Pre- & post- bronchodilator pulmonary function test in Indian females: a survey in and around Jaipur


  • Seema Rawat Department of Physiology, Jodhpur Medical College, Jodhpur, Rajasthan, India
  • Rakesh R. Pathak Department of Pharmacology, C U Shah Medical College, Surendranagar, Gujarat, India
  • Virendra Singh Division of Allergy and Pulmonary Medicine, SMS Medical College & Hospital, Jaipur, Rajasthan, India


Biomass fuel, Indian female, Urban, Rural, FEV1, FVC


Background: Nonsmoker COPD in people is a continued point of concern. Recent standards prescribe that spirometry should be population specific, recent origin and methodically derived (prescribed by GOLD) with influencing factors specified – which this study aims to do.

Methods: From a random sample of 4,500 adults, subjects were invited into study through a 16 point questionnaire. After inclusion/ exclusion criteria applied to 3,733 total responders, 244 rural and 240 urban healthy non-smoker females were enrolled. Spirometry with reproducibility testing before and after bronchodilator (salbutamol) was done as per GOLD prescription. As normality of distribution was disproved, non-parametric methods were used in statistics.

Results: Mean FEV1 and FVC were 2.25 and 2.69 liters respectively in rural females, while it was 2.06 and 2.44 liters in urban females. Post-bronchodilator (after 0.3 mg salbutamol) values in rural females were 2.32 and 2.70 liters respectively while the same were 2.13 and 2.45 liters in urban cases.

Conclusion: PFT of rural females resulted better on FEV1 and FVC, pre as well as post-bronchodilator. Possibly biomass fuel exposure in the rural females might not be causing a generalized decrease in PFT parameters or urban chemical pollution which might have more than counterbalanced in urban side. 


Johannessen A, Lehmann S, Omenaas ER, Eide GE, Bakke PS, Gulsvik A. Post-Bronchodilator Spirometry Reference Values in Adults and Implications for Disease Management. Am J Respir Crit Care Med 2006;173:1316-25.

Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD), update 2010. Global Initiative for Chronic Obstructive Lung disease

Global strategy for the diagnosis (GOLD), management, and prevention of chronic obstructive pulmonary disease, Update 2005;

Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932-46.

Pocket Guide to COPD Diagnosis, Management and Prevention; update 2010; Global Initiative for Chronic Obstructive Lung Disease

Amer Thor Soc. Lung function testing: selection of reference values and interpretative strategies. Am Rev Respir Dis 1991;144:1202-18.

Johannessen A, Omenaas ER, Bakke PS, Gulsvik A. Implications of reversibility testing on prevalence and risk factors for chronic obstructive pulmonary disease: a community study. Thorax 2005;60:842–847.

Anthonisen NR, Lindgren PG, Tashkin DP, Kanner RE, Scanlon PD, Connett JE. Bronchodilator response in the lung health study over 11 yrs. Eur Respir J 2005;26:45–51.

Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993;16:5–40.

Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general US population. Am J Respir Crit Care Med 1999;159:179–187.

Falaschetti E, Laiho J, Primatesta P, Purdon S. Prediction equations for normal and low lung function from the Health Survey for England. Eur Respir J 2004;23:456–463.

Knudson RJ, Slatin RC, Lebowitz MD, Burrows B. The maximal expiratory flow-volume curve. Normal standards, variability, and effects of age. Am Rev Respir Dis 1976;113:587–600.

Dockery DW, Ware JH, Ferris BG Jr, Glicksberg DS, Fay ME, Spiro A III, Speizer FE.Distribution of forced expiratory volume in one second and forced vital capacity in healthy, white, adult never-smokers in six US cities. Am Rev Respir Dis 1985;131:511–520.

Roca J, Sanchis J, Agusti-Vidal A, Segarra F, Navajas D, Rodriguez- R R, Casan P, Sans S. Spirometric reference values from a Mediterranean population. Bull Eur Physiopathol Respir 1986;22:217–224.

Enright PL, Kronmal RA, Higgins M, Schenker M, Haponik EF. Spirometry reference values for women and men 65 to 85 years of age: cardiovascular health study. Am Rev Respir Dis 1993;147:125–133.

Glindmeyer HW, Lefante JJ, McColloster C, Jones RN, Weill H. Bluecollar normative spirometric values for Caucasian and African- American men and women aged 18 to 65. Am J Respir Crit Care Med 1995;151:412–422.

Brandli O, Schindler C, Kunzli N, Keller R, Perruchoud AP. Lung function in healthy never smoking adults: reference values and lower limits of normal of a Swiss population. Thorax 1996;51:277–283.

McDonnell WF, Enright PL, Abbey DE, Knutsen SF, Peters JA, Burchette RJ, Lebowitz MD. Spirometric reference equations for older adults. Respir Med 1998;92:914–921.

Gulsvik A, Tosteson T, Bakke P, Humerfelt S, Weiss ST, Speizer FE. Expiratory and inspiratory forced vital capacity and one-second forced volume in asymptomatic never-smokers in Norway. Clin Physiol 2001; 21:648–660.

Langhammer A, Johnsen R, Gulsvik A, Holmen TL, Bjermer L. Forced spirometry reference values for Norwegian adults: the bronchial obstruction in Nord-Trondelag Study. Eur Respir J 2001;18:770–779.

Garcia-Rio F, Pino JM, Dorgham A, Alonso A, Villamor J. Spirometric reference equations for European females and males aged 65–85 yrs. Eur Respir J 2004;24:397–405.

Pistelli F, Bottai M, Viegi G, Di Pede F, Carrozzi L, Baldacci S, Pedreschi M, Giuntini C. Smooth reference equations for slow vital capacity and flow-volume curve indexes. Am J Respir Crit Care Med 2000;161:899– 905.

American Thoracic Society. Standardization of spirometry, 1994 update. American Thoracic Society.Am J Respir Crit Care Med 1995;152:1107–1136.

Rehman R, Ahmed S, Syed S; Influence of Relative and Central adiposity on Lung Functions of Young Adult Medical Students; J inter Acad, Res; 2010; 10(3)10-15.

Mei-Lin Wang, Lloyd McCabe, Edward L. Petsonk, John L. Hankinson, and Daniel E. Banks; Weight Gain and Longitudinal Changes in Lung Function in Steel Workers. Chest 1997;111:1526-1532.

Antonino De Lorenzo, Patrizia Petrone-De Luca, Guido F. Sasso, Maria G. Carbonelli, Paolo Rossi, Aldo Brancati. Effects of Weight Loss on Body Composition and Pulmonary Function. Respiration 1999;66:407-412.

Mason A, Lee R, Tung AC, Lai MS, Miller T. Population Aging Intergenerational Transfers: Introduction Age Into National Account; NBER [National Bureau of Economic Research] Working Paper Series;

Strunk BC, Ginsburg PB, Banker MI; The Effect Of Population Aging On Future Hospital Demand; Health Affairs, 25, no.3 (2006):w141-w149; <

Looney, SW, Gullege, TR; Use of the Correlation Coefficient with Normal Probability Plots; The American Statistician 1985;39:75-79.

Ferris BG. Epidemiology standardisation project. Am Rev Respir Dis 1978;118(part 2):62-72.

Oscherwitz M, Edlavitch SA, Baker TR, Jarboe T. Differences in Pulmonary Functions in Various Racial Groups. J Epidem 1972;96:319-27.

Aggarwal AN, Gupta D, Behera D, Jindal SK. Applicability of commonly used Caucasian prediction equations for spirometry interpretation in India. Indian J Med Res 2005;122:153-64.

Chhabra SK. Regional Variations in Vital Capacity in Adult Males in India: Comparison of Regression Equations from Four Regions and Impact on Interpretation of Spirometric Data. Indian J Chest Dis Allied Sci 2009;51:7-13.

Ramirez-Venegas A, Sansores RH, Perez-Padilla R, Regalado J, Velazquez A, Sanchez C, Mayar ME. Survival of patients with chronic obstructive pulmonary disease due to biomass smoke and tobacco. Am J Respir Crit Care Med 2005;173:393-7.

Rivera RM, Cosio H, Ghezzo M, Salazar M, Perez-Padilla J. Comparison of the lung morphology in COPD secondary to wood smoke and cigarette smoke [abstract]. Am J Respir Crit Car Med 2003;168:A033.

Zhang JJ, Smith KR. Household Air Pollution from Coal and Biomass Fuels in China: Measurements, Health Impacts, and Interventions. Environ Health Perspect 2007;115:848-55.

Orozco-Levi M, Garcia-Aymerich J, Villar J, Ramı´rez-Sarmiento A, Anto JM, Gea J. Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J 2006;27:542-6.

Sivertsen TS, Diaz E, Pope D, Lie RT, Dıaz A, McCracken J, et al. Effect of Reducing Indoor Air Pollution on Women’s Respiratory Symptoms and Lung Function: The RESPIRE Randomized Trial, Guatemala. Am J Epidemiol 2009;170:211-20.

Donnelly PM, Yang TS, Peat JK, Woolcock AJ. What factors explain racial differences in lung volumes? Eur Respir J 1991;4:829-38.




How to Cite

Rawat, S., Pathak, R. R., & Singh, V. (2017). Pre- & post- bronchodilator pulmonary function test in Indian females: a survey in and around Jaipur. International Journal of Basic & Clinical Pharmacology, 2(5), 583–589. Retrieved from



Original Research Articles