The evaluation of lung function in rural dwelling children
Background: Asthma severity indicators and their risk factors are understudied in the farming and non-farming populations. Further study is needed. Our objective was to evaluate rural exposures and pulmonary function in a rural pediatric population and their relationships. Methods: For this study, data from the Saskatchewan Rural Health Study (SRHS) child component was used. SRHS is a population-based study, conducted in 2011, evaluating the health of rural dwelling residents in the province of Saskatchewan, Canada. The SRHS is designed as a cohort study. However, the data used for this analysis is from the baseline data collection. The initial data collected included a parent-completed survey questionnaire answered on behalf of the child. From this study sample, a subset of children (6-14 years old) was selected to participate in clinical testing, which included anthropometric measures and pulmonary function testing (PFT) using spirometry (n=584). PFTs followed ATS criteria and all statistical analyses were controlled for child age, sex, and height. Results: Among children participating in the clinical testing, 47.5% were female and 54.5% lived on a farm. Of those living on farms, 77.5% were livestock farms. The mean percent predicted value (PPV) for Forced Expiratory Volume in 1 second (FEV1) and forced vital capacity (FVC) among those living on the farm were 104.8% and 105.4%, respectively while the mean PPV for FEV1 and FVC among the non-farm dwellers were 102.7% and 101.4%, respectively. After adjustment for potential confounders using linear regression, higher FEV1 (p=0.03) and FVC (p=0.006) were seen among farm dwelling children while there was a trend towards lower FEV1/FVC ratio (p=0.09) among farm dwellers compared to non-farm dwellers. Higher FVC and lower FEV1/FVC ratio were also seen with children who regularly emptied grain bins (p<0.05). Trends towards a higher FEV1 (p=0.14) and FVC (p=0.08) were also seen with children living on a farm in the first year of life. Conclusion: Differences in lung function were seen between farm and non-farm rural dwelling children and certain farming activities, specifically, emptying grain bins. Despite a higher FEV1 and FVC among farm dwellers, the FEV1/FVC ratio was lower compared to non-farm dwellers. A trend towards a higher FEV1 and FVC was also seen with living on a farm in the first year of life suggesting that differences in lung function seen in farm dwelling children may not be purely due to reverse causality.
Pediatric, Pulmonary Function, Rural
Master of Science (M.Sc.)
Community Health and Epidemiology