DO THE MEDICAL HISTORY AND PHYSICAL-EXAMINATION PREDICT LOW LUNG-FUNCTION

Background: We sought to determine whether an abnormal respiratory his tory or chest physical examination could be used to identify men with low lung function. Methods: We analyzed pulmonary function, physical e xamination, and questionnaire data from 4461 middle-aged male Vietnam- era army veterans. Main Results: The study sample consisted of 1161 ne ver smokers, 1292 former smokers, and 2008 current smokers. Clinical i ndicators of respiratory disease (respiratory symptoms, respiratory si gns, or a history of respiratory disease), were present in 26.1% of th e never smokers, 31.7% of the former smokers, and 47.2% of the current smokers. We defined low forced expiratory volume in 1 second as a val ue less than 81.2% of the predicted value. Seven percent of the never smokers, 8% of the former smokers, and 17.3% of the current smokers de monstrated low forced expiratory volume in 1 second. Among those with a clinical indicator for spirometry only 11% of the never smokers, 13% of the former smokers, and 21% of the current smokers actually had a low forced expiratory volume in 1 second. Among those without a clinic al indicator 6% of the never smokers, 6% of the former smokers, and 14 % of the current smokers actually had a low forced expiratory volume i n 1 second. Conclusions: The use of clinical indicators as a basis for obtaining pulmonary function tests middle-aged men many with low lung function, especially current smokers.