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| LETTER TO THE EDITOR |
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| Year : 2021 | Volume
: 7
| Issue : 2 | Page : 179 |
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Lung Function Status of Delhi: Points to Ponder
Pranav Ish
Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India
| Date of Submission | 28-Apr-2021 |
| Date of Decision | 03-Jun-2021 |
| Date of Acceptance | 03-Jun-2021 |
| Date of Web Publication | 16-Jul-2021 |
Correspondence Address:
Pranav Ish
Room Number 638, Superspeciality Block, Office of Department of Pulmonary, Critical Care and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi 110029
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/mamcjms.mamcjms_44_21
How to cite this article:
Ish P. Lung Function Status of Delhi: Points to Ponder. MAMC J Med Sci 2021;7:179 |
Sir,
The recent article “A Cross-Sectional Study on Lung Function Status of Adults in Delhi” by Garg et al.[1] is an effort to understand the pulmonary function of the community in Delhi and correlate it with sociodemographic parameters. The authors must be congratulated for the effort of collecting data from across Delhi with a sample size of over 3000 people and over one-third showing impaired results. There are, however, a few points which need to be addressed:- The inclusion and exclusion criteria are lacking. Ideally, there should be no exclusion criteria of underlying chronic respiratory illness in such cross-sectional studies to get a true estimate of the burden in the community.
- The technique and repeatability of the spirometry is very important. The number of attempts offered per person for spirometry before interpretation has not been mentioned.
- A common reason for getting restriction can be poor effort. Thus, whether the spirometry was repeated for decreasing this confounder or whether total lung capacity to confirm restriction was performed should be mentioned. In the absence of the above, possible restriction is a better terminology to use.
- Postbronchodilator reversibility not carried out has been mentioned as a limitation by the authors. However, it is easy to miss asthma patients in spirometry who are well-controlled on their inhaler medications. Thus, rather than an overestimation of obstruction, the study has most likely underestimated the same.[2] Postbronchodilator obstruction is necessary only for diagnosing chronic obstructive pulmonary disease[3] and does not apply for all obstructive disorders. Similarly, many interstitial lung diseases also may not show restriction in early phases of illness. Thus, getting a 34% abnormal spirometry may actually under-represent the disease burden in the community.
- A correlation with AQI of the respective sites of the study can yield better evaluation of the impact of the same on the population.
The article, however, emphasizes on the emerging problem of air pollution and the burden of chronic respiratory illnesses in time to come in Delhi.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Garg S, Banerjee B, Meena GS, Sharma N, Singh MM. A cross-sectional study on lung function status of adults in Delhi. MAMC J Med Sci 2021;7:31-8.  [Full text] |
| 2. | Levy ML. Is spirometry essential in diagnosing asthma? No. Br J Gen Pract 2016;66:485. |
| 3. | Gupta N, Malhotra N, Ish P. GOLD 2021 guidelines for COPD − what’s new and why. Adv Respir Med 2021;89:344-6. doi: 10.5603/ARM.a2021.0015. Epub 2021 Apr 21. PMID: 33881161. |
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