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Reduced pulmonary function and indicators of airway obstruction have been shown to be strong predictors of mortality in numerous epidemiologic studies (1—3). Interestingly, even mild reductions in pulmonary function in nonsmokers have been linked to increased mortality (4). Although smoking is the major risk factor for chronic obstructive pulmonary disease (COPD), several issues remain to be resolved (5). For example, why do only 10-20 percent of smokers develop COPD (6)? The balance between the negative effects resulting from exposure to oxidants, for example, from cigarette smoke and air pollutants, and the defense by antioxidants has been suggested to play a role in both the pathogenesis of airway obstruction and the link between reduced pulmonary function and mortality (7-12). In particular, the role of antioxidant vitamins in protection against lung disease has attracted considerable clinical and epidemiologic interest because diseases associated with airway obstruction, such as COPD and asthma, present immense public health problems (13-15). This subject, however, has not been reviewed systematically. The present article is a qualitative systematic review of the epidemiologic and other evidence that deals with the association of antioxidant vitamins with pulmonary function and airway obstruction (16-18).

Epidemiologic Evidence Linking Antioxidant Vitamins to Pulmonary Function and Airway Obstruction