Journal Information
Vol. 42. Issue 7.
Pages 317-325 (July 2006)
Download PDF
More article options
Vol. 42. Issue 7.
Pages 317-325 (July 2006)
Original Articles
Full text access
Spirometric Reference Values in 5 Large Latin American Cities for Subjects Aged 40 Years or Over
Rogelio Pérez-Padillaa,**
Corresponding author

Correspondence: Dr. R. Pérez-Padilla. Instituto Nacional de Enfermedades Respiratorias. Tlalpan, 4.502. 14080 México DF. México
, Gonzalo Valdiviab, Adriana Muiñoc, María Victorina Lópezc, María Nelly Márquezc, María Montes de Ocad, Carlos Tálamod, Carmen Lisboab, Julio Pertuzéb, José Roberto B. Jardime, Ana María B. Menezesf, on behalf of the PLATINO work group *
a Instituto Nacional de Enfermedades Respiratorias, Mexico DF, Mexico
b Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
c Universidad de la República, Montevideo, Uruguay
d Universidad Central de Venezuela, Caracas, Venezuela
e Universidade Federal de São Paulo, São Paulo, Brazil
f Universidade Federal de Pelotas, Pelotas, Brazil
This item has received
Article information
Download PDF

In clinical practice, spirometry is an extremely useful test that requires strict quality control, an appropriate strategy for interpretation, and reliable reference values. The aim of this study was to report spirometric reference values for 5 cities in Latin America.

Patients and methods

From data for 5315 subjects who had undergone spirometry in the PLATINO study in Caracas, Mexico City, Santiago, São Paulo, and Montevideo, we selected information for 906 (17%) individuals aged between 40 years and 90 years to provide reference values. The chosen subjects had never smoked, were asymptomatic, had not been diagnosed with lung disease, and were not obese. Multiple regression models were constructed with the following spirometric parameters: forced expiratory volume in 1 second (FEV1) and in 6 seconds (FEV6), peak expiratory flow, forced vital capacity (FVC), FEV1/FEV6, FEV1/FVC, and forced midexpiratory flow rate. Height, sex, and age were also included in the model.


Average values for the subjects studied were similar to those for the white North American population and the Mexican-American population of the third National Health and Nutrition Examination Survey, but exceeded those of the black population of the same survey by 20%.


The proposed reference values are an improvement on those currently available for Latin America because the participants were chosen by population sampling methods and standardized up-to-date methodology was used.

Key words:
Reference Values
Latin America

La espirometría es una prueba de gran utilidad clínica, que requiere un estricto control de calidad, una estrategia de interpretación y valores de referencia adecuados. El propósito del presente trabajo es comunicar los valores de referencia para la espirometría en 5 ciudades de Latinoamérica.

Pacientes y métodos

El estudio PLATINO se llevó a cabo en Caracas, México, Santiago, São Paulo y Montevideo e incluyó a un total de 5.315 sujetos con espirometría realizada. De ellos, se estudió a 906 (17%) que tenían entre 40 y 90 años de edad para crear valores de referencia, porque nunca habían fumado, estaban asintomáticos y no tenían enfermedad pulmonar diagnosticada ni obesidad. Se efectuaron modelos de regresión múltiple con los valores espirométricos — volumen espiratorio forzado en el primer segundo (FEV1) y en 6 s (FEV6), flujo espiratorio máximo, capacidad vital forzada (FVC), FEV1/FEV6, FEV1/FVC y flujo mesoespiratorio forzado—, la talla, el sexo y la edad.


Los sujetos estudiados presentaron en promedio valores similares a los de la población norteamericana blanca y americana de origen mexicano del estudio NHANES III, pero superiores a los de la población negra en un 20%.


Los valores de referencia propuestos representan una ventaja sobre los disponibles en la actualidad en Latinoamérica, ya que se eligió a los participantes por métodos de muestreo poblacional y el método empleado es estandarizado y actualizado.

Palabras clave:
Valores de referencia
Full text is only aviable in PDF
American Thoracic Society.
Standardization of spirometry, 1994 update.
Am J Respir Crit Care Med, 152 (1995), pp. 1107-1136
Quanjer PH, Tammeling GJ, Cotes JE, et al.
Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official statement of the European Respiratory Society.
Eur Respir J, 16 (1993), pp. 5-40
Ferguson GT, Enright PL, Buist AS, et al.
Office spirometry for lung health assessment in adults: a consensus statement from the National Lung Health Education Program.
Respir Care, 45 (2000), pp. 513-530
American Thoracic Society.
Lung function testing: selection of reference values and interpretative strategies.
Am Rev Respir Dis, 144 (1991), pp. 1202-1218
Celli BR.
The importance of spirometry in COPD and asthma: effect on approach to management.
Chest, 117 (2000), pp. 15S-19S
Crapo RO.
The role of reference values in interpreting lung function tests.
Eur Respir J, 24 (2004), pp. 341-342
Jauregui WO.
Propuesta para la estandarización de la espirometría en la ciudad de Buenos Aires.
Medicina (B Aires), 53 (1993), pp. 21-28
Gutiérrez M, Rioseco F, Rojas A, et al.
Determinación de valores espirométricos en una población chilena normal mayor de 5 años, a nivel del mar.
Rev Med Chil, 124 (1996), pp. 1295-1306
Martínez Guerra ML, Fernández Bonetti P, Balvanera Abreu A, et al.
Valores normales de algunas medidas de la función respiratoria en la ciudad de México.
Prensa Med Mex, 38 (1973), pp. 1-5
GaliAndez F, Sivori M, García O, et al.
Valores espirométricos normales para la ciudad de Buenos Aires.
Medicina (B Aires), 58 (1998), pp. 141-146
Cruz-Mérida AJ, Soto-de la Fuente AE, Méndez-Vargas MM, et al.
Prediction equations for spirometric parameters in Mexican adult population.
Arch Med Res, 35 (2004), pp. 446-449
Pérez-Padilla JR, Regalado-Pineda J, Vázquez-García JC.
Reproducibilidad de espirometrías en trabajadores mexicanos y valores de referencia internacionales.
Salud Publica Mex, 43 (2001), pp. 113-121
Oyarzun M.
Valores espirométricos normales en la población chilena.
Rev Med Chil, 124 (1996), pp. 1365-1367
Rodríguez MN, Rojas MJ, Guevara DP, et al.
Generación de valores de referencia para la evaluación de la espirometría. Estudio en una población colombiana.
Acta Médica Colombiana, 27 (2002), pp. 389-397
Pereira CAC, Barreto SP, Simöes JG, et al.
Valores de referência para a espirometria de uma amostra da população brasileira adulta.
J Pneumol, 18 (1992), pp. 10-22
Menezes AM, Victora CG, Pérez-Padilla R.
The Platino project: methodology of a multicenter prevalence survey of chronic obstructive pulmonary disease in major Latin American cities.
BMC Med Res Methodol, 4 (2004), pp. 15
Menezes A, Pérez-Padilla R, Jardim J, et al.
Chronic obstructive pulmonary disease in five Latin American cities: The PLATINO study.
Lancet, 366 (2005), pp. 1875-1881
Ferris BG.
Epidemiology Standardization Project (American Thoracic Society).
Am Rev Respir Dis, 118 (1978), pp. 1-120
The European Community Respiratory Health Survey II.
Eur Respir J, 20 (2002), pp. 1071-1079
Lung Health Study Questionnaire, BC Cancer Research Center, (2004),
Ware J, Kosinski M, Keller S.
How to score the SF12 Physical and Mental Health Summary Scales, 2nd ed., The Health Institute, New England Medical Center, (1995),
Lohman T, Roche A, Martorell R.
Anthropometric standardization reference manual, Human Kinetics Books, (1988),
Hankinson JL, Odencrantz JR, Fedan KB.
Spirometric reference values from a sample of the general U.S. population.
Am J Respir Crit Care Med, 159 (1999), pp. 179-187
Stata Statistical Software: release 8.0, Stata Corporation, College Station, (2003),
Knudson RJ, Lebowitz MD, Holberg CJ, et al.
Changes in the normal maximal expiratory flow-volume curve with growth and aging.
Am Rev Respir Dis, 127 (1983), pp. 725-734
Crapo RO, Morris AH, Gardner RM.
Reference spirometric values using techniques and equipment that meet ATS recommendations.
Am Rev Respir Dis, 123 (1981), pp. 659-664
Standardized lung function testing.
QuanjerPH. Bull Eur Physiopathol Respir, 19 (1983), pp. 45-51
Roca J, Burgos F, Sunyer J, et al.
References values for forced spirometry. Group of the European Community Respiratory Health Survey.
Eur Respir J, 11 (1998), pp. 1354-1362
Roca J, Sanchis J, Agustí-Vidal A, et al.
Spirometric reference values from a Mediterranean population.
Bull Eur Physiopathol Respir, 22 (1986), pp. 217-224
Enright PL, Adams AB, Boyle PJ, et al.
Spirometry and maximal respiratory pressure references from healthy Minnesota 65- to 85-year-old women and men.
Chest, 108 (1995), pp. 663-669
Miller MR, Hankinson J, Brusasco V, et al.
Standardisation of spirometry.
Eur Respir J, 26 (2005), pp. 319-338
Pérez-Padilla R.
Population distribution residing at different altitudes: implications for hypoxemia.
Arch Med Res, 33 (2002), pp. 162-166
Thomas PS, Harding RM, Milledge JS.
Peak expiratory flow at altitude.
Thorax, 45 (1990), pp. 620-622
Welsh CH, Wagner PD, Reeves JT, et al.
Operation Everest. II: spirometric and radiographic changes in acclimatized humans at simulated high altitudes.
Am Rev Respir Dis, 147 (1993), pp. 1239-1244
White NW, Hanley JH, Lalloo UG, et al.
Review and analysis of variation between spirometric values reported in 29 studies of healthy African adults.
Am J Respir Crit Care Med, 150 (1994), pp. 348-355
Wood S, Norboo T, Lilly M, et al.
Cardiopulmonary function in high altitude residents of Ladakh.
High Alt Med Biol, 4 (2003), pp. 445-454
Havryk AP, Gilbert M, Burgess KR.
Spirometry values in Himalayan high altitude residents (Sherpas).
Respir Physiol Neurobiol, 132 (2002), pp. 223-232

In addition to the listed authors, the group comprises Dr Dolores Moreno (Universidad Central de Venezuela), and Dr César Gomes Victora and Pedro Curi Hallal (Universidad Federal de Pelotas, Brazil).

Study performed with financial support from Boerhinger-Ingelheim and in collaboration with the Latin American Thoracic Association (ALAT) and the Burden of Lung Disease initiative.

Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options

Are you a health professional able to prescribe or dispense drugs?