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Biomedical subjects

S T Weiss

Publications and source records attributed to S T Weiss.

At least 271 records · Page 15Linked to original sources

Alcohol consumption and pulmonary function. A cross-sectional and longitudinal study.

The impact of alcohol consumption on pulmonary function was examined in 1,067 men. Subjects were classified according to their average weekly alcohol consumption, and spirometry was performed twice on all subjects over a 5-year interval. A multiple regression analysis indicated that alcohol consumption did not significantly influence baseline levels of forced vital capacity (FVC) or forced expiratory volume in one second (FEV1) after controlling for age, height, cigarette smoking habits, and educational attainment. Similarly, alcohol consumption did not significantly influence follow-up levels of FVC or FEV1 after controlling for age, height, cigarette smoking habits, educational attainment, and baseline pulmonary function. Although these results do not rule out a possible independent effect of alcohol on pulmonary function, any such effect would be relatively small.

Adult↗

The health effects of involuntary smoking.

Involuntary smoking is defined as the exposure of nonsmokers to tobacco combustion products in the indoor environment. Involuntary smokers are exposed to a quantitatively smaller and qualitatively different smoke exposure than active smokers. Quantitation of exposure is particularly difficult in both physiologic and epidemiologic studies. Acute physiologic studies have documented minimal physiologic changes in healthy subjects. However, individuals with heart or lung disease may be differentially affected. A relatively large body of data relates parental (particularly maternal) cigarette smoking to the occurrence of both acute respiratory illnesses and chronic respiratory symptoms in children. The effect seems to be greatest early in life and cannot be separated from in utero exposure. Data linking parental smoking to lower levels of pulmonary function are all cross-sectional and less conclusive. What is apparent is that the magnitude of the direct effect of passive smoke exposure is likely to be relatively small (from 1 to 5% reduction in maximally obtained lung function level in exposed children). Data on adults are insufficient to allow for a quantitative estimate. The important effects of passive smoke exposure in childhood are twofold. The slight reduction in pulmonary function level may predispose individuals to increased risks from environmental agents later in life. In addition, having a parent who smokes substantially increases the likelihood that a child will become a smoker. Finally, two studies have linked lung cancer in nonsmokers to exposure to spouses' cigarette smoke. Further research is needed to confirm these findings. Involuntary smoking may have important health effects, either direct or indirect, which deserve further study.

Adolescent↗

Association between cigarette smoking and acute respiratory tract illness in young adults.

The association of cigarette smoking with the occurrence and severity of an acute respiratory tract illness (ARTI) was studied. Clinical data were obtained prospectively on 867 men and women with an ARTI and on a control group of 289 women. Three hundred seven (57%) of the 534 women in the ARTI group were smokers, compared with 97 (34%) of the 289 women in the control group, a highly significant difference. Of the 867 men and women with ARTIs, 506 were smokers. Smokers had a statistically significant greater likelihood of having a lower respiratory tract illness (57% v 45%), a longer duration of cough (8.9 v 6.8 days), and a greater frequency of abnormal auscultatory findings (31% v 20%) than did the 361 nonsmokers. Cigarette smoking may thus contribute to the substantial morbidity and lost productivity resulting from ARTI.

Acute Disease↗

Fire fighting and coronary heart disease.

Some studies suggest that fire fighters are at a higher risk of developing coronary heart disease than are males in the general population. We followed 1646 men for 10 years to determine the incidence of coronary heart disease. Subjects were participants of the Normative Aging Study, a longitudinal study of aging. Comparison of fire fighters (n = 171) and non-fire fighters (n = 1475) showed no significant difference in the incidence rates of coronary heart disease. Comparison of the groups regarding baseline risk factors revealed no material difference. These data suggest that fire fighters do not have an excess risk of coronary heart disease.

Adult↗

The effect of occupational exposure on pulmonary function: a longitudinal evaluation of fire fighters and nonfire fighters.

To examine the chronic effect of fire fighting on pulmonary function, we undertook a longitudinal analysis of 168 fire fighters and 1,474 nonfire fighters enrolled in a study of normal aging. Spirometric measurements (FVC and FEV1) were obtained on all subjects over a 5-yr intake period (1963 to 1968) and these subjects were reexamined 5 yr later (1968 to 1973). Questionnaire information about smoking habits, respiratory symptoms, and illness was also obtained. Fire fighters had a greater loss of pulmonary function (FVC and FEV1) than nonfire fighters (p = 0.007 and p = 0.054). This occupational effect could not be explained by differences in age, height, smoking status, or initial level of pulmonary function between the two occupational groups. Although respiratory symptoms were greater among current cigarette smokers, they were not significantly different between either occupational group. However, fire fighters generally reported more symptoms when smoking was controlled for. These results confirm earlier reports of a chronic effect of fire fighting on pulmonary function and suggest an association of this occupational with increased respiratory symptoms and disease independent of cigarette smoke.

Adult↗

The relationship of pulmonary function to copper concentrations in drinking water.

Copper has been shown to be an important cofactor for certain enzymatic reactions. Specifically, cross-linking of elastin is inhibited by copper deficiency. In animal models, this inhibition leads to weakened connective tissue and pathologic changes in the lungs consistent with emphysema. To explore the potential relationship of copper exposure to level of pulmonary function in humans, we examined copper concentrations in tap water in the homes of 297 adult male subjects involved in the Normative Aging Study. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were obtained by standard techniques. The relationship of tap water copper concentration to pulmonary function was explored using multiple regression analysis, controlling for other potential confounding variables (age, height, smoking status, and educational attainment). Separate regressions were performed for each of 3 smoking status groups: never, former, and current. Among never smokers, tap water copper was significantly and positively related to levels of both FVC (p = 0.014) and FEV1 (p = 0.027). No significant trend was found among former or current smokers. These data suggest that copper intake may be an important determinant of level of pulmonary function and deserves further investigation.

Adult↗

Naloxone does not affect bronchoconstriction induced by isocapnic hyperpnea of subfreezing air.

Although respiratory heat loss with cooling of the tracheobronchial mucosa is responsible for the airway obstruction that develops after inhalation of subfreezing air in asthmatics, the mechanism by which airway cooling results in bronchoconstriction is not known. In order to test whether release of endogenous opiate peptides might play a role in mediating this response, asthmatic subjects were studied before and after isocapnic hyperventilation of subfreezing air after the administration of placebo or naloxone, given in a double-blind fashion. Five asthmatic subjects were tested with low-dose (0.8 mg) and 5 with high-dose (10 mg) naloxone given intravenously. Pretreatment with naloxone at either dose did not attenuate the decrease in FVC, FEV1, or FEF25--75 after cold air in comparison with placebo pretreatment. A slightly greater decrease in FEV1 and FEF25--75 after low-dose naloxone than placebo pretreatment can be partially explained by a difference in the temperature achieved during cold air inhalation. We conclude that endogenous opiate peptides are not involved in mediating the bronchoconstrictor response to cold air inhalation in asthmatics.

Adult↗

Longitudinal effect of age and smoking cessation on pulmonary function.

Although it is well known that pulmonary function declines with age and that this decline is accelerated by cigarette smoking, it is not as clear what effect smoking cessation has on pulmonary function. The Normative Aging Study, a longitudinal aging study of 2,280 men, has assessed this question. Longitudinal data on smoking and pulmonary function were available on 850 healthy men. Of 452 who smoked at entry to the study, 98 quit during a 5-yr period. There were no significant differences between current and ex-smokers in FVC (p = 0.12) and FEV1 (p = 0.66) at entry into the study. However, significant differences were observed during the 5-yr period in FVC and FEV1 decline between current, former, and never smokers, after adjusting for age and initial pulmonary function. The decrease in FVC for men who quit smoking was significantly less than that for current smokers (p = 0.02). Similarly, FEV1 for former smokers decreased significantly less than for current smokers (p less than 0.001). When multiple regression was performed among former smokers, no significant effects of years since quitting on rate of decrease in FVC and FEV1 were seen. This study suggested a definite and rapid beneficial effect of smoking cessation.

Adult↗

An assessment of physician knowledge of epidemiology and biostatistics.

A review was conducted of 585 articles in the medical literature, and the articles were categorized by study design and by statistical techniques employed. In the majority, statistics were utilized primarily for data description and hypothesis-testing. Descriptive studies were most frequent, and only a minority were epidemiological investigations. A questionnaire designed to assess knowledge of biostatistics and epidemiology relevant to this literature was administered to internists and medical house staff at a teaching hospital. Of 229 questionnaire recipients, 141 responded and achieved a mean score of 7.4 with 10.0 possible. Practicing physicians had a significantly lower mean score than house staff and full-time faculty. Scores were higher for the 44 percent of respondents who reported prior training in epidemiology or in biostatistics. The results of the journal review suggest that knowledge of basic biostatistics and of study design is important for reading medical literature. Physicians with prior training in epidemiology and in biostatistics appear to be better prepared for this task.

Biometry↗

Persistent wheeze. Its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a population sample of children.

In a study of early-life risk factors for the development of adult obstructive airway disease, respiratory symptoms, disease and smoking histories, and spirometry were obtained for 650 children 5 to 9 yr of age and their families in East Boston, Massachusetts. Persistent wheezing was the most frequently reported chronic symptom, occurring in 9.2% (60/650) of the population. Children with persistent wheezing were more likely to report cough and phlegm (p < 0.001), a history of asthma (p < 0.001), hay fever (p < 0.02), or past hospitalization with a respiratory illness (p < 0.001) than their asymptomatic peers. Prospective evaluation of a subsample of the 650 children confirmed a greater occurrence of acute lower respiratory illness in those children with persistent wheeze. Parental cigarette smoking was linearly related to the occurrence of persistent wheezing (p = 0.012) and lower degrees of mean normalized forced expiratory flow during the middle half of the forced vital capacity (FEF-Z score). A multiple linear regression identified the mother's current smoking status and current persistent wheeze as significant predictors of the children's mean FEF-Z score. Other variables, such as the father's smoking, children's personal smoking, a doctor's diagnosis of asthma, and a past history of lower respiratory illness were not significant predictors of the FEF-Z score.

Child↗

Effect of parental cigarette smoking on the pulmonary function of children.

The authors have investigated the effects of parental smoking patterns on the pulmonary function of children in East Boston, Massachusetts. A crude inverse dose-response relationship was observed between the level of FEF25--75% predicted of children who never smoked and the number of smoking parents in the household. Compared to children with two non-smoking parents, the level of FEF25--75% predicted was 0.156 and 0.355 standard deviation units lower for children with one and two currently smoking parents, respectively. An additional decline in level of FEF25--75% predicted was observed for children who themselves had smoked. Smoking children with two smoking parents had an average FEF25--75% predicted level which was 0.355 standard deviation units lower than non-smoking children with two smoking parents. These data not only confirm that cigarette smoking by young children and teenagers has direct measurable effects on their pulmonary function, but also show that cigarette smoking by parents has a measurable effect on the pulmonary function of their children which is independent of any direct use of cigarettes by the children.

Child↗