development of airflow obstruction, and to look at changes in smoking habits. The study was conducted among 556 men, aged 30 to 54 in 1960, surveyed twice, in 1960 and 1972. The hypothesis of tobacco as a causal factor of airflow obstruction is strengthened, following this study, by three results: 1) FEV1 slope was related to tobacco consumption, even after adjustement for FEV1 level (42 ml/yrs for non-smokers, 51 ml/yrs for heavy smokers); 2) FEV1 loss with age increased with the amount of tobacco consumption: one pack a day smoked for 25 years was equivalent to an aging of 5 years; 3) FEV1 loss decelerated if the subject gave up smoking, thus preventing any further risk. What appeared to be a spontaneous regulation in smoking habits was observed. The men who stopped smoking were those with low respiratory status. In this population, men who were ex-smokers in 1960 and maintained this status until 1972 had a FEV1 slope similar to that of the non-smokers.
Adult↗
[Spirographic reference values. Mathematical models and practical use (author's transl)].
Various models predicting VC and FEV1 from age and height have been compared by both theoretical and practical approaches on several subgroups of a working population examined in 1960 and 1972. The models in which spirographic values are proportional to the cube of the height give a significantly worse fit of the data. All the other models give similar predicted values in practical terms, but cutoff points depend on the distributions of VC and FEV1 given age and height. Results show that these distributions are closer to a normal than to a lognormal distribution. The use of reference values and classical cutoffs is then discussed. Rather than using a single cutoff point, a more quantitative way is proposed to describe the subjects' functional status, for example by situating him in the percentile of the reference population. In screening, cutoff points cannot be choosen without specifying first the decision considered and the population concerned.
Adult↗