(Press-News.org) More than half of long-term smokers and ex-smokers who are considered disease-free because they passed lung-function tests have respiratory-related impairments when more closely evaluated with lung imaging, walking and quality-of-life tests. Many of those people likely have the earliest stages of chronic obstructive pulmonary disease, an incurable progressive disease (COPD) that is the third leading cause of death in the United States.
"The impact of chronic smoking on the lungs and the individual is substantially underestimated when using lung-function tests alone," said James D. Crapo, professor of medicine at National Jewish Health and senior author of the study, which is being published June 22, in JAMA Internal Medicine. "Lung disease is common in smokers whose lung-function tests fall within population norms."
COPD is diagnosed by having people blow as hard and as long as they can into a device called a spirometer, which measures how much air they can blow out in one second and how much total air they can force out of their lungs. Individuals' results are compared to population norms and adjusted for age, size and gender.
The researchers evaluated 8,872 people ages 45 to 80 who had smoked at least a pack of cigarettes a day for 10 years (10 pack-years) or the equivalent. Most had smoked considerably more, 35 to 50 pack-years. About half the participants were considered disease-free based on their lung-function tests.
When researchers considered other criteria including impairments in physical function, respiratory symptoms, CT scans, use of respiratory medications, and respiratory-specific quality of life, they found that 55 percent of the "disease-free" study participants had some form of respiratory related impairment.
CT scans found emphysema or airway thickening in 42 percent of the disease-free participants. Twenty-three percent had significant shortness of breath compared to 3.7 percent of never smokers. Fifteen percent walked less than 350 meters in six minutes, compared to 4 percent of never smokers. The disease-free smokers also had considerably worse quality of life than never smokers, with 25 percent of them having scores on questionnaires that exceeded a threshold considered clinically significant.
"Smokers who have 'normal' lung-function tests often have significant respiratory disease. Many of those smokers likely have the early stages of chronic obstructive pulmonary disease," said Elizabeth Regan, MD, PhD, lead author and assistant professor of medicine at National Jewish Health. "We hope these findings will help debunk the myth of the healthy smoker and highlight the importance of smoking prevention and cessation to prevent lung disease and other long-term effects of smoking."
Recent research has shown that lung CT screening of smokers with smoking histories of at least 30-pack years can lead to early detection of lung cancer and reduce deaths by 20 percent. Early detection of COPD may also enable early treatment that can improve symptoms, functional abilities and quality of life. Drs. Crapo and Regan hope the findings will encourage long-term smokers to get lung CT screenings to detect early stages of lung cancer and COPD.
INFORMATION:
National Jewish Health is the leading respiratory hospital in the nation. Founded in 1899 as a nonprofit hospital, National Jewish Health today is the only facility in the world dedicated exclusively to groundbreaking medical research and treatment of patients with respiratory, cardiac, immune and related disorders. Patients and families come to National Jewish Health from around the world to receive cutting-edge, comprehensive, coordinated care. To learn more, visit http://www.njhealth.org.
A gene previously suspected of wielding the single greatest genetic influence on human obesity actually has nothing to do with body weight, according to a new study led by researchers at Harvard Medical School and Boston Children's Hospital.
The work not only overturns a major finding about the genetics of obesity but also provides the first effective ways to analyze "particularly ornery and confusing" parts of the genome, such as the locus of this gene, said the study's co-senior author, Steven McCarroll, assistant professor of genetics at HMS.
The techniques described ...
In 2002, archaeologists discovered the jawbone of a human who lived in Europe about 40,000 years ago. Geneticists have now analyzed ancient DNA from that jawbone and learned that it belonged to a modern human whose recent ancestors included Neanderthals.
Neanderthals lived in Europe until about 35,000 years ago, disappearing at the same time modern humans were spreading across the continent. The new study, co-led by Howard Hughes Medical Institute (HHMI) investigator David Reich at Harvard Medical School and Svante Pääbo at the Max Planck Institute in Germany, ...
The island Isla Santa María in the south of central Chile is the document of a complete seismic cycle.
Charles Darwin and his captain Robert Fitzroy witnessed the great earthquake of 1835 in south central Chile. The „Beagle"-Captain's precise measurements showed an uplift of the island Isla Santa María of 2 to 3 meters after the earthquake. What Darwin and Fitzroy couldn't know was the fact that 175 years later nearly at the same position such a strong earthquake would recur.
At the South American west coastline the Pacific Ocean floor moves under the ...
Originally it became famous as an anesthetic gas used by dentists. However, laughing gas, or chemically correct nitrous oxide, is also found in large quantities in nature and has serious effects on climate: In the lower atmosphere it is a strong greenhouse gas, and in higher layers of the atmosphere it contributes indirectly to the destruction of ozone. "A global assessment of marine nitrous oxide emissions is, however, difficult because we do not know exactly where and how much nitrous oxide is produced," says marine chemist Damian L. Arévalo-Martínez from GEOMAR ...
Despite the passage of Georgia's Smokefree Air Act in 2005, the number of restaurants and bars that allow smoking has doubled in recent years, according to researchers at Georgia State University's School of Public Health.
Researchers found a significant number of restaurant and bar owners have taken advantage of exemptions in the laws to create smoking zones.
"The increase in smoking-allowed establishments may be attributed to the increase in the percentage of establishments permitting smoking in designated dining areas and the large percentage of establishments that ...
Virginia Tech engineers have shed light on what happens to a nearby particle when bubbles burst.
Sunghwan Jung, an assistant professor of biomedical engineering and mechanics in the College of Engineering, has discovered new information about a phenomenon called cavitation, the process of bubble formation in a fluid like water.
These bubbles eventually collapse under the pressure of the surrounding fluid, sending out pressure waves that can affect anything nearby. For example, shrimp use cavitation bubbles to hunt because the waves can kill small fish.
Cavitation ...
A team of Massachusetts General Hospital (MGH) researchers has found a way to expand the use and precision of the powerful gene-editing tools called CRISPR-Cas9 RNA-guided nucleases. In their report receiving advance online release in Nature, the investigators describe evolved versions of the DNA-cutting Cas9 enzyme that are able to recognize a different range of nucleic acid sequences than is possible with the naturally occurring form of Cas9 that has been used to date.
"In our paper we show that sites in human and zebrafish genes that could not previously be modified ...
COLLEGE PARK, Md. - Doctors have many concerns about online crowdsourced ratings, which are intended to make patients better-informed consumers of health care, but this is a big one: They worry that complainers will be the most outspoken contributors to rating sites, skewing scores and resulting in a kind of heckler's veto.
A new study from the Robert H. Smith School of Business at the University of Maryland finds that that fear is unwarranted. Researchers compared the ratings of 1,425 doctors in three metropolitan areas -- Denver, Kansas City and Memphis -- on the popular ...
A new review by the International Osteoporosis Foundation (IOF) has confirmed the success of the Capture the Fracture®; Best Practice Framework as a single set of quality standards which can be used effectively to benchmark Fracture Liaison Services within a variety of health-care systems worldwide.
Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds. Among those at highest risk of fractures are individuals who have already experienced a first fracture.
Fracture Liaison Services, commonly ...
DURHAM, N.C. - Patients with atrial fibrillation who stopped taking blood thinners before they had elective surgery had no higher risk of developing blood clots and less risk of major bleeding compared to patients who were given a "bridge" therapy, according to research led by Duke Medicine.
The findings add much-needed clarity to inconsistent practice guidelines that annually affect an estimated 250,000 patients with atrial fibrillation/flutter who take the blood thinner warfarin. The Duke-led study was presented June 22, 2015, at the International Society on Thrombosis ...
