Skip to main content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Arch Dis Child Fetal Neonatal Ed. 2005 Sep; 90(5): F423–F428.
doi: 10.1136/adc.2004.062497
PMCID: PMC1721951
PMID: 15871993

Are ethnic differences in lung function explained by chest size?

A Whittaker, A Sutton, and C Beardsmore
Copyright and License information PMC Disclaimer

Abstract

Background: Ethnic differences in lung function (LF) are recognised in adults and children. Most prediction equations for LF are derived from whites, so non-whites are at risk of erroneous assessment. It was hypothesised that differences in chest dimensions would explain differences in LF between Asian (Indian) and white schoolchildren.

Aims: To quantify the impact of chest dimensions on LF, which would inform our understanding of ethnic differences that have implications for health care.

Methods: Children aged 6–11 were studied in school. A questionnaire provided information on ethnicity and respiratory health. Spirometry was used to record FVC, FEV1, FEF25–75, and PEF. Weight, height, sitting height, and chest dimensions (chest height, circumference, antero-posterior and transverse diameters) were measured.

Results: Data were obtained from 294 healthy children. Standing height was the most important predictor of LF. Ethnicity was an independent predictor for all LF measures except PEF, where the effect was marginal. FVC in whites was 13.4% bigger than in Asians of the same height, and the FEV1 was 10.6% greater in whites. The influence of chest dimensions on lung function was trivial. Body mass index was smaller in Asians but did not explain differences in LF.

Conclusions: Differences in chest dimensions did not explain the substantial effect of ethnicity on LF. Mechanisms whereby ethnicity exerts its influence may include differences in inspiratory muscle strength or lung compliance but remain speculative. Nevertheless it remains imperative that ethnic differences are recognised when interpreting LF tests.

Full Text

The Full Text of this article is available as a PDF (90K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  • Schoenberg JB, Beck GJ, Bouhuys A. Growth and decay of pulmonary function in healthy blacks and whites. Respir Physiol. 1978 Jun;33(3):367–393. [PubMed] [Google Scholar]
  • Rossiter CE, Weill H. Ethnic differences in lung function: evidence for proportional differences. Int J Epidemiol. 1974 Mar;3(1):55–61. [PubMed] [Google Scholar]
  • Jacobs DR, Jr, Nelson ET, Dontas AS, Keller J, Slattery ML, Higgins M. Are race and sex differences in lung function explained by frame size? The CARDIA Study. Am Rev Respir Dis. 1992 Sep;146(3):644–649. [PubMed] [Google Scholar]
  • Korotzer B, Ong S, Hansen JE. Ethnic differences in pulmonary function in healthy nonsmoking Asian-Americans and European-Americans. Am J Respir Crit Care Med. 2000 Apr;161(4 Pt 1):1101–1108. [PubMed] [Google Scholar]
  • Stocks J, Henschen M, Hoo AF, Costeloe K, Dezateux C. Influence of ethnicity and gender on airway function in preterm infants. Am J Respir Crit Care Med. 1997 Dec;156(6):1855–1862. [PubMed] [Google Scholar]
  • Binder RE, Mitchell CA, Schoenberg JB, Bouhuys A. Lung function among black and white children. Am Rev Respir Dis. 1976 Nov;114(5):955–959. [PubMed] [Google Scholar]
  • Patrick JM, Patel A. Ethnic differences in the growth of lung function in children: a cross-sectional study in inner-city Nottingham. Ann Hum Biol. 1986 Jul-Aug;13(4):307–315. [PubMed] [Google Scholar]
  • Boggs PB, Stephens AL, Walker RF, Vekovius WA, Acton GS, George RB. Racially specific reference standards for commonly performed spirometric measurements for black and white children, ages 9-18 years. Ann Allergy. 1981 Oct;47(4):273–277. [PubMed] [Google Scholar]
  • Asher MI, Douglas C, Stewart AW, Quinn JP, Hill PM. Lung volumes in Polynesian children. Am Rev Respir Dis. 1987 Dec;136(6):1360–1365. [PubMed] [Google Scholar]
  • Coultas DB, Howard CA, Skipper BJ, Samet JM. Spirometric prediction equations for Hispanic children and adults in New Mexico. Am Rev Respir Dis. 1988 Dec;138(6):1386–1392. [PubMed] [Google Scholar]
  • Strope GL, Helms RW. A longitudinal study of spirometry in young black and young white children. Am Rev Respir Dis. 1984 Dec;130(6):1100–1107. [PubMed] [Google Scholar]
  • Schwartz J, Katz SA, Fegley RW, Tockman MS. Sex and race differences in the development of lung function. Am Rev Respir Dis. 1988 Dec;138(6):1415–1421. [PubMed] [Google Scholar]
  • Hsi BP, Hsu KH, Jenkins DE. Ventilatory functions of normal children and young adults: Mexican-American, white, and black. III. Sitting height as a predictor. J Pediatr. 1983 Jun;102(6):860–865. [PubMed] [Google Scholar]
  • Greenough A, Hird MF, Everett L, Price JF. Importance of using lung function regression equations appropriate for ethnic origin. Pediatr Pulmonol. 1991;11(3):207–211. [PubMed] [Google Scholar]
  • Ghio AJ, Crapo RO, Elliott CG. Reference equations used to predict pulmonary function. Survey at institutions with respiratory disease training programs in the United States and Canada. Chest. 1990 Feb;97(2):400–403. [PubMed] [Google Scholar]
  • Shaffer BA, Samet JM, Coultas DB, Stidley CA. Prediction of lung function in Hispanics using local ethnic-specific and external non-ethnic-specific prediction equations. Am Rev Respir Dis. 1993 Jun;147(6 Pt 1):1349–1353. [PubMed] [Google Scholar]
  • Quadrelli S, Roncoroni A, Montiel G. Assessment of respiratory function: influence of spirometry reference values and normality criteria selection. Respir Med. 1999 Aug;93(8):523–535. [PubMed] [Google Scholar]
  • Myers JE. Differential ethnic standards for lung functions, or one standard for all? S Afr Med J. 1984 May 12;65(19):768–772. [PubMed] [Google Scholar]
  • Harik-Khan RI, Fleg JL, Muller DC, Wise RA. The effect of anthropometric and socioeconomic factors on the racial difference in lung function. Am J Respir Crit Care Med. 2001 Nov 1;164(9):1647–1654. [PubMed] [Google Scholar]
  • Donnelly PM, Yang TS, Peat JK, Woolcock AJ. What factors explain racial differences in lung volumes? Eur Respir J. 1991 Jul;4(7):829–838. [PubMed] [Google Scholar]
  • Cole TJ, Freeman JV, Preece MA. Body mass index reference curves for the UK, 1990. Arch Dis Child. 1995 Jul;73(1):25–29. [PMC free article] [PubMed] [Google Scholar]
  • Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995 Jul;73(1):17–24. [PMC free article] [PubMed] [Google Scholar]
  • Cole TJ. Sympercents: symmetric percentage differences on the 100 log(e) scale simplify the presentation of log transformed data. Stat Med. 2000 Nov 30;19(22):3109–3125. [PubMed] [Google Scholar]
  • Ferris BG, Jr, Stoudt HW. Correlation of anthropometry and simple tests of pulmonary function. Arch Environ Health. 1971 Jun;22(6):672–676. [PubMed] [Google Scholar]
  • Schrader PC, Quanjer PH, Borsboom G, Wise ME. Evaluating lung function and anthropometric growth data in a longitudinal study on adolescents. Hum Biol. 1984 May;56(2):365–381. [PubMed] [Google Scholar]
  • Rosenthal M, Bain SH, Cramer D, Helms P, Denison D, Bush A, Warner JO. Lung function in white children aged 4 to 19 years: I--Spirometry. Thorax. 1993 Aug;48(8):794–802. [PMC free article] [PubMed] [Google Scholar]
  • Srivastava A, Kapoor RK, Misra PK, Srivastava KL, Thakur S, Shukla N. Pulmonary function tests in normal Indian children and changes in respiratory disorders. Indian Pediatr. 1995 Jun;32(6):629–634. [PubMed] [Google Scholar]
  • Malik SK, Jindal SK. Pulmonary function tests in healthy children. Indian Pediatr. 1985 Sep;22(9):677–681. [PubMed] [Google Scholar]
  • Jackson Benita, Kubzansky Laura D, Cohen Sheldon, Weiss Scott, Wright Rosalind J. A matter of life and breath: childhood socioeconomic status is related to young adult pulmonary function in the CARDIA study. Int J Epidemiol. 2004 Apr;33(2):271–278. [PubMed] [Google Scholar]
  • Johnston ID, Bland JM, Anderson HR. Ethnic variation in respiratory morbidity and lung function in childhood. Thorax. 1987 Jul;42(7):542–548. [PMC free article] [PubMed] [Google Scholar]
  • Yang TS, Peat J, Keena V, Donnelly P, Unger W, Woolcock A. A review of the racial differences in the lung function of normal Caucasian, Chinese and Indian subjects. Eur Respir J. 1991 Jul;4(7):872–880. [PubMed] [Google Scholar]
Articles from Archives of Disease in Childhood. Fetal and Neonatal Edition are provided here courtesy of BMJ Publishing Group
-