Am. J. Respir. Crit. Care Med., Volume 162, Number 2, August 2000, 436-439

Maximal and Partial Expiratory Flow Rates in a Population Sample of 10- to 11-yr-old Schoolchildren
Effect of Volume History and Relation to Asthma and Maternal Smoking

GEORGE T. O'CONNOR, DAVID SPARROW, DEBORAH DEMOLLES, DOUGLAS DOCKERY, MARK RAIZENNE, MARTHA FAY, ROLAND H. INGRAM Jr., and FRANK E. SPEIZER

Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Normative Aging Study, Department of Veterans Affairs Outpatient Clinic; Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts; Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Pulmonary and Critical Care Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia

The effect of volume history on forced expiratory flow rates has been reported to differ between patients with asthma and healthy persons, and it has been hypothesized that the peripheral airway inflammation of patients with asthma may underlie this difference. There are no published data, however, on the distribution of such volume history effects or the relation of these effects to airways disease in children. We obtained combined partial and maximal forced expiratory flow-volume curves on 1,834 children, age 10-11 yr, in eight communities in the United States and Canada. The effect of a deep inhalation on forced expiratory flow rates at low lung volumes was quantitated by the ratio of ₃₀ during a maximal expiratory maneuver ( _30M) to ₃₀ during a partial expiratory maneuver ( _30P). The _30M/ _30P ratio was slightly higher among girls than boys (1.26 versus 1.18, p = 0.0001) indicating that a deep inhalation increased ₃₀ slightly more among girls than among boys. The _30M/ _30P ratio was related to neither history of asthma nor to maternal smoking. In contrast, most spirometric indices from either the maximal or the partial expiratory flow-volume curve were lower in association with a history of asthma or a report of maternal smoking. The ratio of FEF_25-75/FVC was particularly consistent as a measurement that discriminated both of these effects in boys and girls. These results suggest that the measurement of volume history effects offers no benefits for epidemiological studies of childhood respiratory disease whereas spirometric indices such as the FEF_25-75/FVC ratio are quite sensitive to the effects of asthma and environmental tobacco smoke exposure on the airways.

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