Advances in Clinical and Experimental Medicine
2018, vol. 27, nr 5, May, p. 689–693
Publication type: original article
Spirometry testing among the homeless
1 Family Medicine Unit, University of Warmia and Mazury, Olsztyn, Poland
2 Department of Biopharmacy, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
3 Department of Pulmonary Medicine and Infectious Diseases, University of Warmia and Mazury, Olsztyn, Poland
Background. Many literature reports have indicated the fact that the percentage of active smokers among the homeless is high, often several times higher than that of the general population. The homeless are known to have worse spirometric parameters than the general population.
Objectives. The question of what the principal and exclusive cause of airway obstruction among the homeless is remains unanswered. Verification of the above-mentioned hypothesis is possible by comparing the spirometric parameters in homeless people with those in the general population, based on the data related to subgroups with similar tobacco smoke exposure, which are homogenous in terms of sex, race and age.
Material and Methods. The spirometric parameters in 58 homeless male smokers were compared with those in 55 male smokers living normal lives. Neither group differed in age, duration of smoking or the number of pack-years. All of the subjects were Caucasian.
Results. The mean values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/ FVC, both corrected and expressed as absolute figures, were lower amongst the smoking homeless men than amongst men living normal lives. In 27.59% of the homeless subjests not receiving treatment for lung diseases, airway obstruction was identified.
Conclusion. Our results suggest that smoking is not the only cause of the worse spirometric parameters found among the homeless.
homeless, spirometry, smoking
- Tan de Bibiana J, Rossi C, Rivest P, et al. Tuberculosis and homelessness in Montreal: A retrospective cohort study. BMC Public Health. 2011;11:833.
- Romaszko J, Buciński A, Kuchta R, Bednarski K, Zakrzewska M. The incidence of pulmonary tuberculosis among the homeless in north-eastern Poland. Cent Eur J Med. 2013;8(2):283–285.
- Fazel S, Khosla V, Doll H, Geddes J. The prevalence of mental disorders among the homeless in western countries: Systematic review and meta-regression analysis. PLoS Med. 2008;5(12):e225.
- Romaszko J, Siemaszko A, Bodzioch M, Buciński A, Doboszyńska A. Active case finding among homeless people as a means of reducing the incidence of pulmonary tuberculosis in general population. Adv Exp Med Biol. 2016;911:67–76.
- Krausz RM, Clarkson AF, Strehlau V, Torchalla I, Li K, Schuetz CG. Mental disorder, service use, and barriers to care among 500 homeless people in 3 different urban settings. Soc Psychiatry Psychiatr Epidemiol. 2013;48(8):1235–1243.
- Busch-Geertsema V, Benjaminsen L, Hrast MF, Pleace N. Extent and profile of homelessness in european member states: A statistical update: FEANTSA; 2014. https://pure.sfi.dk/ws/files/294722/Feantsa_Studies_04_WEB.pdf. Accessed December 27, 2016.
- Rhoades H, Wenzel SL, Golinelli D, et al. The social context of homeless men’s substance use. Drug Alcohol Depend. 2011;118(2):320–325.
- Baggett TP, Rigotti NA. Cigarette smoking and advice to quit in a national sample of homeless adults. Am J Prev Med. 2010;39(2):164–172.
- Chen Q, Wan M, Ban C, Gao Y. Retrospective assessment of the prevalence of cardiovascular risk factors among homeless individuals with schizophrenia in Shanghai. Shanghai Arch Psychiatry. 2014;26(3):149–156.
- Wincup E, Buckland G, Bayliss R. Youth Homelessness and Substance Use: Report to the Drugs and Alcohol Research Unit. London: Home Office Research, Development and Statistics Directorate; 2003.
- Vestbo J, Hurd SS, Agusti AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):347–365.
- Snyder LD, Eisner MD. Obstructive lung disease among the urban homeless. Chest. 2004;125(5):1719–1725.
- Badiaga S, Richet H, Azas P, et al. Contribution of a shelter-based survey for screening respiratory diseases in the homeless. Eur J Public Health. 2009;19(2):157–160.
- Amore K, Baker M, Howden-Chapman P. The ETHOS definition and classification of homelessness: An analysis. Europ J Homeless. 2011;5(2)19–37.
- Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–338.
- Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999;159(1):179–187.
- Villa L, Trompa IM, Montes FN, Gomez JG, Restrepo CA. Analysis of mortality caused by tuberculosis in Medellin, Colombia, 2012. Biomedica. 2014;34(3):425–432.
- Forey BA, Thornton AJ, Lee PN. Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema. BMC Pulm Med. 2011;11:36.