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Thorax 54:1119-1138 doi:10.1136/thx.54.12.1119
  • Occasional review

Gender differences in airway behaviour over the human life span

  1. Margaret R Becklakea,
  2. Francine Kauffmannb
  1. aRespiratory Epidemiology Unit, Departments of Epidemiology, Biostatistics and Occupational Health and of Medicine, McGill University, Montréal, Québec, Canada H3A 1A3, bINSERM U472 Epidémiologie et Biostatistique, Villejuif, France
  1. Dr M R Becklake
  • Received 27 April 1999
  • Accepted 28 July 1999

Gender differences in airway behaviour and in the clinical manifestations of airway disease occur throughout the human life span and are related to biological as well as sociocultural factors.1-11 Though they have not escaped recognition, they have received less attention than gender differences in the rates of, for instance, cardiovascular disease, both in terms of research and their implications for clinical practice.4 5 10-12Physiologists have in general paid more attention than clinicians to gender differences in airway behaviour, even though gender differences are an important determinant of the clinical manifestations of airway disease. Similarly, in population based (epidemiological) studies of airway disease, gender is invariably considered a standardising variable rather than a determinant worthy of investigation in its own right.4 However, there have been some notable historical exceptions.

Historical perspective

In 1846 John Hutchison,1 a London surgeon, presented a report to the Royal Medical and Chirurgical Society entitledOn the capacity of the lungs and the respiratory functions with a view of establishing a precise and easy method of detecting disease by the spirometer. He had developed the spirometer specifically for this research and his study is one of the first, if not the first, population based (epidemiological) study in respiratory health. One of the outcome measurements he used in his research was the “vital capacity” (VC), a term he coined to describe “the greatest voluntary expiration following the deepest inspiration”. His study population comprised over 2000 men drawn from various professions and occupations (including soldiers, sailors, guardsmen, policemen, gentlemen, giants, and dwarfs) and 26 young girls, and he identified height, weight, and age as the important determinants of VC. His epitome (as he called his summary) does not include a comment on whether there were gender differences, probably wisely given the limited number of women …