Predictors of spirometric test failure: a comparison of the 1983 and 1993 acceptability criteria from the European Community for Coal and Steel.

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Abstract
OBJECTIVES--To identify, in this general population study, predictors of spirometric test failure on the 1983 and 1993 acceptability criteria from the European Community for Coal and Steel (ECCS). METHODS--All men aged 30-46 years living in western Norway (n = 45,380) were invited to join a cross sectional community survey. Respiratory symptoms, smoking habits, and marital status were found from self administered questionnaires, and measurements of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were performed with dry wedge bellow spirometers. RESULTS--Altogether 29,611 subjects (65%) participated in this survey. Spirometric recordings were obtained in 26,803 of these (91%) of whom 1.6% failed the 1983 criterion (< or = 300 ml between the two highest FVC values) and 9.5% failed the 1993 criteria (< or = 5% or 100 ml between the two highest FEV1 and the two highest FVC values). Spirometric failures on both criteria were more prevalent in never smokers, single men, and subjects with respiratory symptoms than in ever smokers, married, and asymptomatic subjects. Failure of the 1993 criteria increased with age and declining height. Morning cough and phlegm, breathlessness uphill, attacks of breathlessness, and wheezing were related to failure of the 1993 criteria after adjustment for demographic variables and smoking, whereas only breathlessness uphill was related to failure of the 1983 criterion. CONCLUSIONS--In men aged 30-46 years, spirometric test failures on both the 1983 and 1993 ECCS acceptability criteria occurred more often in never smokers than in smokers and ex-smokers after adjustment for other covariables. Spirometric test failure with the 1993 criteria also varied with height and most respiratory symptoms. The higher failure rates found in non-smokers, in shorter, and in single men could be due to late compression of the airways, smaller lung volumes, and poor general health, respectively.