The effect of applying ethnicity-specific spirometric reference equations to Asian migrant workers in Korea

Abstract

ObjectivesAsian migrant workers in Korea have various ethnicities. The purpose of this study was to evaluate the difference in spirometric interpretation made using the set of third National Health and Nutrition Examination Survey (NHANES III) reference equations and the relevant ethnicity-specific reference sets.MethodsSpirometry was performed on 166 migrant and 498 Korean male workers between March and November 2012. We analyzed the spirometric data of healthy never-smokers. Spirometric patterns were evaluated using the NHANES III reference set and some relevant ethnicity-specific equations (Eom’s equation for Koreans, Ip’s equation for East Asians, Crapo’s equation for Central Asians, Memon’s equation for South Asians, and Gnanou’s equation for Southeast Asian people).ResultsIn all migrant groups except the Central Asian group, the forced expiratory volume in 1 second percentage (FEV1%) and forced vital capacity percentage (FVC%) calculated using each of the ethnicity-specific reference equations considered were significantly higher than those calculated using the NHANES III reference set. This study showed that in the evaluation of the spirometric result of subjects from Southeast Asia or South Asia, the percentage of cases with an abnormal FEV1 or FVC increased when the NHANES III set of equations was used as compared to when the ethnicity-specific equations were used.ConclusionsWe found that the spirometric results of all ethnic groups were higher and the composition of the abnormal spirometric result was lower when the ethnicity-specific reference equations were used instead of the NHANES III reference set.

Basic spirometry testing and interpretation for the primary care provider

“…Most notably, patients with African and Southeast Asian ancestry are expected to have smaller lungs than Caucasians, Latinos, and patients with North Asian (e.g., North China, Korea) ancestry [19]. As an example, Kim et al [20] showed that in healthy nonsmokers, 30% of Southeast Asians had abnormal lung function when a reference equation that did not account for race was utilized.…”

FEV1/FEV6May Misdiagnose Patients With COPD

“…7,8 The fact that the incidence of tracheostomy was larger in a group does not mean greater efficiency in predicting extubation failure or success: The decision to perform tracheotomy includes several issues, like consciousness level, underlying medical conditions, and etiology of respiratory failure. 9 Therefore, Mathews et al share our conclusions, that proportional assist ventilation plus is a safe method and is efficient to perform a spontaneous breathing trial, comparable with other existing methods (T-tube and pressure support ventilation), and a clinical option for clinicians and respiratory practitioners in the ICU.…”

“…Defining the presence of moderate airway obstruction as an FEV 1 Ͻ80% has been shown to misclassify subjects because of age, sex, and ethnicity biases, depending on the reference equations chosen. 7 Kim et al 8 showed that applying the third National Health and Nutrition Examination Survey (NHANES III) FEV 1 reference equations to Asians misclassified 30% of never-smokers when compared with an ethnically specific equation.…”