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EXPOSURE TO VEHICULAR

POLLUTION AND RESPIRATORY


HEALTH STATUS OF
THE URBAN INHABITANTS OF
KOLKATA: A CROSS SECTIONAL
DISTRIBUTION

A THESIS SUBMITTED AS A PARTIAL FULFILLMENT OF


THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF SCIENCE
IN
ENVIRONMENTAL SYSTEM MANAGEMENT
OF PRESIDENCY COLLEGE, KOLKATA
(AUTONOMOUS)
UNDER THE UNIVERSITY OF CALCUTTA

2009

Submitted By

MURARI MOHAN MANNA


Registration No. 063730 of 2004-05

DEPARTMENT OF APPLIED GEOLOGY &


ENVIRONMENTAL SYSTEM MANAGEMENT
PRESIDENCY COLLEGE, KOLKATA

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ACKNOWLEDGEMENT
I feel immense pleasure in expressing my sense of gratitude and gratefulness to
Dr.H.N.Bhattacharya, Professor and Departmental Head, Department of Applied
Geology and Environmental System Management, Presidency College, Kolkata, for kind
permission to allow me to perform this project work in the department and giving
valuable suggestions to complete the entire study.

I convey my regards, sincere gratitude and gratefulness to Dr. Saradindra


Chakraborty, Departmental coordinator and Reader, Department of Environmental
System Management, Presidency College, Kolkata for his overall guidance and
constructive criticism to perform this project work and giving the valuable suggestions in
entire study.

I am thankful to the Director, National Institute of occupational health, (NIOH),


Ahmedabad and officer in charge, Regional Occupational Health Centre (Eastern),
Kolkata for providing infrastructural facility and according permission for carrying out
the study in the esteemed institute.

I convey my great regards, sincere gratitude and gratefulness to Dr. B.P.


Chattopadhyay, Scientist Emeritus of Respiratory Physiology Division Regional
Occupational Health Centre (E), Indian Council of Medical Research (ICMR), Block-DP
Sec-V, Salt Lake, and Kolkata-700091 for his guidance, supervision, realistic criticism
and valuable suggestion of this project. I am really indebted to you Sir.

I also convey my regards, sincere gratitude and gratefulness to Dr. Subrata Ghosh,
Reader, Department of physiology & Environmental System Management, Presidency
College, Kolkata for his guidance to perform this project work and giving the valuable
suggestion in the entire study.

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I express my deepest gratitude to Mubaraq Hossain (Research Scholar), Sk. Jane
Alam (Technician) and Tilak Kanti Dasgupta (Lab Assisstant) Respiratory physiology
division of R.O.H.C (E) for their co-operation and encouragement throughout the entire
project work.

I am truly grateful to the inhabitants of Kolkata whom I have studied for their
voluntary cordial cooperation and successful completion of the work. Their kind
cooperation is thankfully acknowledged.

Lastly I convey my thanks to all of my friends and batch mates for their heartily co-
operation and continuous encouragement through out the study.

Date: 01.06.2009 MURARI MOHAN MANNA


Department of Applied Geology
and Environmental System
Management
Presidency College

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Introduction:-
Since the onset of the industrial revolution, there has been a steady change in the
composition of the atmosphere mainly due to the combustion of fossil fuels used for the
generation of energy and transportation. Air pollution is a major environmental health
problem affecting the developing and the developed countries alike. The effects of air
pollution on health are very complex as there are many different sources and their
individual effects vary from one to the other.
Air pollution has been aggravated by developments that typically occur as
countries become industrialized: growing cities, increasing traffic, rapid economic
development and industrialization, and higher levels of energy consumption. The high
influx of population to urban areas, increase in consumption patterns and unplanned
urban and industrial development has led to the problem of air pollution. Currently, in
India, air pollution is widespread in urban areas where vehicles are the major contributors
and in a few other areas with a high concentration of industries and thermal power plants.
Vehicular emissions are of particular concern since these are ground level sources and
thus have the maximum impact on the general population. Also, vehicles contribute
significantly to the total air pollution load in many urban areas.
The behaviour of the particles and gases in the respiratory system is greatly
influenced by the region of the lung in which they are located. After the air is channelized
through the trachea to the first bronchi the air is divided at each subsequent bronchial
bifurcation until very little apparent flow is occurring within the alveolar sacs. Because of
the very different flows in the various sections of the respiratory region, particles
suspended in air and gaseous air pollutants are treated differently in the lungs. For
gaseous pollutants released from automobiles, solubility controls removal from the air –
stream. Highly soluble gases like SO2 are absorbed in the upper airways , whereas less
soluble gases like NO2, O3 may penetrate to the pulmonary region .Irritant gases are
thought to stimulate neuro–receptors in the respiratory walls and cause a variety of
responses including sneezing, coughing, broncho-constriction and rapid shallow
breathing.(1)
Many studies have shown links between pollution and health effects. Increases in
air pollution have been linked to decreases in lung function, neurological impairments

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and increases in heart attacks. High levels of air pollution directly affect people with
asthma and other types of lung or heart disease (according to the EPA Air Quality Index).
The elderly and children are especially vulnerable to the effects of air pollution in
large metropolitan cities like Kolkata.
The level of risk depends on several factors:
• The amount of pollution in the air,
• The amount of air we breathe in a given time
• Our overall health.
Other, less direct ways people are exposed to air pollutants are:
• eating food products contaminated by air toxins that have been deposited where
they grow,
• drinking water contaminated by air pollutants,
• Ingesting contaminated soil, and touching contaminated soil, dust or water.

The pollution in Kolkata is further aggravated by usage of adultered fuel by the


two-stroke auto-rickshaws. Thousands of these auto-rickshaws fleet plies crisscrossing
the city caring a fig to the Pollution guidelines and health safety of the inhabitants of the
city. Considering the environmental pollution of the city the respiratory health status of
the population is very much essential to be evaluated. Considering the above facts the
present study was undertaken to evaluate the respiratory function status of the inhabitants
of Kolkata. The respiratory function status of the inhabitants is also to be assessed among
according to their age, duration of stay on that area and smoking habit.

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Pic: 1- Environmental quality is a key determinant of human health. Pollution especially
air pollution from different sources may contain various obnoxious gas as pollutant which
may cause respiratory impairments which in turn causes respiratory diseases.

Pic: 2- Different organic and inorganic sources of


air pollution and their effects on the human health.

Pic: 3- Kolkata’s two-stroke auto rickshaw Pic: 4-Diesel taxi emanating dense
using adultered fuel smoke from tailpipe are a common
major source of smoke belchers have sight on the city roads of Kolkata.
immense potential for health hazard.

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Review of Literature:-
The combustion in the diesel engine produces soot along with smoke. Soot
consists of aggregates of spherical primary particles that form in the combustion
chamber, grow by agglomeration and are emitted as clusters having average particle
diameter ranging from 0.1-0.5 micrometer (2).As released to the environment, the
portions of the mass of the diesel soot consisting of adsorbed organic matter can range
from 5-90 percent (3). Values of 10-15% are representative of modern engines under
most operating conditions. The size of the diesel soot particles makes it easily respirable
.Approximately 20-30 % of the inhaled particles in diluted exhaust can be expected to
deposit in the lungs and airways of humans (4).Regarding the carcinogenicity of diesel
exhaust, however results from animals have not proved to be very helpful because
essentially the same lung tumor response is obtained with pure carbon soot and other
inert particles as with diesel exhaust at comparable mass concentration (5).When bound
to soot or to haematite, pure chemical carcinogens such as benzo-alpha-pyrene known to
be present in polluted air have been shown to be carcinogenic for lungs of rodents by
intertracheal instillations.(6).In US , the EPA has concluded that diesel particulate is a
probable human carcinogen. The International Agency for Research on Cancer (IARC)
concluded that diesel exhaust is a probable human carcinogen (7). California in 1998
listed diesel exhaust as a toxic air contaminant (California, EPA, 1998)
The important contaminants of the automobile exhausts are oxides of nitrogen
(NOx), CO, hydrocarbons, respirable particles, sulphur dioxide and volatile organic
compounds. Increased Volatile Organic Compounds (VOCs) in ambient air of urban
areas observed because of vehicular exhausts, petrol bunk emissions and industrial
activities prevailing within the areas (8). Ulvarson et al (9) established the reduction of
FVC, FEV1 in vehicular exhaust exposed persons and causing obstructive type of PFT
changes. Nakai et al (10) stated the personal exposure of NO2 concentrations decreased as
distance from the roadside is increased. Laxen and Noordally (11) assessed the major
pollutant NO2 arising from automobile exhausts at a street in London and the
concentration declined as the distance from the road increased. Chattopadhyay et al. (12)
stated the decrement of PFT values with the synergistic effect of age and automobile
exposures. The gaseous pollutants and VOCs are mainly formed due to fuel adulteration,
keeping the vehicles in running condition and traffic density (8). Rao et al (13) revealed
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that exposure to auto exhaust pollutants caused both restrictive and obstructive type of
respiratory impairments. Some studies have already reported the health risks like
increased mortality, morbidity rates and hospital admission due to cardio respiratory
disease, oxidative stress and increase the incidence of cancer among urban population
(14, 15, 16, 9).
Rao et.al (17) reported various volatile hydrocarbons including benzene in ambient air of
industrial areas in New Mumbai. Srivastava et.al (18) identified more than sixty VOC
species in Delhi air at residential, commercial and industrial areas. Pandit et.al (19)
showed that about 10 % of the C2-C5 hydrocarbons are emitted from auto-exhaust in
Mumbai. Ingle et.al (20) reported ambient air levels of pollutants like SO2, NOx and
PM10 in traffic areas of Jalgaon and significant reduction in pulmonary function test
values, particularly the FEV1 and PEFR among traffic police.
One study demonstrated that children inhaling grossly polluted air of Calcutta
suffer from adverse lung reactions and genetic abnormality in the exposed tissues. The
potential health hazards associated with inhalation of airborne pollutants are now well
recognized. In this context, children are reported to be more susceptible to environmental
exposures than adults – “An estimated 4 million children in developing countries die each
year from respiratory diseases which are potentially preventable and/or treatable. In
addition, some of the adverse effects of air pollution may be obvious in the adult owing
to the prolonged latent period” (21). Some 70% of people in the city of Calcutta suffer
from respiratory disorders caused by air pollution, a recent study by a prominent cancer
institute in India has concluded. The city of Kolkata ranks highest in the country in terms
of pollution. Ailments include lung cancer, breathing difficulties and asthma, the
Chittaranjan National Cancer Institute (CNCI) study says. (22) .Diesel soot emitted from
automobiles is carbon compound coated with organic matter are generally less than 1
micron in diameter and can penetrate in the lower portions of the lungs. (23).Suspended
particulate matter is one of the most critical air pollutants in most of the urban areas of
India and permissible standards are grossly violated frequently (24)

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Aims and objectives:
The Study was conducted with the following aims and objectives.

 To evaluate pulmonary function status of the inhabitants of Kolkata.

 To assess the PFT according to their age, duration of stay and smoking habit.

 To evaluate the respiratory function impairments amongst the inhabitants as a whole.

 To evaluate the respiratory function impairment amongst the inhabitants according to


their duration of stay in their area.

 Comparative analyses of the lung function of North, Central and South Kolkata
inhabitants.

Pic: 5- Two-stroke auto rickshaws are a Pic: 6-City pedestrian, porters, hawkers,
major source to the city air pollution. rickshaw pullers are vulnerable groups to
city’s environmental pollution.

Pic: 7- People working in the open air like food sellers’


and traffic policemen are at risk of City’s environmental pollution.

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Materials & Methods:

 Selection of subjects:

The present study was carried out North, Central and Southern pockets of
Kolkata. The pulmonary function study was carried out on total 113 inhabitants from the
three areas. The subjects were classified into broadly three groups North (37), Central
(35) and South (41).The subjects were selected from 21-50age range from varied
economic class people.

 Questionnaire method :

Detailed present and past personal and occupational history was taken.
Due stress was given to note the smoking history and the frequency of smoking per day.
Among the inhabitants who smoked at least 5-6 beedi and/or cigarette per day are
included in the smoking category and those who have not smoked through out their life
time was considered as non-smoker and those who left smoking are considered as ex-
smokers. The time of taking personal history of the individuals’ special attention was
given to make the respiratory impairments if any.

 Pulmonary Function Test:

Vital capacity (VC) and Forced Vital Capacity (FVC) was recorded by
Spirovit SP-10(Pic-15) (Schiller Health Care Pvt Ltd., Switzerland) and Peak Expiratory
Flow Rate by Wrights Peak Flow meter (Clement and Clarke, UK). Forced expiratory
volume in one second (FEV1) Forced expiratory volume in 1st sec. as the percentage of
FVC (FEV1%), forced expiratory flow at 200 ml – 1200 ml, 25 – 75% and 75 – 85% was
calculated from the tracings. Before the recordings were taken all subjects were made
well motivated thus ensuring recording at optimum levels. The PFT measurements were
made in a comfortable standing position. The body height and body weight were
measured with a standard scale without footwear. All measured lung volumes obtained
was expressed in body temperature pressure saturated with water vapour (BTPS). Body
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surface area (BSA) was calculated from the Du-Bois and Du-Bois formula. Pulmonary
function test values were predicted from the standard prediction equation of the Kolkata
normal subjects. The criteria followed for categorization of the severity of restrictive
impairment are based upon the ratios between predicted and observed values of VC and
obstructive impairment based of FEV1%.

 Statistical Analysis:

Student two tail‘t’ tests are being performed by the inhabitants to find
whether there are any significant changes due to duration of staying at that area.

 Formulae Used:

BMI = Weight in Kg / (Height in Metre)2


BSA = (Height in cm) * 0.725*(Weight in Kg) * 0.425 * 71.84 / 10000

Criteria for Determination of Obstructive Type Impairment:


Obstructive Type Impairment is determined with respect to the FEV1% value.
Normal ≥ 70%
Mild Obstructive 65-69.99%
Moderate Obstructive 50-64.99%
Severe Obstructive ≤49.99%
Criteria for Determination of Restrictive Type Impairment:
Restrictive Type Impairment is determined with respect to the SVC

For male (Predicted SVC value) -0.024 * age + 0.044 * height in cm - 2.704
For female (Predicted SVC Value) -0.025 * age + 0.021 * height in cm – 0.003
(Predicted SVC Value – Observed SVC Value)*100/Predicted SVC Value
Up to 20 Normal
20.01-30 Mild Restrictive Type
30.01-40 Moderate Restrictive Type

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≥40.01 Severe Restrictive Type

Terminology and Definitions of Static and Dynamic PFT


parameters:-
Static PFT parameters:-
TV – Tidal Volume – The respiratory excursion for each breadth.

SVC - Slow vital capacity - This test is performed by having the patient slowly and
completely blows out all the air from the lungs.

IC – Inspiratory Capacity - The volume of gas that can be taken into the lungs in a full
inhalation, starting from the resting inspiratory position; equal to the tidal volume plus
the inspiratory reserve volume.

IRV - Inspiratory Reserve Volume – Maximum Volume that can be inspired is beginning
from the position of resting inspiration.

ERV - Expiratory Reserve volume – Volume which can be expired by a maximum effort
beginning at the position of resting expiration.

Dynamic PFT parameters:-


FVC - Forced Vital Capacity - after the subject has taken in the deepest possible
inspiration, this is the volume of air which can be forcibly and maximally exhaled out of
the lungs until no more can be expired. FVC is usually expressed in units called liters.
This PFT value is critically important in the diagnosis of obstructive and restrictive
diseases.

FEV1 - Forced Expiratory Volume in One Second - this is the volume of air which can be
forcibly exhaled from the lungs in the first second of a forced expiratory maneuver. It is
expressed as liters. This PFT value is critically important in the diagnosis of obstructive
and restrictive diseases.

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FEV1/FVC - (FEV1%) - This number is the ratio of FEV1 to FVC - it indicates what
percentage of the total FVC was expelled from the lungs during the first second of forced
exhalation - this number is called FEV1%, %FEV1 or FEV1/FVC ratio. This PFT value is
critically important in the diagnosis of obstructive and restrictive diseases.

FEV3- Forced Expiratory Volume in Three Seconds - this is the volume of air which can
be forcibly exhaled in three seconds - measured in Liters - this volume usually is fairly
close to the FVC since, in the normal individual, most of the air in the lungs can be
forcibly exhaled in three seconds.

FEV3/FVC – FEV3%- This number is the ratio of FEV3 to the FVC - it indicates what
percentage of the total FVC was expelled during the first three seconds of forced
exhalation. This is called %FEV3 or FEV3%.

PEFR - Peak Expiratory Flow Rate - this is maximum flow rate achieved by the patient
during the forced vital capacity maneuver beginning after full inspiration and starting and
ending with maximal expiration - it can either be measured in L/sec or L/min - this is a
useful measure to see if the treatment is improving obstructive diseases like broncho
constriction. This parameter can be studied by Wright’s Peak Flow Meter and expressed
in l/min.

FEF - Forced Expiratory Flow - Forced expiratory Flow is a measure of how much air
can be expired from the lungs. It is a flow rate measurement. It is measured as
liters/second or liters/minute. The FVC expiratory curve is divided into quartiles and
therefore there is a FEF that exists for each quartile. The quartiles are expressed as
FEF25%, FEF50%, and FEF75% of FVC.

FEF 25% - This measurement describes the amount of air that was forcibly expelled in the
first 25% of the total forced vital capacity test.

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FEF 50% - This measurement describes the amount of air expelled from the lungs during
the first half (50%) of the forced vital capacity test. This test is useful when looking for
obstructive disease. The amount of air that will have been expired in an obstructed patient
is smaller than that measured in a normal patient.

FEF.2-1.21- Forcefully expiratory flow rate during expired air 200ml to 1200ml of the
forced vital capacity test.

FEF25%-75% - This measurement describes the amount of air expelled from the lungs
during the middle half of the forced vital capacity test. Many physicians like to look at
this value because it is an indicator of obstructive disease.

FEF75-85% - Lung flow rate during expiration of 75% to 85% of the forced vital capacity
test.

MVV - Maximal Voluntary Ventilation - this value is determined by having the patient
breathe in and out as rapidly and fully as possible for 12 -15 seconds - the total volume of
air moved during the test can be expressed as L/sec or L/min - this test parameter reflects
the status of the respiratory muscles, compliance of the thorax-lung complex, and airway
resistance

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Pic: 8- City Traffic in North Kolkata.

Pic: 9- City Traffic in Central Kolkata.

Pic: 10- City Traffic in South Kolkata.

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Pic: 11- Taking personal history of the subjects using Pic: 12 – Stadiometer (height
standard proforma by questionnaire method. and weight measurement).

Pic: 13- Measurement of weight and height of subjects using Stadiometer.

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Pic: 14-Wright’s Peak flow meter.

Pic: 15 – Measurement of Peak Expiratory flow rates by Wright’s Peak Flow Meter.

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Pic: 16- Schiller Spirovit SP10 Spirometer.

Pic: 17- Measurement of Pulmonary Function using Spirovit SP 10 Spirometer.

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Results and Discussion:-
The pulmonary function tests were performed in phased manner on 113
individuals in areas of North, Central and South Kolkata.
The distribution of male and female individuals of North, Central and South
Kolkata according to age range distribution in given in Table 1 and Fig 1.
In North Kolkata 21 males and 16 females were studied. In the age range of 21-
30; 6 males and 8 females were studied. In the age range of 31-40, 8 and 4 males and
females were studied respectively. In the age range of 41-50, 7 and 4 males and females
were studied respectively.

Table: -1: Distribution of male and female individual of north, central and south
Kolkata according to age range

North Kolkata Central Kolkata South Kolkata


Age range Male Female Male Female Male Female
(Yrs) group group group group group group
(n=21) (n=16) (n=18) (n=17) (n=21) (n=20)
21-30 6 8 4 8 8 7
31-40 8 4 10 7 6 9
41-50 7 4 4 2 7 4
Total 21 16 18 17 21 20

Fig-1: Age and area wise distribution of


male and female inhabitants of Kolkata

7, 17% 6, 15%

8, 19%
8, 20%

8, 19% 4, 10%

North Male North Female Central Male


Central Female South Male South Female

In Central Kolkata total 18 males and 17 females were studied. In the age range of
21-30, 4 males and 8 females were studied. In the age range of 31-40, 10 and 6 males and

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females were studied respectively. In the age range of 41-50, 4 and 3 males and females
were studied respectively.
In South Kolkata 21 males and 20 females were studied. In the age range of 21-30
8 and 7 males and females were studied. In the age range of 31-40 6 and 9 males and
females was studied .In the age range of 41-50 7 and 4 males and females were studied
respectively.

The physical characteristics of the male and female subjects are presented in
Table 2.Because of the sex difference in mean values males have higher values in height,
weight and body surface area while the mean value of body mass index varies.

Table: - 2: Physical parameters of male and female inhabitants of north, central and
south Kolkata (Mean ±SD)

Zone Category Age Height Weight BSA BMI


(Years) (cm) (Kg) (m2)
Male 35.71 162.52 60.38 1.64 22.86
North (n=21) ±8.06 ±7.93 ±12.84 ±0.17 ±4.58
Kolkata Female 33.50 152.81 50.56 1.45 21.43
(n=16) ±9.47 ±10.67 ±12.12 ±0.21 ±3.36
Male 35.06 159.72 54.94 1.56* 21.42
Central (n=18) ±7.64 ±7.95 ±10.17 ±0.17 ±2.96
Kolkata Female 33.41 149.94 46.59 1.39 20.59
(n=17) ±8.07 ±7.73 ±9.39 ±0.16 ±3.11
Male 34.52 166.33** 62.76 1.69 22.74
South (n=21) ±8.53 ±6.84 ±12.59 ±0.16 ±4.86
Kolkata Female 34.95 148.45 53.50 1.46 24.30**
(n=20) ±7.34 ±5.33 ±9.69 ±0.13 ±4.28

[* p<0.05, ** p<0.01; when compared with Central Kolkata Vs South Kolkata of same
sex category]

In North Kolkata, the mean age of male and female individuals are 35.71(±8.06)
and 33.50 (±9.47) respectively. Because of the sex difference males have higher mean
values in height (male-162.52cm, female-152.81cm), weight(male-60.38Kg, female-
50.56Kg), body surface area(male-1.64 m2, female-1.45 m2 ), body mass index (male –
22.86, female – 21.43)
In Central Kolkata, the mean age of male and female individuals are 35.06(±7.64)
and 33.41(±8.07) respectively. Because of the sex difference males have higher mean
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values in height (male-159.72cm, female-149.94cm), weight(male-54.94Kg, female-
46.59 Kg), body surface area(male-1.56 m2 , female-1.39 m2 ), body mass index (male –
21.42, female – 20.59)
In South Kolkata, the mean age of male and female individuals are 34.52(±8.53)
and 34.95(±7.34) respectively. Because of the sex difference males have higher mean
values in height (male-166.33cm, female-148.45cm), weight(male-62.76Kg, female -
53.50 Kg),body surface area(male-1.69 m2 , female-1.46 m2 ).The body mass index
showed higher values in females (male – 22.74, female – 24.3)
Significant changes have been observed in the height and body surface area
between the inhabitants of Central Kolkata male and South Kolkata male and in body
mass index when compared Central Kolkata female with South Kolkata females. The
statistical analyses were carried out separately in the two sexes.

Pulmonary function Tests (PFT) of the study population are presented in Table-3
and Fig:2, 3 and 4. The male subjects are having higher mean values in lung volumes and
flow rates compared to the female inhabitants.

Table:-3: Lung volume and flow rates of male and female inhabitants of north,
central and south Kolkata (Mean ± SD)
Zone Category SVC FVC FEV1 FEV1% FEF.2-1.21ml FEF25-75% FEF75-85% PEFR
(l) (l) (l) (l/s) (l/s) (l/s) (l/min)
Male 3.44 3.63 3.03 82.20 5.78 3.44 1.29 430.95
North (n=21) ±0.78 ±0.99 ±0.95 ±9.09 ±2.24 ±1.52 ±0.84 ±134.57
Kolkata Female 2.72 2.73 2.38 87.74 4.64 3.25 1.43 368.44
(n=16) ±0.39 ±0.48 ±0.40 ±9.81 ±1.04 ±0.70 ±0.76 ±53.66
Male 3.36# 3.38 2.90 85.83 6.04 3.36# 1.18# 440.56
Central (n=18) ±0.47 ±0.48 ±0.47 ±5.99 ±1.60 ±0.54 ±.34 ±65.84
Kolkata Female 2.39* 2.34* 2.02* 86.12 3.72 2.68 1.06 320.88
(n=17) ±0.39 ±0.43 ±0.48 ±11.55 ±1.58 ±1.15 ±0.48 ±80.78
Male 3.84 3.86 3.38 86.53 7.02 4.15 1.67 479.05
South (n=21) ±0.92 ±1.02 ±0.97 ±8.34 ±2.024 ±1.60 ±0.83 ±130.42
Kolkata Female 2.50 2.54 2.32 91.21 4.30 3.29 1.37 316.50$
(n=20) ±0.55 ±0.53 ±0.53 ±5.08 ±1.37 ±0.97 ±0.66 ±70.88
[* p<0.05 when compared North Vs Central, # p<0.05when compared Central Vs South,
$ p<0.05 when compared North Vs South within the same sex category]

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Fig-2: Lung volume of Kolkata inhabitants
areawise

4.5
4 North Kolkata Male
3.5
3 North Kolkata Female
Central Kolkata Male
litres

2.5
2 Central Kolkata Female
1.5
South Kolkata Male
1
0.5 South Kolkata Female
0
SVC FVC FEV1

Fig-3: Flow rates of Kolkata inhabitants areawise

8
7 North Kolkata Male
6
North Kolkata Female
5
Central Kolkata Male
l/sec

4
Central Kolkata Female
3
South Kolkata Male
2
1 South Kolkata Female
0
FEF.2-1.21ml FEF25-75% FEF75-85%

Fig-4: PEFR values of Kolkata inhabitants


areawise

600
500 North Kolkata Male
PEFR(l/min)

400 North Kolkata Female


Central Kolkata Male
300
Central Kolkata Female
200
South Kolkata Male
100 South Kolkata Female
0
PEFR (l/min)

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The SVC, FEF25-75% and FEF75-85 % values of Central Kolkata male population
has been found to be statistically lower than South Kolkata males. The SVC, FVC and
FEV1 values of Central Kolkata female inhabitants have been found to be statistically
lower as compared to North Kolkata females. The PEFR value of North Kolkata female
population has also been statistically found to be higher than South Kolkata females. In
general the lung volume and flow rates of South Kolkata population have been observed
to be better than North Kolkata and the values of Central Kolkata population have been
found to be the least.
.

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The PFT values of male inhabitants according to their duration of stay in the
region have been given in Table-4 and fig 5-11.All the subjects were classified
according to their duration of stay in the area into four groups as: up to 20, 21-30, 31-40,
41-50.

Table:-4: Lung volumes and flow rates of male individual according to duration of
stay in north, central and south Kolkata (Mean ± SD)

Category Duration SVC FVC FEV1 FEV1% FEF.2- FEF25- FEF75- PEFR
of stay (l) (l) (l) 1.21ml 75% 85% (l/s) (l/min)
(Yrs) (l/s) (l/s)
Up to 20 - - - - - - - -
(n=0)
North 21-30 3.92 4.17 3.65 87.67 6.60 4.58 1.97‡ 462.50
Kolkata (n=8) ±0.35 ±0.56 ±0.43 ±2.97 ±1.73 ±1.06 ±0.79 ±117.81
Male
31-40 3.51 3.72 3.04 81.26 6.20 3.22 1.06 453.75
(n=21)
(n=8) ±0.56 ±0.79 ±0.81 ±8.24 ±1.95 ±1.49 ±0.64 ±130.81

41-50 2.55** 2.64* 2.02** 74.95* 3.78 1.97*** 0.59*** 344.00
(n=5) ±0.89 ±1.19 ±0.98 ±12.33 ±2.56 ±0.61 ±0.26 ±154.37
θλ λ
Up to 20 3.62 3.74 3.18 84.40 6.56 3.60 1.32 472.00
(n=5) ±0.52 ±0.49 ±0.69 ±9.96 ±2.36 ±1.42 ±0.49 ±81.98
Central 21-30 3.20 3.24 2.74 84.40 5.39 3.01 1.10 406.00
Kolkata (n=5) ±0.09 ±0.12 ±0.26 ±5.18 ±0.76 ±1.01 ±0.38 ±53.20
Male £££ £££ £££
(n=18) 31-40 3.29 3.24 2.85 88.17 5.92 3.39 1.23 430.00
(n=6) ±0.50 ±0.46 ±0.33 ±2.64 ±1.69 ±0.61 ±0.17 ±64.50
41-50 3.32 3.26 2.78 86.00 6.72 3.39 0.90† 480.00
(n=2) ±0.92 ±1.00 ±0.74 ±4.24 ±0.59 ±0.23 ±0.08 ±0
Up to 20 4.53 4.60 3.75 82.00 6.25 3.47 1.68 400.00
(n=1)
South 21-30 4.28 4.23 3.82 90.62 7.81 4.91 2.01 532.86
Kolkata (n=7) ±0.96 ±0.99 ±0.86 ±6.91 ±1.37 ±1.35 ±0.86 ±70.17
Male ¥ ¥ ¥
(n=21) 31-40 3.74 3.58 3.24 86.87 6.62 4.58 1.86 478.33
(n=6) ±1.04 ±1.48 ±1.41 ±11.18 ±3.23 ±2.11 ±0.95 ±187.87
41-50 3.39 3.61 3.00 82.88 6.69 3.11◊ 1.16 437.14
(n=7) ±0.66 ±0.54 ±0.54 ±6.40 ±2.22 ±0.87 ±0.54 ±126.06

[* p<0.05, ** p<0.01, ***p<0.001 when compared 21-30 Vs 41-50; ‡ p<0.05 when compared 21-30 Vs
31-40 among North Kolkata male inhabitants, † p<0.05 when compared 21-30 Vs 41-50 age group of
Central Kolkata male inhabitants , ◊ p<0.05 when compared 21-30 Vs 41-50 age group of South Kolkata
male inhabitants.]
[£££ p<.001 when compared North Vs Central Kolkata of 21-30 age group, ¥ p<0.05 when compared
Central Vs South Kolkata of 21-30 age group, € p<0.01 when compared North Vs. Central of 31-40 age
group, θ p<0.01 when compared North Vs. Central of 41-50 age group, λ p<0.05 when compared North Vs.
South of 41-50 age group.]

23
Fig-5: Lung volume of north Kolkata male
inhabitants according to duration of stay

5
4
SVC (l)
3
litres

FVC (l)
2
FEV1 (l)
1
0
Up to 20 21-30 31-40 41-50
Stay range distribution

Fig-6: Lung volume of central Kolkata male


inhabitants according to duration of stay

3
SVC (l)
litres

2 FVC (l)
FEV1 (l)
1

0
Up to 20 21-30 31-40 41-50
Stay range distribution

Fig-7: Lung volume of south Kolkata male


inhabitants according to duration of stay

5
4
SVC (l)
3
litres

FVC (l)
2
FEV1 (l)
1
0
Up to 20 21-30 31-40 41-50
Stay range distribution

24
Fig-8: Different flow rates of north Kolkata male
inhabitants according to duration of stay

7
Flow rates (l/sec)
6
5 FEF.2-1.21ml (l/s)
4
FEF25-75%(l/s)
3
2 FEF75-85% (l/s)
1
0
up to 20 21-30 31-40 41-50
Stay range distribution

Fig-9: Different flow rates of central Kolkata male


inhabitants according to duration of stay

8
Flow rates (l/sec)

6
FEF.2-1.21ml (l/s)
4 FEF25-75%(l/s)
FEF75-85% (l/s)
2

0
up to 20 21-30 31-40 41-50
Stay range distribution

Fig-10: Different flow rates of south Kolkata male


inhabitants according to duration of stay

10
Flow rates (l/sec)

8
FEF.2-1.21ml (l/s)
6
FEF25-75%(l/s)
4
FEF75-85% (l/s)
2
0
Up to 20 21-30 31-40 41-50
Stay range distribution

25
Fig-11: PEFR of Kolkata male inhabitants
according to duration of stay

600
500
PEFR(l/min)

400 North Kolkata male


300 Central Kolkata male
200 South Kolkata male
100
0
up to 20 21-30 31-40 41-50
Stay range distribution

It has been observed that there is a gradual trend of decrement of lung volume and
flow rates with the increase of duration of stay in the respective areas.
Among the North Kolkata males there is a significant decrement of the SVC,
FVC, FEV1, FEV1%, FEF25-75%, FEF 75-85% values of the individuals residing in the area
residing for 41-50 years as compared to residents residing in the area for 21-30 years.
There is also a significant decrement of the FEF75-85 % value of the subjects residing for
41-50 years as compared to subjects residing for 31-40 years. Among the Central Kolkata
males there is a significant decrement of the FEF75-85% value of the subjects residing for
41-50 years as compared to subjects residing for 31-40 years. Among the South Kolkata
males there is a significant decrement of the FEF 25-75% value of the subjects residing for
41-50 years as compared to subjects residing for 31-40 years.
The SVC, FVC and FEV1 values of Central Kolkata in the age group of 21-30 has
been found to be significantly lower than their North Kolkata and South Kolkata
counterparts. In the 31-40 age group the FEV1% mean value of North Kolkata inhabitants
has been found to be significantly lower than the Central Kolkata inhabitants of the same
age group. In the age group of 41-50 the FEF25-75% and FEF75-85% of North Kolkata male
inhabitants have been found to be significantly lower than the South Kolkata inhabitants.
The FEF25-75% value of North Kolkata inhabitants of the same age group has also been
found to be significantly lower than the Central Kolkata male population of the same age
group.
The PFT values of female inhabitants according to their duration of stay in the
area have been given in Table-5 and fig: 12-18. All the subjects were classified
26
according to their duration of stay in the area into four groups as: up to 20, 21-30, 31-40,
41-50.
Table:-5: Lung volumes and flow rates of female individuals according to duration
of stay in north, central and south Kolkata (Mean ± SD)

Duration
Category SVC FVC FEV1 FEV1% FEF.2- FEF25- FEF75- PEFR
of stay
(l) (l) (l) 1.21ml 75% 85% (l/s) (l/min)
(Yrs)
(l/s) (l/s)
Up to 20 2.80 2.79 2.31 83.16 4.20 3.45 1.45 372.00
(n=5) ±0.28 ±0.26 ±0.41 ±14.78 ±1.11 ±0.60 ±0.49 ±40.25
North
2.61 2.73 2.46 5.00 375.71
Kolkata 21-30 90.50 3.38 1.61
±0.18 ±0.59 ±0.47 ±1.02 ±54.12
Female (n=7) ±4.90 ±0.79 ±1.01
λ λ λ λ λ
(n=16)
31-40
2.28 2.26 2.19 96.90 4.37 3.54 1.53 365
(n=1)
41-50 2.98 2.79 2.37 85.89 4.65 2.66 0.93 346.67
(n=3) ±0.79 ±0.64 ±0.38 ±9.34 ±1.27 ±0.66 ±0.48 ±92.92
Up to 20 2.60 2.63 2.23 87.50 4.40 3.06 1.61 375.71
(n=8) ±0.24 ±0.28 ±0.29 ±8.80 ±1.31 ±0.79 ±1.01 ±54.12

Central 21-30 2.17* 2.07** 1.80 83.63 2.99 2.28 0.98 283.75*
Kolkata (n=8) ±0.44 ±0.41 ±0.59 ±14.38 ±1.69 ±1.29 ±0.64 ±77.26
Female 31-40
(n=17) 2.35 2.28 2.17 95.00 4.21 2.74 1.18 375.00
(n=1)
41-50
- - - - - - - -
(n=0)
Up to 20
- - - - - - - -
(n=0)
2.87 2.80 2.57
South 21-30 91.43 4.13 3.36 1.76 311.43
±0.68 ±0.61 ±0.64
Kolkata (n=7) ±5.45 ±1.07 ±1.04 ±0.79 ±79.46
¥ ¥ ¥
Female
31-40 2.38 2.45 2.23 91.05 4.60 3.34 1.13 317.78
(n=20)
(n=9) ±0.37 ±0.37 ±0.34 ±5.28 ±1.54 ±0.88 ±0.40 ±80.28
41-50 2.10# 2.28 2.08 91.19 3.93 3.08 1.23 322.50
(n=4) ±0.24 ±0.64 ±0.61 ±5.44 ±1.66 ±1.29 ±0.73 ±43.49
[* p<0.05, ** p<0.01 when compared up to 20 Vs 21-30 age group of Central Kolkata
female, # p<0.05 when compared 21-30 Vs 41-50 age group of South Kolkata female]
[λ p<0.05 when compared North Vs Central Kolkata of 21-30 age group; ¥ p<0.05 when
compared Central Vs South Kolkata females within the 21-30 age group]

27
Fig-12: Lung volume of north Kolkata female
inhabitants according to duration of stay

3.5
3
litres 2.5 SVC (l)
2
FVC (l)
1.5
1 FEV1 (l)
0.5
0
Up to 20 21-30 31-40 41-50
Stay range distribution

Fig-13: Lung volume of central Kolkata female


inhabitants according to duration of stay

3
2.5
2 SVC (l)
litres

1.5 FVC (l)


1 FEV1 (l)
0.5
0
Up to 20 21-30 31-40 41-50
Stay range distribution

Fig-14: Lung volume of south Kolkata female


inhabitants according to duration of stay

3.5
3
2.5 SVC (l)
litres

2
FVC (l)
1.5
1 FEV1 (l)
0.5
0
Up to 20 21-30 31-40 41-50
Stay range distribution

28
Fig-15: Different flow rates of north kolakta female
inhabitants according to duration of stay

Flow rates (l/sec)


5
4 FEF.2-1.21ml (l/s)
3 FEF25-75% (l/s)
2 FEF75-85% (l/s)
1
0
up to 20 21-30 31-40 41-50
Stay range distribution

Fig-16: Different flow rates of central Kolkata


female inhabitants according to duration of stay

5
Flow rates (l/sec)

4
FEF.2-1.21ml (l/s)
3
FEF25-75% (l/s)
2
FEF75-85% (l/s)
1
0
up to 20 21-30 31-40 41-50
Stay range distribution

Fig-17: Different flow rates of south Kolkata


female inhabitants according to duration of stay

5
Flow rates (l/sec)

4
FEF.2-1.21ml (l/s)
3
FEF25-75% (l/s)
2
FEF75-85% (l/s)
1
0
up to 20 21-30 31-40 41-50
Stay range distribution

29
Fig-18: PEFR of Kolkata female inhabitants
according to duration of stay

400

PEFR(l/min) 300
North Kolkata female
200 Central Kolkata female
South Kolkata female
100

0
up to 20 21-30 31-40 41-50
Stay range distribution

It has been observed that there is a gradual trend of decrement of lung volume and
flow rates with the increase of duration of stay in the respective areas.

Among the Central Kolkata females there is a significant decrement in the SVC,
FVC and PEFR values of the resident duration range of 21-30 years as compared to the
group staying up to 20 years. Among the South Kolkata females there is a significant
decrement in the SVC value of the resident duration range of 41-50 years as compared to
the group staying up to 21-30 years.

In the age group of 21-30 the SVC, FVC, FEV1, FEF.2-1.21ml and PEFR of North
Kolkata and SVC, FVC, FEV1 of South Kolkata have been found to be significantly
higher than the population of Central Kolkata .

30
The PFT values of male inhabitants according to their age distribution in the
region have been given in Table-6 and fig: 19-25.All the subjects were classified
according to their age into three groups: 21-30, 31-40, 41-50.It has been observed that
there is a gradual trend in the decrement of the lung volume and flow rates of the subjects
with age.
Table:-6: Lung volumes and flow rates of male individual according to age range
(Mean ± SD)

Category Age SVC FVC FEV1 FEV1% FEF.2- FEF25- FEF75- PEFR
range (l) (l) (l) 1.21ml 75% 85% (l/s) (l/min)
(Yrs) (l/s) (l/s)
21-30 3.95 4.09 3.58 87.82 6.58 4.27 1.81 486.67
North (n=6) ±0.40 ±0.61 ±0.49 ±2.54 ±1.26 ±0.36 ±0.50 ±93.74
Kolkata ¥ ¥
Male 31-40 3.58 3.79 3.23 84.76† 6.16 3.96† 1.46 442.50
(n=21) (n=8) ±0.55 ±0.80 ±0.77 ±4.50 ±2.00 ±1.77 ±1.03 ±145.09
41-50 2.84* 3.07 2.33* 74.46* 4.65 2.15*** 0.66*** 370.00
(n=7) ±0.90 ±1.26 ±1.07 ±11.68 ±2.91 ±0.99 ±0.37 ±144.45
21-30 3.27 3.28 2.90 88.00 5.89 3.45 1.33 440.00
Central (n=4) ±6.13 ±0.14 ±0.24 ±3.65 ±0.64 ±0.87 ±0.36 ±38.30
Kolkata 31-40 3.51 3.53 3.00 84.80 6.21 3.41 1.22 444.00
Male (n=10) ±0.45 ±0.48 ±0.54 ±7.32 ±2.04 ±1.15 ±0.37 ±80.72
(n=18) 41-50 3.07 3.10 2.66 86.25 5.75 3.17 0.94† 432.50
(n=4) ±0.64 ±0.64 ±0.45 ±4.43 ±1.17 ±0.46 ±0.10 ±58.52
£ £
21-30 4.31 4.28 3.81 89.48 7.62 4.73 1.97 516.25
South (n=8) ±0.89 ±0.92 ±0.80 ±7.16 ±1.38 ±1.35 ±0.81 ±80.17
Kolkata € € € €
Male 31-40 3.74 3.58 3.24 86.87 6.62 4.58 1.86 478.33
(n=21) (n=6) ±1.04 ±1.48 ±1.41 ±11.18 ±3.23 ±2.11 ±0.95 ±187.87
41-50 3.39* 3.61 3.00* 82.88 6.69 3.11* 1.16* 437.14
(n=7) ±0.66 ±0.54 ±0.54 ±6.40 ±2.22 ±0.87 ±0.54 ±126.06

[* p<0.05, ** p<0.01, *** p<0.001 when compared 21-30 Vs 41-50 and † p<0.05 when
compared 31-40 Vs 41-50 within the same area]
[¥ p<0.05 when compared North Vs. Central Kolkata male in the 21-30 age group, €
p<0.05 when compared Central Vs. South Kolkata male in the 21-30 age group, £ p<0.05
when compared North Vs. Central Kolkata male in the 41-50 age range]

Among the North Kolkata males a significant decrement of the SVC,


FEV1,FEV1%, FEF25-75%, FEF75-85% values in the age range of 41-50 as compared to the
age range of 21-30 have been observed. There is also a significant decrement of FEV1 %
and FEF25-75% value in the age range of 41-50 as compared to the age range of 31-
31
40.Among the Central Kolkata males subjects a significant decrease in the FEF75-85% value
in the 41-50 age group as compared to the 31-40 age group have been observed. Among
the South Kolkata male subjects a statistically significant decrement in the SVC, FEV1,
FEF25-75% and FEF75-85% values have been observed in the age group of 41-50 as
compared to the age group of 21-30.
In the age range of 21-30 the FVC and FEV1 of North Kolkata and FVC, FEV1,
FEF.2-1.21ml and PEFR of south Kolkata males have been found to be significantly higher
than their Central Kolkata counterparts of the same age group. In the age range of 41-50
the FEV1% and FEF25-75% value of Central Kolkata has been found to be significantly
lower than the North Kolkata male inhabitants of the same age group.

Fig-19: PEFR of male inhabitants according to


age distribution

600
500
PEFR l/min

400 NORTH MALE


300 CENTRAL MALE
200 SOUTH MALE

100
0
21-30 31-40 41-50

32
Fig-20: Lung volume of north Kolkata male
inhabitants according to age distribution

5
4
SVC
3
litres

FVC
2
FEV1
1
0
21-30 31-40 41-50
Age range distribution

Fig-21: Lung Volume of central Kolkata male


inhabitants according to age distribution

4
3.5
3
2.5 SVC
litres

2 FVC
1.5 FEV1
1
0.5
0
21-30 31-40 41-50
Age range distribution

Fig-22: Lung Volume of south Kolkata male


inhabitants according to age distribution

5
4.5
4
3.5
3 SVC
litres

2.5 FVC
2 FEV1
1.5
1
0.5
0
21-30 31-40 41-50
Age range distribution

33
Fig-23: Different flow rates of north kolkata male
inhabitants according to age distribution

7
Flow rates (l/sec)
6
5 FEF.2-1.21ml (l/s)
4
FEF25-75% (l/s)
3
2 FEF75-85% (l/s)
1
0
21-30 31-40 41-50
Age range distribution

Fig-24: Different flow rates of central Kolkata male


inhabitants according to age distribution

7
6
Flow rate (l/sec)

5 FEF.2-1.21ml (l/s)
4
FEF25-75% (l/s)
3
2 FEF75-85% (l/s)
1
0
21-30 31-40 41-50
Age range distribution

Fig-25: Different flow rates of south Kolkata male


inhabitants according to age distribuition

10
Flow rate (l/sec)

8
FEF.2-1.21ml (l/s)
6
FEF25-75% (l/s)
4
FEF75-85% (l/s)
2
0
21-30 31-40 41-50
Age range distribution

34
The PFT values of female inhabitants according to their age distribution in the
region have been given in Table-7 and Fig: 26-32.All the subjects were classified
according to their age into three groups: 21-30, 31-40, 41-50.It has been observed that
there is a gradual trend in the decrement of the lung volume and flow rates of the subjects
with age.

Table:-7: Lung volumes and flow rates of female individual according to age range
(Mean ± SD)

Category Age SVC FVC FEV1 FEV1% FEF.2- FEF25- FEF75- PEFR
range (l) (l) (l) 1.21ml 75% 85% (l/min)
(Yrs) (l/s) (l/s) (l/s)
21-30 2.67 2.65 2.40 90.47 4.58 3.24 1.32 367.50
North (n=8) ±0.24 ±0.25 ±0.24 ±6.32 ±1.02 ±0.52 ±0.47 ±42.68
Kolkata 31-40 2.66 2.96 2.47 84.45 4.69 3.93 2.16 378.75
Female (n=4) ±0.32 ±0.74 ±0.70 ±17.27 ±1.07 ±0.57 ±1.06 ±45.89
(n=16) ¥¥ ¥
41-50 2.87 2.66 2.25 85.59 4.72 2.59† 0.90 360.00
(n=4) ±0.69 ±0.59 ±0.37 ±7.04 ±1.36 ±0.54 ±0.33 ±80.32
21-30 2.57 2.48 2.30 91.50 4.35 3.24 1.34 337.50
Central (n=8) ±0.25 ±0.27 ±0.26 ±3.85 ±1.05 ±0.85 ±0.43 ±73.82
Kolkata 31-40 2.37 2.38 1.92‡ 84.71 3.37 2.30 0.86‡ 312.14
Female (n=6) ±0.25 ±0.43 ±0.26 ±9.21 ±0.98 ±0.82 ±0.27 ±52.11
(n=17) 41-50 1.78* 1.76* 1.34 72.33 2.35 1.60 0.56 276.67
(n=3) ±0.45 ±0.45 ±0.73 ±19.63 ±3.14 ±1.86 ±0.62 ±150.11
21-30 2.87 2.80 2.57 91.43 4.13 3.36 1.76 311.43
South (n=7) ±0.68 ±0.61 ±0.64 ±5.45 ±1.07 ±1.04 ±0.79 ±79.46
Kolkata 31-40 2.38 2.45 2.23 91.05 4.60 3.34 1.13 317.78
Female (n=9) ±0.37 ±0.37 ±0.34 ±5.28 ±1.54 ±0.88 ±0.40 ±80.28
(n=20) €
41-50 2.10◊ 2.28 2.08 91.19 3.93 3.08 1.23 322.50
(n=4) ±0.24 ±0.64 ±0.61 ±5.44 ±1.66 ±1.29 ±0.73 ±43.49

[† p<0.05 when compared between 31-40 Vs 41-50 age group of North Kolkata;
‡p<0.05 when compared 21-30 Vs 31-40, * p<0.05 when compared 21-30 Vs 41-50 age
group of Central Kolkata and ◊ p<0.05 when compared 21-30 Vs 41-50 of South
Kolkata]
[¥ p<0.05, ¥¥ p<0.01 when compared North Vs. Central Kolkata male in the age group of
31-40; € p<0.05 when compared Central Vs. South Kolkata male in the age group of 31-
40]

Among the North Kolkata female subjects a significant decrease in the FEF25-75%
value in the 41-50 age range as compared to the 31-40 age range has been observed.
35
Among the Central Kolkata female inhabitants a significant decrease in the FEF75-85%
and FEV1 values in the age range of 31-40 as compared to the age range of 21-30 has
been observed. There is also a significant decrease in the SVC and FVC values in the age
range of 41-50 as compared to the age range of 21-30. Among the South Kolkata female
inhabitants a significant decrease in the FVC value in the age range of 41-50 as compared
to 21-30 age group has been observed.
In the age range of 31-40 the FEF25-75% and FEF75-85% value of Central Kolkata
female individuals have been found to be statistically lower than that of the North
Kolkata female population.. The FEF25-75% value of Central Kolkata population of the
same age group has also been found to be statistically lower than the South Kolkata
female population of the same age group.

Fig-26: PEFR of female inhabitants according to


age distribution

400
350
300
PEFR l/min

250 NORTH FEMALE


200 CENTRAL FEMALE
150 SOUTH FEMALE
100
50
0
21-30 31-40 41-50

36
Fig-27: Lung volume of north Kolkata female
inhabitants according to age distribution

3.5
3
2.5 SVC
litres

2
FVC
1.5
1 FEV1
0.5
0
21-30 31-40 41-50
Age range distribution

Fig-28: Lung volume of central Kolkata female


inhabitants according to age distribution

3
2.5
2 SVC
litres

1.5 FVC
1 FEV1
0.5
0
21-30 31-40 41-50
Age range distribution

Fig-29: Lung volume of south Kolkata female


inhabitants according to age distribution

3.5
3
2.5 SVC
litres

2
FVC
1.5
1 FEV1
0.5
0
21-30 31-40 41-50
Age range distribution

37
Fig-30: Different flow rates of north Kolkata female
inhabitants according to age distribution

5
Flow rate (l/sec)
4
FEF.2-1.21ml (l/s)
3
FEF25-75% (l/s)
2
FEF75-85% (l/s)
1
0
21-30 31-40 41-50
Age range distribution

Fig-31: Different flow rates of central Kolkata female


inhabitants according to age distribution

5
Flow rate (l/sec)

4
FEF.2-1.21ml (l/s)
3
FEF25-75% (l/s)
2
FEF75-85% (l/s)
1
0
21-30 31-40 41-50
Age range distribution

Fig-32: Different flow rates of south Kolkata female


inhabitants according to age distribution

5
Flow rate (l/sec)

4
FEF.2-1.21ml (l/s)
3
FEF25-75% (l/s)
2
FEF75-85% (l/s)
1
0
21-30 31-40 41-50
Age range distribution

38
The PFT values according smoking habit are represented in Table-8 and Fig-33-
36. The PFT values of the smokers are slightly higher compared to the non-smoker in
several parameters.

Table: - 8:-Lung volume and flow rates of male subjects according to their smoking
habits (Mean ± SD)

Duration
Category BSA BMI SVC FVC FEV1 FEV1% FEF.2- FEF25- FEF75- PEFR
of stay
(l) (l) (l) 1.21ml 75% 85% (l/min)
(Yrs)
(l/s) (l/s) (l/s)
Non-
North 3.42 3.63 3.10 83.99 5.71 3.82 1.47 430.00
Smoker 1.66 24.07
Kolkata ±0.85 ±1.04 ±0.98 ±9.46 ±2.40 ±1.45 ±0.89 ±143.99
(n=13) ±0.19 ±3.38
(n=21)
Smoker 1.6 20.9 3.47 3.64 2.41 79.2 5.89 2.83 1.01 432.50
(n=8) ±0.19 ±5.06 ±0.70 ±0.96 ±0.93 ±8.2 ±2.11 ±1.53 ±0.71 ±127.25
Non-
3.34 3.38 2.93 86.79 6.17 3.46 1.22 452.14
Central Smoker 1.55 21.26
±0.48 ±0.51 ±0.47 ±4.04 ±1.24 ±0.89 ±0.35 ±62.04
Kolkata (n=14) ±0.16 ±2.63
(n=18) Smoker 1.58 21.99 3.44 3.39 2.80 82.50 5.59 3.03 1.04 400.00
(n=4) ±0.20 ±4.37 ±0.47 ±0.45 ±0.52 ±10.66 ±2.75 ±1.19 ±0.33 ±71.18
Non-
3.72 3.73 3.29 86.37 6.77 4.04 1.66 476.43
South Smoker 1.66 21.67
±0.98 ±1.09 ±1.07 ±8.94 ±2.37 ±1.69 ±0.91 ±142.70
Kolkata (n=14) ±0.17 ±4.41
(n=21) Smoker 1.76 24.86 4.07 4.11 3.56 86.86 7.52 4.36 1.69 484.29
(n=7) ±0.15 ±5.35 ±0.80 ±0.89 ±0.78 ±7.66 ±2.01 ±1.48 ±0.69 ±111.93

[No statistically significant difference in the values has been observed]

No statistical significant variation has been observed in the


pulmonary function tests of various parameters between the smokers and the non-
smokers of the different areas but variations in the mean values have been observed.
Among the North Kolkata males the mean values of SVC, FVC,
FEF.2-1.21 and PEFR have been found to be higher in the smokers in comparison to that of
the non-smokers. Similarly among the Central Kolkata subjects the mean values of SVC
and FVC have been found to be higher in the smokers than in the non-smokers. Likewise
in South Kolkata all the PFT parameters have been found to be higher in the smokers as
compared to the non-smokers.
A number of reasons may be cited to explain this anomalous variation by the fact
that only small number of individuals (n) have been studied i.e the numbers of smokers
39
are very low in comparison to the non-smokers and they had better lung function values
than the non-smokers. From the given table it is observed that the mean values of BSA
and BMI of the smokers are higher than the non-smokers, as the thoracic cavity and the
body surface area of their body are higher they have a greater possibility to have more
lung volume and hence better flow rates. The smoking factor also depends on the number
of beedi/cigarettes smoked per day, duration of smoking and the number of puffs taken
each time.

Fig-33: Distribution of male Kolkata inhabitants


according to their smoking habit

16
14
12
Numbers

10
NON-SMOKER
8
SMOKER
6
4
2
0
North Kolkata Central Kolkata South Kolkata

40
Fig-34: Comparison of Lung volume of Kolkata
male inhabitants according to their smoking habit
North Kolkata Non-
4.5 Smoker
4 North Kolkata Smoker
3.5
3 Central Kolkata Non-
litres

2.5 Smoker
2
Central Kolkata Smoker
1.5
1
0.5 South Kolkata Non-
0 Smoker
SVC FVC FEV1 South Kolkata Smoker

Fig-35: Comparison of flow rates of Kolkata male


inhabitants according to their smoking habit
North Kolkata Non-
8 Smoker
7 North Kolkata Smoker
6
5 Central Kolkata Non-
l/sec

4 Smoker
3
Central Kolkata Smoker
2
1
0 South Kolkata Non-
Smoker
FEF.2-1.21ml FEF25-75% FEF75-85%
(l/s) (l/s) (l/s) South Kolkata Smoker

Fig-36: PEFR values of Kolkata male inhabitants


according to their smoking habit
North Kolkata Non-
600 Smoker
North Kolkata Smoker
500
PEFR (l/min)

400 Central Kolkata Non-


300 Smoker
Central Kolkata Smoker
200
100 South Kolkata Non-
0 Smoker
PEFR (l/min) South Kolkata Smoker

The spirometric classifications of the pulmonary function impairments are presented


in Table-9. The pulmonary function impairments are of restrictive, obstructive and
41
combined type. Obstructive disease characterized by an increase in resistance to airflow
owing to partial or completes obstruction at any level, from the trachea and larger bronchi
to the terminal and respiratory bronchioles also may be due to mucous occurrence in the
trachea. Restrictive disease characterized by reduced expansion of lung parenchyma,
with decreased total lung capacity.
Each type of impairments was found less among female subjects. Among the total
113 subjects analysed 8.85% of the subjects were detected to be with pulmonary
impairments. The highest impairment has been noticed among the Central Kolkata
inhabitants with 11.43 % followed by North Kolkata (10.81 %) and South Kolkata
(8.85%)
Table: 9- Respiratory impairments among male and female individuals of north,
central and south Kolkata

Impairments
Area Category Restrictive Obstructive Combined Total

Male 1 1 1 3
(n=21) (4.76) (4.76) (4.76) (14.28)
North Female 0 1 0 1
Kolkata (n=16) (4.76) (4.76)
Total 1 2 1 4
(n=37) (2.70) (5.40) (2.70) (10.81)
Male 1 1 0 2
(n=18) (5.56) (5.56) (11.11)
Central Female 0 2 0 2
Kolkata (n=17) (11.76) (11.76)
Total 1 3 0 4
(n=35) (2.86) (8.57) (11.43)
Male 1 0 1 2
South (n=21) (4.76) (4.76) (9.52)
Kolkata Female 0 0 0 0
(n=20)
Total 1 0 1 2
(n=41) (2.43) (2.43) (4.88)
Total 3 5 2 10
Kolkata Surveyed (2.65) (4.42) (1.77) (8.85)
=113

(Figures in the parenthesis are percentage)

42
Conclusion:-
The health effect of environmental pollution has been a great concern for mankind
since several decades. In the developing countries industrial emission continues to be the
major source of air pollution but with the increasing number of vehicles, vehicular air
pollution is becoming increasingly important especially in the metropolitan city, Kolkata
is one of the polluted cities in India as per the CPCB. The pollution level showed a rising
trends from day to day. This is confirmed by the Lung function impairment data of the
inhabitants only due to the exponential vehicular pollution rise. This produces rise in
SPM and other pollutant levels in residential, commercial area. Urbanization creates
pollution. The 3 P’s- Population, Poverty and pollution are quite interlinked with one
another. Population explosion at Kolkata because of new births and migration is the most
vital reason for deterioration of the environment.
Vehicles pollution occurs due to:-
 Unscrupulous use of Adultered Fuel.
 Poor maintenance of the vehicles.
 Faulty Driving techniques.
 Road borne dust.
 Age of the vehicle and it’s present roadworthiness.
Miscellaneous-
 Open burning of garbage, running of generator sets, burning of
tyres etc.
 Road side dust.
 Construction activities.
 Effect of deplantation.
 Meteorological conditions.

The people residing in the city are exposed to that environment. The
particular populations residing nearer to the main traffic junction or by the side of the
main roads of the city are very much exposed to the automobile exhausts. Rapid increase
of number of vehicles, vehicular air pollution is becoming increasingly important
43
especially in the metropolitan city, Kolkata where road transport is the main means of all
traffic.
The study was conducted in phased manner on total 113 individuals in areas of
North, Central and South Kolkata and it was done on both adult males and female
individuals in the age range of 21-50 years. The results were evaluated on the basis of age
of the subject, duration of stay in the area and smoking habit in case of male individuals.
Because of the sex difference males have higher mean values of height, weight and Body
surface area than the females within the same area. The mean values of the BMI vary
within certain limits within the same area. There is a gradual decrement of lung volume
and flow rate values with increment of age range in both sexes. The maximum values are
found in the age range of 21-30 and after that the values show a steady decrement with
age. It has also been shown that with the duration of stay in their respective areas the lung
volume and the flow rates of the individuals also show a steady decline.
By comparing the PFT values of North, Central and South Kolkata residents we
can conclude that the lowest values are found among the Central Kolkata residents. The
area is most polluted by vehicular pollution and it is reflected in the health status of the
inhabitants of the area. The PFT values of North Kolkata residents stands next to Central
Kolkata suggesting that the vehicular pollution impact has also taken its toll among the
residents of the area.
Each type of respiratory impairments was found less among female subjects.
Among the total 113 subjects analysed 8.85% of the subjects were detected to be with
pulmonary impairments. The highest impairment has been noticed among the Central
Kolkata inhabitants with 11.43 % followed by North Kolkata (10.81 %) and South
Kolkata (8.85%). It has been concluded that respiratory impairments are maximum
among the inhabitants of Central Kolkata followed by North Kolkata and the South
Kolkata people are least affected by the pulmonary function impairments caused due to
vehicular pollution.

44
Recommendation:-
In the context to the present study some ideas and suggestions for possible
management of environmental pollution of Kolkata air can be forwarded- .
The burning of fuel is major source of pollution so the possible measure should be
the replacement of burning fossil fuel by electricity or solar energy or by improvement of
the fuel quality and fuel burning process. There are number of mechanical devices that
might be helpful for reduction of pollutant emission level from different industries and
other sources.
Since vehicles contribute significantly to the total air pollution load in most urban
areas, vehicular pollution control deserves top priority. A practical strategy should be
devised that reduces both emissions and congestion. Some of these strategies may be –
Phase out the all vehicles older than ten to fifteen years, two and three wheelers
should have four stroke engines with catalytic converter and fuelled by Biodiesel, LPG or
CNG. Catalytic Converters convert comparatively more toxic CO and Hydrocarbons to
less toxic CO2 and water. In addition to these fuels, use of diesel fuel with lower sulfur
content can help to reduce emissions. A newer vehicle that meets more stringent
emission standards is purchased to replace the scrapped vehicles.
Bharat Stage IV norms should be enforced on all vehicles and smooth movement
of vehicles should be facilitated by construction of new flyover, bridges, improvement of
road condition and width of the roads. Mass Rapid Transport System may be considered
for the fast expanding and major urban cities like Kolkata. Greater promotion and use of
alternative fuels such as CNG/LPG/Propane/ battery operated vehicles. Expansion of
CNG dispensing facilities and increased fiscal incentives for CNG kits should be
encouraged. Taxes on fuels, vehicles—the revenue so generated could be used for
pollution control measures. Strengthening of inspection and maintenance (I&M) system:
The I&M system, comprising inspection, maintenance, and certification of vehicles, is
crucial for regulating pollution for the large fleet of in-use vehicles. It should include
testing of various elements of safety, road worthiness and compliance to pollution norms.
Diversion of heavy goods traffic in peak hours is very much essential to
minimize the automobile pollution and the pollution of the city as a whole. Use of Public
Vehicles should be encouraged as it saves not only fuel but also the load of city ambient
air pollution. Plantation at the city road side is essential to reduce the suspended
45
particulates of the air and for providing clean air. The plantation acts as sink and help in
sequestering a lot of CO2 from the atmosphere.
At personal level several steps may be taken to feel better and slow the damage to
the lungs due to the impact of air pollution –
 Clear the airways to remove the mucus settled in the air passage.
 Exercise regularly as regular exercise can improve the overall strength and
endurance and strengthen the respiratory muscles.
 Eat healthy foods as a healthy diet can help to maintain the body strength
 Drink plenty of water as water flushes out the toxins from the body.
 Avoid smoking, in addition to quitting smoking, it's important to avoid places
where others smoke. Passive smoke may contribute to further lung damage

46
References:-
(1) Stern Arthur C, Boubel Richard W, Turner D.Bruce, Fox Donald L. (1984),
Fundamentals of Air Pollution IInd ed, Academic Press London, pp108-112.
(2) Cheng, YS, Yeh HC, Manderly JL and Mekler BV(1984) ‘Characterization of
Diesel exhaust in a chronic inhalation study’ in American Industrial Hygiene
Association Journal, vol 45, pp.547-555.
(3) Johnson, JH (1988) ‘Automotive emissions’ in AY Watson et.al (Ed s) ‘Air pollution, the
Automobile and Public’, National Academy Press, Washington, DC, pp39-75
(4) Snipes, MB (1989) ‘Long term retention and clearance of particles inhaled by
mammalian species’ in critical reviews in Toxicology, volume 20, pp175-211.
(5) Manderly JL (2000) ‘Diesel exhaust’ in M Lippmann (Ed), Toxicant; Human
Exposures and their Health effects, 2nd Ed, Niley, New York.
(6) Stern.Arthur C (1977) ’Air Pollution’, volume II ,Academic Press London, pp563.
(7) IARC report: 1989.
(8) Burgess WL, Diberadius L, Speizer FE (1975), Exposure to automobile exhaust
III. An Environmental Assessment 26(6) : pp325-329.
(9) Ulvarson UL, Alexanderson R, Aringer L, Svensson E, Hedenstierna G, Hogstedt
C, Holmberg B, Rosen G, Sorsa MT (1987), Effects of exposure to vehicle
exhaust on health , Scand J Work Environ Health, 13: pp 505-512.
(10) Nakai S, Nitta H, Maeda K (1950) Respiratory Health associated with exposure to
automobile exhaust .II. Personal NO2 exposure levels according to distance from
the roadside. J exposure Anal Environ Epidemial 5: 125-136.
(11) Laxen DPH, Noordally E (1987) Nitrogen oxide distribution in street canyons.
Atmospheric Environment 21: pp1899-1903
(12) Chattopadhyay BP, Alam J, Roychowdhury A (2003) , Pulmonary function
abnormalities associated with exposure to automobile exhaust in a diesel bus
garage and roads . Lung- An International Journal on lungs, airways and breathing
181: pp 291-332
(13) Rao NM, Petal TS, Raiyani CV, Kulkarni PK, Aggarwal AL, Kashyap SK,
Chatterjee SK(1991) A Dose response Relationship between pollution index and
pulmonary function in shopkeepers exposed to auto exhaust. Indian Journal
Environ Protec 11(10) : pp737-740.
47
(14) Dockery DW, Pope CA IV, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG,,
Spiezer FE (1993).An Association between air pollution and mortality in six US
cities. The New England Journal of Medicine 329: pp1753-1759.
(15) Padhy PK, Varshney CK (2000) Total non methane volatile organic compounds
(TNMVOC) in the atmosphere of Delhi. Atmospheric Environment 34: pp577-
584.
(16) Samet J, Domonici F, Curriero C, Coursac I, Zeger SL (2000) Fine particulate Air
Pollution and Mortality in 20 US cities,1987-1994,The New England Journal of
medicine 343:pp1742-1749.
(17) Rao MA, Pandit GG, Sain P, Sharma S, Krishnamoorthy TM, Nambi KSV
(1997). Non methane Hydrocarbon in Industrial location of Bombay atmospheric
environment 31(7) :pp1077-1085.
(18) Srivastava A, Joseph AE, Patil S, More A, Dixit RC, Prakash M (2005) Air toxics
in ambient air of Delhi. Atmospheric Environment 39: pp59-71.
(19) Pandit GG, Mohon Rao AM (1990) Evaluation of auto exhaust contribution to
atmospheric C2-C5 hydrocarbonat Deoner, Bombay. Atmospheric Environment
24A: pp811-813
(20) Ingle ST, Pachpande BG, Wagh ND, Patel VS, Attarde SB (2005) Exposure to
vehicular pollution and Respiratory Impairment of Traffic Policemen in Jalgaon
City, India , Industrial health. 43: pp656-662.
(21) Lahiri Twisha, Roy Senjuti, Basu Chandreyi, Ganguly Sangeeta, Et al (Jul 2000),
Indian Journal of Medical Research
(22) CNCI Report 2007.
(23) Wei E T, Shu Helen P et.al (September 1983), Nitro aromatic Carcinogens in
Diesel Soot, Vol. 73, No. 9.
(24) S. T. Ingle, N. D. Wagh, B. G. Pachpande, V. S. Patel and S. B. Attarde, The
influence of workplace environment on lung function of shopkeepers working
near National Highway in Jalgaon: A note. Transporatation Research: Part D,
2005.

48
Proforma of the project:

Regional Occupational Health Centre


(Eastern)
(Indian Council of Medical Research)
Block-DP, Sector-V, Salt Lake, Kolkata-700091

Assessment of the Effects of High Particulate Pollutants on Pulmonary Health


Status in Selected Mega cities of South Asia
Area information
A. Serial no. B. Interviewer:

C. Air Quality Monitoring Station: D. Distance from the station

E. Date: F. Room Temperature:

Part – 1. IDENTIFICATION DATA


01. Identification Number (4 Digits): ……………
02. Name:
03. Name of the father/spouse:
04. Name of the Head of the family
05. Age:
06. Sex: (Male - 1, Female - 2)
07. Address:

Part – 2. GENERAL INFORMATION ON HOUSEHOLD AND FAMILY

08. Distance from the main road:


09. Any local sources of outdoor pollution: (eg. Factory etc):
10. Floor of residence:
11. Number of rooms:
Kitchen is in the separate room or in the same room-----------------------------------

Ventilation of the house or room---------Good----------Satisfactory---------------


Poor

49
12. Number of household members:

13. Type of fuel used: (encircle the response, one or more)


a. Gas – 1 b. Kerosene – 2 c. Wood – 3 d. Cow dung cakes – 4 e. Coal - 5

14. Is there a separate kitchen? Yes (1) / No (2)


15. Do you use mosquito coils/liquid repellants? Yes (1) / No (2)
16. Total family income per month per capita (divide total by number of persons &
encircle the response):

a. Below Rs 1000 – 1, b. Rs 1000 - 3000 – 2, c. Rs 3000 - 5000 – 3 ,d. Rs 5000 -


10,000 - 4
e. Rs 10,000 and above - 5

17. Total duration of stay in that area A. Present: –


B. Past:-

18. Occupational status: (encircle the response)


a. Employed – 1 b. Student – 2 c. Housewife – 3 d. Unemployed – 4 e.
Previously employed but now unemployed - 5

Occupation-------------------------------------------------------------------------------------
----

Specify the Occupation in detail-


Duration in that occupation (Yrs) ----------------------------------

Nature of Work-------------------------------------------------------

Work shift (if any) ----------------------------------------------------

19. Smoking status:


a. Never smoked – 1 b. Ex-smoker – 2 c. Current smoker - 3

20. What do you or did you smoke?


a. Bidis – 1 b. Cigarettes – 2 c. Hukka – 3 d. Others - 4 (please
specify)__________

50
21. How many bidis/cigarettes etc do you smoke or used to smoke every day?
(Maximum no. ever) ------

22. How many years you smoked-----------------Number of smoker in the family------------


---------------

23. If ex-smoker, reason for stopping: ____________________

24. PERSONAL HISTORY OF THE SUBJECT.

Are you suffering from any respiratory or other diseases already diagnose----------
-------------------

If yes specify the name of the disease------------------------------------------------------


------------------

Did you have any periodical illness--------------------------------------------------------


-------------------?

Did you have any respiratory problem like cough---------------------------------------


----------Yes/ No,
Specify-----------------------------------------------------------------------------------------
--------------------

Did you have any respiratory problem like breathlessness------------------------------


---------Yes/ No.
Specify-----------------------------------------------------------------------------------------
--------------------

Did you have any respiratory problem like morning cough-----------------------------


---------Yes/ No.
Specify-----------------------------------------------------------------------------------------
--------------------

Did you have any respiratory problem like chest tightness-----------------------------


---------Yes/ No.
Specify-----------------------------------------------------------------------------------------
--------------------

Did you have any respiratory problem like cough through out the day---------------
----------Yes/No.?
Specify-----------------------------------------------------------------------------------------
--------------------

Do you have the respiratory problem during seasonal variations?


Summer, winter, Rainy etc------------------------------------------------------------------
-------------------
51
Do you feel any breathlessness: ------------------------------------------------------------
----------Yes/No.

FAMILY HISTORY
Any of the family members suffer from respiratory disease----------------------------
----------Yes/No.

Relationship with the subject----------------------------------------------------------------


-------------------

If diagnosed name of the disease-----------------------------------------------------------


--------------------

A. Physical Characteristics

Height :______________( cm); Weight :_______________( Kg)


BSA: _______________ ; BMI: _________________

B. Static Lung Function Test Values


(In each parameter selected the best of three simultaneous records)

a) SVC---------------------- (l) b) ERV------------------------------- (l)

c) IRV----------------------- (l) d) TV--------------------------------- (ml)

C. Dynamic Lung Function Test Values:


(In each parameter selected the best of three simultaneous records)

(a) FVC------------------------------ (l)

(b) FEV1----------------------------- (l)

(c) FEV1/FVC---------------------- (%)

(d) FEF.2-1.21------------------------- (l/s)

(e) FEF25-75%-------------------------(l/s)

(f) FEF75-85%-------------------------(l/s)
52
(g) PEFR-i)--------------ii)--------------------iii)----------------------------(l/min)

(h) MEF75%---------------------------(l/s)

(i) MEF50%---------------------------(l/s)

(j) MEF25%---------------------------(l/s)

(k) FIVC------------------------------- (l)

(l) FIV1-------------------------------- (l)

(m) FIV1/FIVC------------------------ (l)

(n) MV--------------------------------- (l/m)

(o) MVV------------------------------- (l/m)

…………………………….. ……………………………………..
Signatures of interviewer Signatures of .
. Supervisor

-----------------------------X----------------------------

53