Extract In their landmark study of the natural history of chronic airflow obstruction among London working men, F letcher and P eto [1] identified two factors leading to impaired lung function in later life. The first and most important was cigarette smoking causing an accelerated age-related decline in forced expiratory volume in 1 s (FEV 1 ). However, they also demonstrated that starting with a low lung function in early adulthood enhanced the risk. Thus, someone who already has lung function at the lower end of the normal range in their mid-20s is likely to experience disability much earlier than someone who starts with above average lung function, despite a similar rate of lung function decline. This second factor, having been largely ignored for many years, has been reaffirmed in more recent studies and is now highlighted in international guidelines [2, 3]. Attention has therefore turned to how we might maximise lung growth in childhood and adolescence.
Extract In their landmark study of the natural history of chronic airflow obstruction among London working men, F letcher and P eto [1] identified two factors leading to impaired lung function in later life. The first and most important was cigarette smoking causing an accelerated age-related decline in forced expiratory volume in 1 s (FEV 1 ). However, they also demonstrated that starting with a low lung function in early adulthood enhanced the risk. Thus, someone who already has lung function at the lower end of the normal range in their mid-20s is likely to experience disability much earlier than someone who starts with above average lung function, despite a similar rate of lung function decline. This second factor, having been largely ignored for many years, has been reaffirmed in more recent studies and is now highlighted in international guidelines [2, 3]. Attention has therefore turned to how we might maximise lung growth in childhood and adolescence.