RT Journal Article SR Electronic T1 Environmental correlates of impaired lung function in non-smokers with severe α1-antitrypsin deficiency (PiZZ) JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 939 OP 943 DO 10.1136/thx.53.11.939 VO 53 IS 11 A1 Piitulainen, Eeva A1 Tornling, Göran A1 Eriksson, Sten YR 1998 UL http://thorax.bmj.com/content/53/11/939.abstract AB BACKGROUND Active smoking is the most important risk factor for pulmonary emphysema in subjects with severe α1-antitrypsin (AAT) deficiency. The aim of this study was to analyse the effects of environmental risk factors other than active smoking on lung function and on respiratory symptoms in non-smoking PiZZ individuals.METHODS Lifetime exposure to passive smoking, domiciliary use of a kerosene (paraffin) heater or gas cooker, and all occupations since leaving school were reported by 205 non-smoking PiZZ individuals (95 men and 110 women) included in the Swedish AAT deficiency register. Lung function test results and histories of respiratory symptoms (chronic bronchitis, recurrent wheezing, and exertional dyspnoea) were elicited from the AAT register records.RESULTS After adjustment for age, agricultural employment and domiciliary kerosene heater usage, but not gas cooker usage or passive smoking, were both associated with significantly decreased lung function. Multiple linear regression analysis showed age, sex, kerosene heater usage, and agricultural employment to be independent determinants of lung function impairment. Age and passive smoking for 10 years or more, both at home and at the work place, were associated with the presence of chronic bronchitis. Age and agricultural employment for ⩾10 years were associated with recurrent wheezing and exertional dyspnoea.CONCLUSIONS Domiciliary kerosene heater usage and an agricultural occupation therefore appear to be environmental factors associated with decreased lung function in non-smoking PiZZ individuals, and passive smoking is associated with an increased frequency of chronic bronchitis, but not with impaired lung function.