Chest
Volume 93, Issue 2, February 1988, Pages 359-363
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Clinical Investigations
Longitudinal Pulmonary Function Changes in Pigeon Breeders

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We studied 15 subjects (14 men and one woman; seven symptomatic and eight asymptomatic) at three- to four-year intervals from 1967 through 1985 (18 years) to determine if continued pigeon antigen exposure in these groups was associated with a decline in pulmonary function greater than expected in healthy individuals. We collected immunologic studies at the initial visit, performed sequential pulmonary function studies and obtained chest radiographs. After compensating for the normal changes expected with increasing age, we found the declines in FVC, FEV1, and Dsb in the symptomatic group were nearly four times greater than expected. There was no significant difference in the decline of pulmonary function between asymptomatic subjects and the normal predicted declines with increasing age. We conclude that, if an individual has episodes of acute hypersensitivity pneumonitis, long-term exposure to pigeon antigens will result in an accelerated decline in pulmonary function.

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METHODS

Eleven symptomatic and 42 asymptomatic pigeon breeders were initially identified and were entered, with consent, into a study during a 1967 survey of pigeon racing clubs in Utah.7 The symptomatic subjects were defined as having had acute hypersensitivity pneumonitis based on a history of systemic symptoms (chills, fever, sweating, cough and malaise) following exposure to pigeons on at least two occasions. No subacute or chronic cases were identified when members of this group were examined in

DATA ANALYSIS

Means and percent predicted values of the pulmonary measurements made in 1985 for these symptomatic and asymptomatic subjects were calculated. All measurements of each parameter for all subjects in each subgroup were separately regressed against age to test for significant average declines.12 Parameters showing significant declines with age were further tested by comparing the slope of the decline for the symptomatic and asymptomatic groups of pigeon breeders to the slope of the normal decline

RESULTS

Twelve subjects were lifetime nonsmokers and three were ex-smokers at the beginning of the study. One of these breeders (subject 11) resumed smoking cigarettes and had a 48 pack-year history by 1985 and one (subject 9) resumed smoking a pipe. Except for exposure to pigeons, the occupational and environmental exposure history of the 15 subjects was otherwise unremarkable (Table 1).

Six of the seven symptomatic and seven of the eight asymptomatic subjects had precipitating antibodies to pigeon

DISCUSSION

This study demonstrates that symptomatic pigeon breeders with ongoing antigen exposure experience declines in FVC, FEV1 and Dsb that are three to four times normal (Table 3; Figure 1, Figure 2, Figure 3). The same functional parameters decline at normal rates in asymptomatic pigeon breeders. Since cross-sectional studies tend to overestimate the rate of decline, the declines observed in symptomatic breeders are even more pronounced when compared to longitudinal predictions.13, 14

In the absence

ACKNOWLEDGMENTS

The authors appreciate the technical assistance of the Pulmonary Laboratories of the LDS Hospital and Salt Lake Clinic, and of Steven Berlin, Debbie Crews, Harriet May and Beth Jarman in the collection of data and preparation of this manuscript.

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    Supported in part by grants from Salt Lake Clinic Research Foundation and the Intermountain Allergy and Immunology Clinic.

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